As of 21 August 2025, Express Entry applicants will now require an upfront immigration medical exam (IME) as part of a complete application for Canadian permanent residence (PR)—unless they meet certain exemptions.
This article will cover 10 of the most frequently asked questions around IMEs for new Express Entry candidates and applicants.
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What conditions do I have to meet to be exempt from doing an IME?
You may be exempt from doing an IME for your PR application if you meet all the following conditions:
You already live in Canada;
You previously completed an IME in the last five years; and
Your previous IME indicated you were a low risk or no risk to public health and public safety.
What happens if I have a medical condition—can I still be approved?
Approval depends on whether your condition poses a risk to public health/safety or is likely to cause excessive demand on Canada’s healthcare or social services.
IRCC considers a condition to create excessive demand if:
The health or social services required to treat the condition would negatively impact wait times for services in Canada, or
The cost of treatment and management is expected to exceed the excessive demand cost threshold.
Excessive Demand Cost Threshold (2025)
For 2025, IRCC has set the threshold at $135,810 over 5 years (equivalent to $27,162 per year). This figure is used by IRCC to determine whether the anticipated cost of an applicant’s condition would place an excessive demand on Canada’s health and social services.
Some applicants may be subject to medical surveillance after landing (for example, follow-up for tuberculosis). Many medical conditions do not automatically result in refusal.
To learn more about being found medically inadmissible to Canada, visit our dedicated webpage.
Who is allowed to perform the exam? Can my family doctor do it?
No, your family doctor cannot perform the exam.
Only Immigration Refugees and Citizenship Canada (IRCC)-approved panel physicians are authorized to conduct immigration medical exams. You must choose a doctor from IRCC’s list of panel physicians.
You can find a list of certified panel physicians here.
How much does an IME cost in Canada?
Costs vary by clinic, country/region, and the necessary tests.
Typically, for a standard medical exam in Canada, costs range from CAD $ 140 – 150 for kids aged 0 – 14, and CAD $170 – 180 for those 15 – 74.
Applicants must pay all related fees out of pocket, including
The physician’s exam fee;
Radiology and laboratory tests; and
Specialist consultations (if required).
Vaccinations offered at the clinic may involve additional costs. Refugees and asylum seekers may have some fees covered.
What documents should I bring to the exam?
IRCC recommends applicants bring the following documents:
A valid identification, including a passport (recommended) or other government-issued ID (national ID card, driver’s license from certain countries, refugee documents, birth certificate for children under 18, etc.).
Medical Report form (IMM 1017E or IMM 1020E) if IRCC has sent you one.
Four passport-style photos if the clinic doesn’t use the eMedical system.
Eyeglasses or contact lenses (if you wear them).
Medical history and reports of previous or ongoing conditions.
List of current medications.
Vaccination records (optional but recommended, including COVID-19).
What happens during the medical exam?
Note that there are two kinds of IME for Canadian immigration:
The Standard Medical Exam; and
The Streamlined Medical Exam.
Under the Standard Medical Exam:
When you arrive, clinic staff will confirm your identity with official ID and may ask for it again if you need further tests. A photo will also be taken for IRCC’s records.
Medical history
The doctor will complete a questionnaire with you, covering past or current medical conditions and any medications you take. Be honest and thorough—missing details can delay processing.
Physical examination
You’ll have a standard physical check, which usually includes:
Measuring height and weight;
Checking vision and hearing;
Listening to your heart and lungs; and
Examining your abdomen, skin, and limb movement.
Genital and rectal exams are not required. A breast exam may be done if medically necessary, with an explanation provided beforehand.
Additional tests
Depending on your age and medical history, you may be asked to do chest X-rays, blood or urine tests, or see a specialist. These are routine and should be completed promptly to avoid delays.
Vaccinations
Bringing proof of past vaccinations is encouraged but not mandatory.
Vaccines may be offered during the exam, including COVID-19 vaccines, but taking them is voluntary.
If you provide proof of previous vaccines or receive new ones, the doctor will record the details and share them with IRCC (with your consent).
IRCC suggests always keeping copies of vaccination records for your personal files.
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Under the Streamlined Medical Exam:
When you check in, staff will confirm your identity using official ID and take your photo for IRCC’s records. If you need additional tests, such as chest X-rays, you may be asked to show your ID again.
Medical history
The doctor will complete a questionnaire with you about your past and current medical conditions. IRCC advises applicants to be open and thorough about their medical history, as leaving out details can delay processing.
Additional tests
Routine screenings, such as chest X-rays or lab tests, may be required depending on your age. If results show something that needs further review, you may be referred to a specialist.
IRCC recommends that applicants make sure to complete all requested steps promptly to avoid delays in their medical exam processing.
Under both tests, you have the right to a chaperone. This means you can request a chaperone at any point during the exam. You may also pause the exam to ask questions or raise concerns if you feel uncomfortable.
Once your IME is complete
Your physician will upload the results for you to IRCC and provide you with a document attesting that you have completed a recognized medical exam with a panel physician. IRCC advises you to keep this document for your records.
How long does the IME take, and how long does it take to process?
The medical exam itself usually takes between 30 minutes to a few hours, depending on how busy the clinic is and whether additional tests are needed.
Processing times vary—panel physicians normally upload results within 10 days through the eMedical system that IRCC and panel physicians use. However, IRCC’s review of your results will be tied to the overall processing of your immigration application.
Can I get a copy of my results, and does IRCC notify me after they receive them?
Panel physicians send your results directly to IRCC.
You can request a copy from the clinic when you attend the exam. IRCC will contact you in writing if further medical information is needed or if issues arise, but they don’t automatically confirm receipt of results.
Physicians generally do not inform patients once they send IME results to IRCC. The immigration department recommends regularly checking your application status through the PR portal to see when IME results are updated there.
Note that medical reports and X-rays that are part of the medical exam become IRCC’s property and will not be returned to you after the IME has been processed.
How do I attach my IME to my PR application?
Once you have completed your IME, the panel physician will give you either an
Information printout sheet; or
IMM 1017B Upfront Medical Report form.
When you apply online, you’ll need to provide one of those documents in the relevant section of the PR portal.
How long are IME results valid?
Medical exam results are generally valid for 12 months from the date of the exam. If your results expire before IRCC makes a decision, you may be asked to undergo a new exam.