Good news for candidates planning to enter Express Entry for permanent residence: as of August 21, 2025, Immigration, Refugees and Citizenship Canada will begin requesting that all applicants undergo a medical exam upfront before submitting their application.

This represents a significant change from the current system, which requires candidates to submit their entire Express Entry application once and then obtain medical instructions from IRCC.

According to IRCC, applicants submitting applications before August 21, 2025, will be considered under the old system. Other permanent residence streams outside of Express Entry shall therefore not be impacted.

Why This Change Matters

For many hopeful immigrants, this adjustment means:

  1. You will need to prepare earlier by scheduling your medical exam before your application.
  2. Processing times could speed up, as IRCC will have health results immediately.
  3. Applicants must plan financially to cover the cost up front.

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Understanding Medical Admissibility

During permanent residence application processing via the Express Entry, both the principal applicants and accompanying family members, as well as non-accompanying members, have to be medically cleared for Canada.

An individual can be found medically inadmissible if:

  1. Their condition may cause excessive demand on Canada's health-care system, defined as demand that causes costs in excess of three times the national average per capita health costs (currently $27,162 per year).
  2. Their health condition is a health risk (e.g., infectious disease).

Tip: Try to prove that chronic illnesses (such as diabetes) are under control to avoid refusal.

What is an Immigration Medical Exam (IME)?

An IME is a health check performed by a panel physician approved by IRCC.

It can include:

  1. Review of past medical history (surgeries, illnesses, treatments)
  2. Physical examination (heart, lungs, eyes, etc.)
  3. Chest X-rays (to detect tuberculosis)
  4. Blood and urine tests
  5. Mental health evaluation
  6. Immunization history check

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Steps to Complete Your Upfront Medical Exam

  1. Find an IRCC-approved panel physician in your country or territory.
  2. Book an appointment directly with the physician.

Prepare the required documents:

  1. Passport or national ID
  2. Four recent photographs
  3. Vaccination records
  4. Medical reports for chronic conditions
  5. List of current medications

Pay for the exam and related costs (doctor fees, lab tests, X-rays, specialist visits).

Cost of a Medical Exam for Express Entry

Item Cost Range (CAD)
Doctor or radiologist's fee $140 – $280
Special tests or treatments Varies
Specialist visits Varies

Who May Not Need a New Medical Exam

Some applicants inside Canada may be exempt if:

  1. They completed an IME in the last five years for a work permit, study permit, or other immigration process.
  2. Their previous results showed low or no public health risk.

In these cases, applicants can provide their IME number or unique medical identifier. However, if IRCC decides that previous results cannot be reused, they will request a new exam.

Impact on Express Entry Applicants

This new medical exam requirement will particularly impact:

  1. Skilled workers preparing for Express Entry in 2025.
  2. Applicants with families, as all members require an upfront medical exam.
  3. Those from countries where panel physician appointments may have long waiting times.

By completing the medical exam upfront, applicants may see faster processing once their profile is submitted.

Key Takeaways

  1. New rule effective August 21, 2025.
  2. Upfront medical exams are now mandatory for Express Entry permanent residence applicants.
  3. Prepare documents and a budget in advance.
  4. IMEs must be done through IRCC-approved panel physicians only.

How Visa Solutions 4u Can Help

Navigating the Express Entry medical exam requirement can be challenging, but Visa Solutions 4u offers expert assistance to make the process smooth:

  1. Profile review to check if you meet Express Entry eligibility.
  2. Guidance on medical exam preparation, including connecting you with IRCC-approved physicians.
  3. Complete application management to avoid delays or rejections.
  4. Fast-tracking support to help you meet deadlines before and after August 21, 2025.

With professional help, you can meet the new medical exam requirement confidently and increase your chances of a quick and successful Express Entry approval.