Last Updated Dec 12, 2025

BREAKING: New Medical Exam Requirements for Permanent Residence applications under Express Entry — What You Must Know

BREAKING: New Medical Exam Requirements for Permanent Residence applications under Express Entry— What You Must Know

By Vineet Tiwari

Breaking News

Immigration, Refugees and Citizenship Canada (IRCC) has introduced a key change: upfront immigration medical exams (IMEs) will be required for permanent residence applications submitted through Express Entry starting August 21, 2025. This article explains the change, what “medical admissibility” means, how to book and prepare for an IME, and exactly what you should do next to avoid delays.


Who this change affects

  • Applies to: Principal applicants applying for permanent residence through Express Entry on or after August 21, 2025.
  • Does NOT apply to: Applications submitted before August 21, 2025 and non-Express Entry permanent residence streams (those remain unchanged for now).
  • Family members: The principal applicant and all family members listed on the PR application must be medically admissible — even if a family member will not come to Canada.

What is “medical admissibility”?

Medical admissibility determines whether an applicant’s health condition could pose a risk to public health or create an excessive demand on Canada’s publicly funded health and social services.

Typical reasons an applicant may be found medically inadmissible include:

  • Conditions likely to cause excessive demand on public health services (IRCC uses a cost threshold to define “excessive demand”); and
  • Conditions that pose a public-health risk (for example, certain untreated infectious diseases).

Showing that chronic conditions (e.g., diabetes, asthma) are stable and managed reduces the risk of inadmissibility.


What is an Immigration Medical Exam (IME)?

An IME is a health assessment performed only by IRCC-approved panel physicians. The exam usually includes:

  • Medical history review (surgeries, chronic illnesses, treatments)
  • Full physical examination (heart, lungs, eyes, etc.)
  • Chest X-ray (e.g., TB screening)
  • Blood and urine tests
  • Mental health assessment where relevant
  • Vaccine / immunization record check

Costs: Expect to pay roughly $140–$280 CAD per person for the basic IME. Additional fees may apply for specialist tests, radiology, or follow-up investigations — all of which you pay at the time of the exam.


How to schedule an IME

  1. Visit the IRCC list of panel physicians and select your country/territory.
  2. Contact a listed panel physician office directly to book an appointment.
  3. Bring to the appointment: passport/ID, list of current medications, medical records (test results, specialist reports), and vaccination records. Also bring four recent photos if requested.

Timing: Under the new rule, applicants should obtain the IME before submitting their Express Entry PR application (or immediately when IRCC requires it under the updated process). Plan ahead — panel physician availability varies by country and season.


Practical checklist before your IME

  • ✅ Check whether your country’s panel physician offices have appointment availability.
  • ✅ Gather recent medical reports, prescriptions, and immunization records.
  • ✅ Prepare a clear list of medications (names, dosages).
  • ✅ Ensure your passport is valid for the duration of the process.
  • ✅ Arrange funds to cover IME fees and possible additional tests.
  • ✅ If you have a chronic condition, bring evidence showing it is controlled (consultation notes, lab results, treatment plans).

Why IRCC is requiring upfront IMEs

IRCC’s objective with upfront medical exams is to ensure medical admissibility is assessed early in the PR process. For applicants, this means medical issues are identified sooner — which can reduce the risk of later refusal or prolonged processing due to missing medical information.


Common questions

  • Will IME fees be refunded if PR is refused? No — IME fees and associated medical costs are typically not refundable.
  • Can family members be examined later? Under the new Express Entry rule, all family members listed on the application must complete IMEs as required. Don’t delay.
  • Who pays for IMEs? The applicant pays their own IME and any related medical fees. Employers do not cover these costs unless otherwise agreed.

How Liberty Immigration can help

Liberty Immigration will support you through every step to comply with the new medical exam requirements for permanent residence:

  • Verify whether your application must include an upfront IME.
  • Direct you to IRCC-approved panel physicians in your country or region.
  • Prepare a medical document checklist and help you gather records.
  • Review health documentation to reduce the risk of an adverse medical assessment.
  • Coordinate timelines so your IME timing aligns with your PR submission strategy.

Next steps (recommended)

  1. Don’t wait — if you plan to submit an Express Entry PR application after Aug 21, 2025, start arranging your IME now.
  2. Gather medical records and vaccination history.
  3. Book an appointment with a listed panel physician.
  4. Contact Liberty Immigration for a pre-submission check to make sure your medical documentation and PR application are aligned.

Need help booking your IME or reviewing medical documentation?
Book a consultation with Liberty Immigration and let our team guide you step-by-step to meet the new medical exam requirements for permanent residence.

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Written By

Vineet Tiwari

Vineet is a caring and creative leader who has lived in India, Oman, UAE, and Canada, giving him a rich multicultural perspective. His commitment to physical fitness keeps him energetic and focused. Vineet's dedication to his clients is evident as he often takes calls on weekends, ensuring they always feel supported and valued. His diverse background and unwavering availability help build strong, trusting relationships with our clients.