Express Entry
Canada Express Entry Upfront Medical Exam – New 2025 Rule Every Applicant Must Know
Canada just changed the order of steps for thousands of hopefuls. Starting August 21, 2025, most people applying for permanent residence through Express Entry must complete Canada Express Entry upfront medical exam before submitting their PR application. The goal: faster files, fewer last-minute delays, and earlier clarity on medical admissibility.
Why IRCC Moved Medicals to the Front
IRCC’s update makes applicants do the health check first so officers receive medical results with the application. That helps speed up decisions and reduce back-and-forth requests. The official page now states plainly: “As of August 21, 2025: If you’re applying under Express Entry, you must do a medical exam first.”
Who Must Do Canada Express Entry Upfront Exam (and Who Doesn’t)
If you receive an Invitation to Apply (ITA) on or after August 21, 2025, you—and all listed family members, even if not accompanying—must include proof of your completed exam in your PR submission. Several reputable immigration sources and law firms have echoed the same requirement since IRCC’s update went live.
There are still important carve-outs. IRCC has extended its in-Canada public policy so some applicants inside Canada can re-use an IME completed within the last five years—as long as it was low-risk and you include the prior IME/UMI number. If IRCC can’t reuse it, they’ll tell you to do a new exam.
Quick View: What Changed
| Timing | Before Aug 21, 2025 | From Aug 21, 2025 |
| Express Entry PR | Submit application, then wait for medical instructions | Do medical first and upload proof with your PR application |
| Other PR streams | Generally wait for IRCC instructions | No change (unless IRCC says otherwise) |
Step-by-Step: How to Get the Medical Done Right
- Find a panel physician near you (only doctors on IRCC’s list can perform IMEs).
- Book and attend the exam. Bring ID, medical history, and photos if requested.
- Keep the proof (information printout and/or IME/UMI number).
- Upload proof of your upfront exam with your PR application (Express Entry only).
Typical Costs and What to Expect
Panel clinics set their own fees (amounts vary by country). You pay for the exam, any tests, and any specialist referrals. Results are sent directly to IRCC; you keep the confirmation sheet for your records.
Common Scenarios in 2025
- You have an ITA dated Aug 21 or later Do the Express Entry upfront medical exam first, then submit your PR file with proof.
- You completed an IME in the last five years (inside Canada, low risk) Add your prior IME/UMI number; IRCC may reuse it.
- You applied under a non-Express Entry PR stream Most still wait for instructions after applying unless IRCC tells you otherwise.
Why This Helps Applicants
Doing medicals up front can prevent avoidable refusals due to missed deadlines, reduce post-submission requests, and give a clearer timeline for you and your family. Leading immigration publishers have also flagged the same practical advantages since the announcement.
FAQs we hear from clients
Q1. Do children need exams?
Yes—listed family members must have an IME, even if they aren’t accompanying you.
Q2. Can I choose any doctor?
No. Only IRCC-approved panel physicians.
Q3. How long are results valid?
Typically 12 months. If you don’t land in time, you may need a new exam.
Q4. Pro tips to avoid delays
- Book early—panel clinics in large cities fill quickly after big draws.
- Bring all prior IME numbers to maximize reuse where eligible.
- If you’re in a regulated health situation (e.g., ongoing treatment), bring recent reports to the appointment.
If Canada Express Entry is your pathway, plan for the Express Entry upfront medical exam right after your ITA. It’s now a standard part of a complete application and one more way IRCC is pushing for faster, cleaner decisions
