If you are applying for permanent residence in Canada through Express Entry, you will now need to complete an upfront immigration medical exam (IME) as part of your application. This is a mandatory step, unless you meet certain exemptions. Many applicants have questions about this process, so we have put together simple answers to the most common ones.
Who needs a medical exam and who is exempt?
Most applicants must complete a medical exam before submitting their PR application. However, you may be exempt if all of the following apply to you:
- You are already living in Canada,
- You did a medical exam within the last five years, and
- Your last exam showed you were at low or no risk to public health and safety.
If you do not meet all three conditions, you will need to do a new IME.
What if I have a medical condition?
Having a medical condition does not automatically mean your application will be refused. Immigration officers look at two things:
- If your condition is a risk to public health or safety, or
- If the cost of your treatment will be too high for Canada’s healthcare system.
Canada sets a cost limit each year, called the Excessive Demand Cost Threshold.
Excessive Demand Cost Threshold (2025)
| Period | Cost Limit |
|---|---|
| 5 years | $135,810 |
| 1 year | $27,162 |
If the estimated cost of your treatment is above this threshold, you may be refused. But many conditions are not an issue, and sometimes applicants are simply asked to go for medical surveillance (for example, follow-up for tuberculosis).
Who can do the medical exam?
Your family doctor cannot do the exam. Only doctors approved by Immigration, Refugees and Citizenship Canada (IRCC), called panel physicians, are allowed. You must choose a doctor from the official IRCC list of panel physicians.
How much does the exam cost?
Costs vary by country and clinic, but in Canada the typical range is:
- Children (0–14 years): $140–150 CAD
- Adults (15–74 years): $170–180 CAD
You will also pay for any lab tests, X-rays, or specialist visits if required. Vaccines may cost extra, unless you are a refugee or asylum seeker, in which case some costs may be covered.
What documents should I bring?
Make sure you take:
- A valid passport or government-issued ID,
- The medical form (IMM 1017E or IMM 1020E) if IRCC gave you one,
- Four passport-style photos if the clinic doesn’t use the eMedical system,
- Glasses or contact lenses (if you use them),
- Medical history, reports, and prescriptions for ongoing conditions,
- Vaccination records (recommended but not required).
What happens during the medical exam?
The exam is straightforward. It usually includes:
- A review of your medical history,
- A physical check (height, weight, vision, hearing, heart, lungs, abdomen, skin, and movement),
- Routine tests such as chest X-rays, blood, or urine tests depending on age,
- Specialist tests if needed.
Genital and rectal exams are not required. Breast exams are only done if medically necessary, with an explanation first.
Doctors may also ask about vaccinations. Proof of vaccines, including COVID-19, can be recorded but is not mandatory.
You always have the right to ask questions, request a chaperone, or pause the exam if you feel uncomfortable.
How long does it take?
The exam itself usually takes 30 minutes to a few hours, depending on how busy the clinic is and whether you need extra tests. Doctors normally upload results to IRCC within 10 days.
Will I get a copy of my results?
Yes, you can request a copy from the clinic. The doctor sends your results directly to IRCC. IRCC will only contact you if there is an issue or if they need more information.
How do I add my medical exam to my PR application?
After the exam, the panel physician will give you a document—either an Information Printout Sheet or an IMM 1017B Upfront Medical Report. You must upload this document in the medical section of your PR application.
How long is the medical exam valid?
Your IME results are valid for 12 months from the exam date. If they expire before IRCC finalizes your PR application, you may need to do another one.
Additional questions applicants often ask
Can I choose any clinic or hospital?
No. Only IRCC-approved panel physicians can perform the exam. If you go to a regular clinic, the exam will not count.
What if I am pregnant?
Pregnant applicants may choose to delay the X-ray until after delivery. However, this could delay your PR application. Some women proceed with the exam using protective measures for X-rays. Discuss your options with the doctor.
Can children skip the exam?
No. All family members included in the application, regardless of age, must complete the exam.
Do I need to fast before the exam?
Usually not. However, if your clinic requires fasting for certain blood tests, they will let you know in advance.
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