Immigration, Refugees and Citizenship Canada (IRCC) announced a change to the Express Entry program, effective August 21st, 2025.
All applicants who receive an Invitation to Apply (ITA) for permanent residence, along with their family members, will be required to complete an Immigration Medical Exam (IME) before submitting their application.
According to Immigration News Canada (INC), this update replaces the previous process, where applicants completed the medical exam after receiving instructions from IRCC. The new policy will in time, reduce delays and allow faster processing by assessing medical admissibility earlier in the process.
Mandatory Upfront Medical Exams for All Express Entry Applicants
Reports cite that from August 21st, 2025, any applicant submitting a permanent residence application through Express Entry must upload proof of a completed IME in the Express Entry Profile Builder.
This requirement applies to the principal applicant and all family members, including those not accompanying the applicant to Canada.
Applicants currently in Canada who have completed an IME within the past five years—for example, for a work or study permit—may reuse the results. Also, these applicants can include their IME number or unique medical identifier in their application.
IRCC will assess whether the results are still valid. If they are not acceptable, applicants will receive instructions to undergo a new medical exam.
It is expressed that this exception does not apply to applicants who have never completed an IME before. New applicants must schedule and complete the exam with an IRCC-approved panel physician after receiving an ITA but before submitting their application.
What the Medical Exam Involves
The IME must be conducted by a panel physician approved by IRCC. It is not a regular medical check-up and includes several components depending on the applicant’s age and medical history.
These may include:
Physical examination: A general health check.
Blood and urine tests: To detect infectious diseases or other health issues.
Chest X-ray: Usually required for adults to check for tuberculosis.
Medical history review: Disclosure of past and current health conditions.
Vaccination record: Optional but may be recorded with consent.
It is mentioned that IME results are valid for 12 months. If an application is not finalised during that time, a new IME may be required.
Applicability and Exemptions Across Immigration Streams
INC informs that this change is specific to the Express Entry system. Other immigration pathways, such as the Provincial Nominee Program (PNP) outside of Express Entry, family sponsorships, and refugee programs, are not affected unless specified by IRCC.
IRCC clarified that all family members must complete an IME, including non-accompanying dependents. The authority also advised that applicants should plan to schedule the IME immediately after receiving an ITA to avoid delays in submission.
Applicants unsure whether their prior IME results are still valid can consult IRCC’s website or contact an IRCC-approved panel physician.
Guidance for Applicants
This policy introduces a new mandatory step in the Express Entry process. While it adds to the initial preparation for applicants, IRCC says it will help streamline application decisions and reduce backlogs.
Applicants planning to apply through Express Entry are encouraged to:
Check if they have a valid IME on record.
Schedule the IME immediately after receiving an ITA.
Ensure all family members undergo the exam, regardless of accompanying status.
Upload proof of the IME when applying.
This change applies to all ITAs issued on or after August 21st, 2025. Hence, applications submitted before that date will follow the current process, where medical exams are completed after instructions from IRCC.
