Canada’s Express Entry To Require Upfront Medical Effective August 21

On August 12, 2025, Immigration, Refugees and Citizenship Canada (IRCC) announced a pivotal change to the Express Entry system, effective August 21, 2025.

This update requires all applicants for permanent residence (PR) through Express Entry, along with their family members, to complete an upfront Immigration Medical Exam (IME) before submitting their application.

Express Entry is Canada’s flagship immigration program for skilled workers seeking permanent residency, and it is the fastest way to get Canadian permanent residency.

This new change in medical exam requirement marks a significant shift from the previous process, where applicants were instructed to wait for IRCC’s guidance post-submission to schedule their medical exams.

This article explores the details of this new policy, its implications for prospective immigrants, and how applicants can prepare to navigate this change effectively.

With comprehensive insights, actionable advice, and expert analysis, this guide aims to inform and empower those pursuing their Canadian dream.

What’s Changing: Upfront Immigration Medical Exams for Express Entry

Effective August 21, 2025, all Express Entry applicants who receive an ITA must complete an Immigration Medical Exam (IME) before submitting their permanent residence application.

Now, proof of a completed IME must be uploaded directly into the Express Entry Profile Builder when submitting the PR application after receiving an invitation to apply.

This change applies to both the principal applicant and their family members, regardless of whether the family members are accompanying the applicant to Canada.

The goal, according to immigration experts, is to expedite further processing times by ensuring medical admissibility is assessed earlier in the process or to add it to automation.

By requiring upfront IMEs, IRCC aims to reduce delays and streamline decision-making for visa officers.

Key Details of the New Policy

• • Effective Date: August 21, 2025. Applications submitted before this date follow the current process, where IMEs are completed after IRCC instructions.

• • Who It Affects: All Express Entry applicants and their family members, including non-accompanying dependents.
  • Exceptions: Applicants in Canada who have completed an IME within the past five years (e.g., for a work or study permit) may reuse their existing IME results by providing the IME number or unique medical identifier in their application. If the results are not usable, IRCC will provide further instructions.
  • New Applicants: Those who have never completed an IME must contact an IRCC-approved panel physician to schedule and complete the exam after receiving an ITA but before submitting their PR application.

• Proof Requirement: Applicants must upload proof of the completed IME in the Express Entry Profile Builder when submitting their application.

This policy shift underscores the importance of medical admissibility in Canada’s immigration framework.

What Does the Immigration Medical Exam Involve?

The IME is not a standard doctor’s visit. It follows strict guidelines set by IRCC and is conducted exclusively by panel physicians.

Depending on the applicant’s age and health, the exam may include:

• • Physical Assessment: A general check-up to evaluate overall health.
  • Blood and Urine Tests: To screen for infectious diseases and other conditions.

• Chest X-Rays: Typically required for adults to check for tuberculosis or other lung conditions.
• Medical History Review: Applicants must disclose past and current medical conditions and medications.
• Vaccination Records: While not mandatory, panel physicians may record vaccination history (e.g., for measles, polio, or COVID-19) if the applicant consents.

The results are valid for 12 months, so timing is critical. If an application is not finalized within this period, applicants may need to repeat the exam.

Who Does This Change Affect and Exemptions?

The new upfront IME requirement applies specifically to Express Entry applicants who receive an ITA on or after August 21, 2025.

Other permanent residence pathways, such as Provincial Nominee Programs (PNPs) not aligned with Express Entry, family sponsorship, or refugee streams, are unaffected by this change unless otherwise specified by IRCC.

Scenarios Based on Applicant Status

1. Applicants in Canada with a Recent IME:
   • If you’ve completed an IME within the last five years (e.g., for a work or study permit) and are applying from within Canada, you can include your IME number or unique medical identifier in your application.
   • IRCC will verify if the results are still valid. If not, you’ll receive instructions to complete a new IME.
2. Applicants Who Have Never Had an IME:
   • If you’ve never undergone an IME, you must schedule one with a panel physician after receiving an ITA but before submitting your PR application.
   • Contact an IRCC-approved panel physician in your country or region to book the exam.
3. Family Members:
   • All family members, including non-accompanying dependents, must complete an IME.
   • The same rules apply: those with a valid IME from the past five years can submit their IME number, while others must schedule a new exam.

The introduction of upfront Immigration Medical Exams for Express Entry applicants starting August 21, 2025, marks a significant shift in Canada’s immigration process.

While it adds an extra step for applicants, it also promises faster processing and greater transparency.

By preparing early, scheduling IMEs strategically, and working with IRCC-approved panel physicians, applicants can position themselves for success.

This change, though initially daunting, is a step toward a more efficient immigration system that benefits both applicants and the country.

For those planning to apply through Express Entry, now is the time to assess your CRS score, gather necessary documents, and stay informed about IRCC updates.