Canada has introduced an important change to the Express Entry system. From August 21, 2025, all applicants seeking Permanent Residence (PR) must complete an Immigration Medical Exam (IME) before submitting their application. This adjustment shifts the timeline for medical exams, placing more responsibility on applicants to prepare ahead of time. Here’s a breakdown of what’s new, who must comply, and how to ensure you meet this requirement without delays.

What Has Changed?

In the past, medical exams were completed after submitting a PR application, once IRCC sent specific instructions. Now, applicants must arrange and finalize the IME as part of their application package. This means that once you receive an Invitation to Apply (ITA), you should book your exam right away and upload proof—such as an Information Printout or IMM 1017B form—before submitting your PR file.

Who Doesn’t Need to Do It?

Not everyone is required to repeat the medical exam. Exemptions apply if:

  • You are currently living in Canada,
  • You completed a medical exam within the past five years, and
  • Your results showed you were either low-risk or no risk to public health and safety.

If you meet these conditions, you may use your previous IME by submitting the related documentation with your application.

What’s Included in the Medical Exam?

The exam must be performed by a doctor who is approved by IRCC (known as a panel physician). The typical assessment includes:

  • A review of your medical history and a physical check-up,
  • A chest X-ray, usually for tuberculosis screening,
  • Blood and urine tests,
  • Review of your immunization records, and
  • An overall health assessment.

Once completed, the panel physician submits your results electronically to IRCC using the eMedical system.

Costs and Duration of Validity

The cost of an IME varies but generally ranges from 140 CAD to 280 CAD per applicant, depending on where you take the test and what additional tests are required. The results remain valid for 12 months. If your PR application is not finalized within that time, you’ll need to complete another exam.

Practical Details to Keep in Mind

Because only IRCC-approved panel physicians can perform the exam, appointments may be limited—especially in smaller cities. It’s best to schedule as early as possible after receiving your ITA. When attending your appointment, bring the following:

  • Government-issued ID (such as your passport),
  • Any previous medical records,
  • Proof of vaccinations,
  • A list of medications you are currently taking, and
  • Passport-style photographs if the clinic does not use eMedical.

Why the Rule Changed

By requiring medical exams upfront, IRCC aims to make PR processing more efficient. This approach allows officers to review health-related admissibility earlier in the process, reducing bottlenecks and last-minute delays. While this change adds costs and planning responsibilities for applicants, it should also shorten the overall time it takes to finalize PR decisions.

How Applicants Can Prepare

  1. Book early: Secure an appointment with a panel physician as soon as possible after your ITA.
  2. Check if you’re exempt: If you recently completed an IME in Canada, confirm whether you can reuse it.
  3. Include all dependents: Remember that spouses, partners, and dependent children must also complete the exam.
  4. Upload proof: Make sure your results or proof of exemption are added to your PR application before submission.

The upfront medical exam requirement represents a major change for Express Entry applicants. Now, all candidates must show proof of medical clearance before submitting their PR application, unless exempt under specific conditions. With good planning—booking early, gathering documents, and confirming exemptions—you can meet this new requirement confidently and keep your PR journey on track.

FAQs

Do I Need to Finish a Medical Exam Before Sending my Express Entry PR Application?

Yes. If your PR application is submitted on or after August 21, 2025, you must include proof of an upfront medical exam unless you qualify for an exemption.

How Long Will My Exam Results Remain Valid?

Your IME results are valid for 12 months. If IRCC hasn’t decided on your PR application within that time, you’ll need a new exam.

Can I Reuse an Old Medical Exam?

Yes, but only if you’re in Canada, had an IME in the past five years, and it showed no public health risks. You must also provide documentation to confirm this.