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Canada tightens express entry rules, requires medical exam for PR applicants starting August 21 

Canada’s immigration authority, Immigration, Refugees, and Citizenship Canada (IRCC), has announced that, starting August 21, 2025, all applicants for permanent residence (PR) through the Express Entry system will be required to complete an immigration medical exam before submitting their applications.

The rule, announced by Immigration, Refugees, and Citizenship Canada (IRCC), aims to streamline the PR application process and reduce delays caused by medical clearance issues.

Previously, applicants could submit their PR applications before completing the medical exam.

The new requirement ensures that medical results are available from the start, potentially speeding up processing, although it adds an extra step and cost for applicants.

Under the revised rules, every individual listed on a PR application including family members not moving immediately must complete an immigration medical exam.

IRCC also determines whether applicants require a standard or streamlined exam, and only IRCC-approved panel physicians are authorized to conduct the test. Regular family doctors are not allowed.

For other PR categories, applicants will receive instructions after submission and must complete the medical exam within 30 days. Refugee claimants at ports of entry are also given 30 days to comply.

Applicants already in Canada may use a recent exam taken within the last five years by providing their previous medical identifier number.

The temporary policy is set to run until October 5, 2029.

What the immigration medical exam involves 

Applicants should expect, review of medical history and ongoing conditions

Most exams cost CAD 140–280 per person, covering doctor fees, lab tests, X-rays, and specialist referrals if needed. IRCC does not reimburse these costs.

To book an exam, applicants should visit the IRCC Panel Physician list, select their country and city, and schedule the Immigration Medical Exam (IME). Exams must be completed before submitting the PR application.

Applicants with medical conditions expected to cost more than three times Canada’s per capita health spending (currently CAD 27,162) may be denied, though well-managed chronic conditions, such as controlled diabetes, may still be accepted.

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