Canada will require upfront medical exam requirements for permanent residence applications under Express Entry starting August 21, 2025. This change affects all new permanent residence applications through Express Entry. It demands that applicants complete medical exams before submitting their applications. The government made this announcement on the official Immigration, Refugees and Citizenship Canada (IRCC) website.
Applications submitted before August 21, 2025, will follow the old process. That process allowed applicants to submit their full PR application, then wait for exam instructions from IRCC. Now, applicants must include test results up front. This development applies only to Express Entry permanent residence applications. Other permanent residence streams remain unchanged.
Why Canada Changes the Medical Exam Timing
Medical admissibility plays a critical role in permanent residence applications. The principal applicant and all listed family members must pass an immigration medical exam, even if those family members are not moving to Canada.
Immigration, Refugees and Citizenship Canada (IRCC) reviews medical results to determine whether an applicant could create an undue demand on public health services or pose a risk to public safety. Canada defines “excessive demand” as projected annual healthcare costs exceeding three times the national average—currently set at CA$27,162.
Demonstrating that chronic conditions like diabetes are well-managed can help applicants avoid inadmissibility. IRCC also considers infectious diseases, such as active tuberculosis, as potential public health threats that can lead to medical refusal.
What the New Upfront Medical Exam Means for Applicants
If you file an Express Entry PR application, you must schedule your IRCC medical exam before submitting your profile. You cannot upload missing results later. That shift demands precise and early planning. Ensure your medical exam requirements for permanent residence applications under Express Entry are complete and current.
Applicants whose full PR submissions arrive before August 21 won’t need upfront exams. But those who file August 21 or later must include medical clearances.
How to Book Your IRCC-Approved Medical Exam
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Go to IRCC’s online list of panel physicians.
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Select your country or territory.
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Contact a physician directly to book.
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Bring identification, four photos, vaccination records, medication lists, and medical reports.
Expect to pay between CA$140 and CA$280 per person. Expect additional costs for x-rays, lab tests, specialist evaluations, or treatments.
Exam contents usually include:
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Full-body physical exam
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Medical history review
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Chest x-ray (usually for tuberculosis)
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Blood and urine analysis
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Mental health screening
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Immunization record review
Stabilized chronic illnesses help reduce inadmissibility risk. IRCC can still reject exam results if they raise health or demand concerns.
If You Already Completed a Medical Exam in Canada
If you had an IRCC medical exam in Canada within the last five years, include the IME file or unique medical identifier. Submit it with your permanent residence application. IRCC may accept it if your health risk is considered low or none.
Step-By-Step Comparison: Old vs New Medical Exam Process
The change in medical exam timing for permanent residence applications under Express Entry significantly alters how applicants prepare their files. Below is a detailed breakdown of the process before and after August 21, 2025, and what each stage means in practice.
| Step | Pre-August 21, 2025 | Post-August 21, 2025 |
|---|---|---|
| When to take medical exam | Applicants completed their medical exam only after submitting the full PR application. IRCC would then send exam instructions. | Applicants must complete the medical exam before filing an Express Entry application. Results must be ready for upload at the time of submission. |
| Can you submit without exam? | Yes. Applicants could submit without medical results and wait for IRCC’s request. | No. Submitting without medical exam results will lead to an incomplete file, which is automatically rejected. |
| Cost and booking | Fees ranged from CA$140–CA$280 per person, plus any additional tests. Booking could be done at any stage after submission. | Fees remain the same, but applicants must budget earlier and secure an appointment well before the submission deadline. |
| Use of past exam (in Canada) | Previous medical exams taken within the last five years could sometimes be reused, depending on IRCC’s decision. | Still accepted if done within five years and if IRCC confirms no new health risks. Proof must be included in the application. |
| Risk of missing exam | Late or missed exams could cause delays in processing and final decision-making. | Missing the upfront exam will result in the Express Entry application being rejected without review. |
This shift means applicants must be more proactive, starting medical preparations as soon as they are ready to apply. Early booking is crucial since panel physician appointments can fill quickly, especially around the policy change date.
Practical Tips
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Mark the Deadline Clearly: The new rule begins on August 21, 2025. All new permanent residence applications via Express Entry filed from that date must include completed medical exam results. Submitting without them will result in rejection.
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Book Your IRCC Panel Physician Early: Contact an approved panel physician weeks in advance. As the deadline approaches, appointment slots may become limited due to increased demand from applicants rushing to meet the new requirement.
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Prepare Health Records in Advance: Gather your vaccination certificates, a full list of medications, and medical reports for any existing or past conditions. Having these ready ensures a smooth medical exam and reduces the risk of delays.
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Budget for the Full Cost: The exam typically costs between CA$140 and CA$280 per person, but you should also plan for extra expenses. These can include specialist referrals, additional lab tests, or imaging scans if the panel physician requires them.
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Leverage a Previous IRCC Exam: If you took an IRCC-approved medical exam in Canada within the last five years, submit your IME number or unique medical identifier with your application. IRCC may accept it if you are still considered low or no health risk.
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Ensure Document Accuracy and Completeness: Double-check all submitted medical reports, receipts, and identification details before sending your application. Even small mistakes or missing pages can cause processing delays or lead to a refusal.
Why Maple Crest Immigration Should Guide You
Maple Crest Immigration works deeply with Express Entry permanent residence applications. We handle timeline shifts, document prep, scheduling IRCC exams, and avoiding medical inadmissibility. Let us guide you through every step.
Take action now to ensure a smooth submission. Our consultants assess your eligibility, help gather medical documentation, confirm you meet medical exam requirements for permanent residence applications under Express Entry, and integrate your paperwork correctly. Reach out today for expert support.
