Canada to require medical exams for Express Entry Permanent Residence applicants starting August 21

Starting August 21, 2025, Canada’s immigration department will require applicants applying for permanent residence through the Express Entry system to complete medical exams before submitting their applications. This new rule was announced by Immigration, Refugees, and Citizenship Canada (IRCC).

Previously, applicants submitted their full permanent residence applications first and waited for IRCC’s instructions to complete any medical exams. However, from the new date onwards, the medical exam must be done upfront.

This change applies only to Express Entry permanent residence applications. Applications submitted before August 21, 2025, and other types of permanent residence applications are not affected.

Medical eligibility criteria

Applicants and their family members must be medically admissible to Canada to qualify for permanent residence. This includes family members even if they are not accompanying the principal applicant.

A common reason for medical inadmissibility is if an applicant’s health condition is expected to cause an excessive demand on Canada’s public health services. IRCC defines excessive demand as costs exceeding three times the national average healthcare cost per person, currently set at $27,162 per year.

Conditions such as chronic illnesses, like diabetes, are less likely to cause inadmissibility if they are stable and properly treated. Applicants can also be found inadmissible if they have certain infectious diseases posing a public health risk.

Immigration medical exam process

Medical exams must be conducted by IRCC-approved panel physicians. Applicants can find a list of these doctors on the IRCC website, select their country, and book an appointment directly.

The exam cost generally ranges from $140 to $280 per person. Applicants must also cover any additional fees for tests, treatments, or specialist visits.

The exam typically includes:

• Review of medical history (surgeries, chronic illnesses, treatments)
• Full physical examination (heart, lungs, eyes, etc.)
• Chest X-rays to check for diseases like tuberculosis
• Blood and urine tests
• Mental health assessments
• Verification of immunization records

Applicants should bring identification documents, four recent photos, medication lists, medical reports, and vaccination proof to their exam.

Using previous medical exams

Applicants already in Canada who had a medical exam for work or study permits within the last five years can provide their medical exam number when applying for permanent residence. If IRCC finds that previous exam results are not acceptable for permanent residence, the applicant will be asked to undergo a new medical exam.