Canada’s Immigration, Refugees and Citizenship Canada (IRCC) has announced a major change to the Express Entry permanent residence (PR) process. Starting August 21, 2025, all Express Entry candidates will need to complete an immigration medical examination before submitting their PR application.
According to IRCC, the move is intended to speed up application processing by eliminating delays caused by pending medical clearances. Until now, applicants could submit their PR forms and complete the exam later in the process.
Who Will Be Affected
The requirement applies to everyone included in a PR application—this includes family members listed on the form even if they are not moving to Canada immediately. Only physicians on IRCC’s approved panel list are allowed to carry out the medical exam; regular family doctors are not eligible.
For PR streams outside Express Entry, applicants will still receive instructions after submission and must complete the exam within 30 days. Refugee claimants at ports of entry will also be given 30 days to comply.
If an applicant has already taken an immigration medical exam in Canada within the last five years, they may be able to reuse the results by providing their previous medical identifier number. This policy will remain in effect until October 5, 2029.
What the Exam Involves
The immigration medical exam typically includes:
What to bring:
Costs and Booking
The price for the exam usually ranges between CAD 140 and CAD 280 per person, covering the doctor’s fee, lab work, X-rays, and specialist referrals if needed. These costs are paid by the applicant and are non-refundable by IRCC.
Booking is done through the IRCC Panel Physician list, where applicants can search by country and city to arrange their Immigration Medical Exam (IME) before sending in their PR application.
Medical Admissibility
Applicants whose medical conditions are expected to cost the Canadian health system more than three times the national per-capita healthcare spending (currently CAD 27,162) may be refused entry. However, controlled chronic conditions—such as well-managed diabetes—are generally not a barrier.
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