Starting August 21, 2025, anyone applying for permanent residence through Express Entry will need to complete their immigration medical exam (IME) upfront—before submitting their application.

Until now, applicants submitted their PR applications first and then waited for IRCC (Immigration, Refugees and Citizenship Canada) to request a medical exam. From August 21, upfront medical exams will be mandatory for all Express Entry PR applications, both the principal applicant and all family members, whether they plan to move to Canada or not. Applications submitted before Aug 21, 2025, and non-Express Entry PR streams are not affected.

Canada requires all PR applicants to be medically admissible, this means that applicants and their family members must not: Pose a danger to public health (e.g., certain infectious diseases), place an excessive demand on Canada’s healthcare system (more than $27,162 per year in medical costs), applicants with chronic conditions such as diabetes can often still qualify if their condition is stable, controlled, and well-documented.

The immigration medical exams (IMEs) must be completed with an IRCC-approved panel physician. The costs usually range from $140 to $280 per person, plus any extra fees for tests, specialists, or treatments.

The exams may include:

• Review of medical history (past surgeries, illnesses, treatments)
• Full physical check-up (eyes, heart, lungs, etc.)
• X-rays (e.g., chest X-rays for Tuberculosis)
• Blood and urine tests
• Mental health assessments
• Immunization (vaccine) record check

Things required to bring to your IME are: a passport or a national ID, four recent photos, a list of current medications, medical reports for existing conditions, and proof of past vaccinations.

Preparing your medical documents in advance and showing that your condition is being managed can make the process smoother.