Introduction
The Canadian immigration medical exam — officially called the Immigration Medical Examination, or IME — is a mandatory health screening that Immigration, Refugees and Citizenship Canada (IRCC) requires from most people applying to live, work, or study in Canada. It is not a general wellness check. It is a specific, standardized assessment designed to determine whether an applicant poses a risk to public health or safety, or would place excessive demand on Canada’s health or social services.
This guide covers everything you need to know: who needs the exam, what it involves, what it costs, how long results are valid, and what has changed in 2026. If you are ready to book, use the IRCC Doctors directory to find an approved panel physician in your city or country.
What is the Canadian immigration medical exam?
The IME is a health assessment conducted by a physician officially approved by IRCC. These approved doctors are called panel physicians, and they are the only medical professionals authorized to perform an immigration medical exam. Your family doctor, a walk-in clinic, or a hospital cannot do this exam — even if you trust them with your everyday healthcare.
The exam covers four main components: a review of your medical history, a physical examination, a chest X-ray, and laboratory tests. The exact tests required depend on your age. Results are submitted electronically by the panel physician directly to IRCC through the eMedical system — you do not receive a copy.
IRCC uses the exam to screen for three categories of concern:
- Public health risk — primarily active pulmonary tuberculosis and untreated syphilis
- Public safety risk — serious mental health conditions with a history of violence
- Excessive demand on health or social services — conditions that would require healthcare or social support costing more than CAD $28,878 per year (the 2026 threshold), or that would affect wait lists for certain services in Canada
The vast majority of applicants pass without issue. Medical inadmissibility affects a small minority, and many common health conditions do not trigger it.
Who needs a Canadian immigration medical exam?
Permanent residence applicants
Almost all applicants for Canadian permanent residence must complete an IME. According to IRCC’s official guidance, this applies to people applying through:
- Express Entry (Federal Skilled Worker, Canadian Experience Class, Federal Skilled Trades)
- Provincial Nominee Programs (PNP)
- Family sponsorship (spouses, partners, children, parents, grandparents)
- Atlantic Immigration Program
- Rural and Northern Immigration Pilot
- Refugee and humanitarian programs
Even family members who are not accompanying the principal applicant to Canada may still be required to complete the exam — including dependants who have no intention of immigrating.
Temporary residence applicants
Not all temporary residents need an IME, but several categories do. IRCC’s temporary resident medical exam requirements apply in three situations:
Based on country of origin or travel history. Applicants who have lived in or travelled to a designated country for six or more consecutive months in the year before arriving in Canada must complete an IME. As of November 2025, more than 100 countries are on IRCC’s designated list, including Afghanistan, Bangladesh, Brazil, Cambodia, China, India, Nigeria, Pakistan, and the Philippines. Four countries were added in November 2025 (Fiji, Singapore, Timor-Leste, and Tunisia), while several others were removed (including Argentina, Colombia, and Venezuela). Always check the current IRCC list before assuming your country’s status.
Based on intended length of stay. Applicants planning to stay in Canada for more than six months may need an IME depending on their country of origin.
Based on occupation. Certain workers require an IME regardless of their country of origin or intended length of stay, because their work involves close contact with people. This includes healthcare workers, childcare and eldercare workers, teachers, food handlers, and agricultural workers from designated countries.
Super visa applicants. Parents and grandparents of Canadian citizens or permanent residents applying for a super visa must complete an IME.
Who does not need the exam
Canadian citizens and permanent residents do not require an IME. Applicants staying in Canada for less than six months who are not working in a public health–sensitive occupation are generally exempt. Certain diplomatic and official visa holders are also exempt.
What changed in 2025–2026
Two significant policy changes affect how and when you complete your IME.
The Express Entry upfront IME requirement (August 2025)
The most important recent change: as of August 21, 2025, all Express Entry applicants must complete an upfront IME before submitting their permanent residence application. Previously, applicants submitted their application first and completed the medical exam only after receiving instructions from IRCC.
Under the current rules, Express Entry applicants must book and complete their IME after receiving an Invitation to Apply (ITA), and submit proof of the completed exam together with their application within the 60-day window. Without proof of a completed IME, an Express Entry application is considered incomplete.
This change applies only to Express Entry. Applicants through family sponsorship, PNP outside of Express Entry, and other streams follow the existing process: submit your application, then wait for IRCC’s medical instruction letter.
The 5-year IME exemption for in-Canada applicants (extended to October 2029)
IRCC has extended its temporary public policy exempting certain in-Canada applicants from completing a new IME until October 5, 2029. If you completed an IME within the last five years and received a low-risk or no-risk result, and you are applying for permanent or temporary residence from within Canada, you may be exempt. To claim it, include your previous IME number or unique medical identifier in your application — IRCC will assess whether your previous results can be used.
This exemption does not apply to Express Entry upfront medicals.
What happens during the exam
Understanding exactly what the exam involves removes most of the anxiety around it. Read our full preparation guide for a detailed walkthrough — here is the overview.
Step 1 — Identity verification and photo
The clinic confirms your identity using your passport and takes a digital photo for your IRCC file.
Step 2 — Medical history questionnaire
You complete a written questionnaire covering past illnesses, surgeries, mental health history, current medications, and prior diagnoses of tuberculosis, HIV, hepatitis, or other conditions. Answer honestly and completely — withholding information that later appears in test results is treated as misrepresentation and carries serious consequences for your application.
Step 3 — Physical examination
The panel physician examines your height, weight, blood pressure, vision, hearing, heart, lungs, abdomen, lymph nodes, skin, and limbs. As IRCC confirms, a genital or rectal exam is not part of the standard IME.
Step 4 — Chest X-ray
Required for all applicants aged 11 and older, including pregnant applicants (who receive a lead shield). The X-ray screens primarily for active pulmonary tuberculosis. If inactive tuberculosis is detected, you are not barred from entry but will be required to complete medical surveillance after arriving in Canada.
Step 5 — Blood tests
Required for applicants aged 15 and older. Screens for syphilis and HIV. Blood tests do not check for drugs, COVID-19, pregnancy, or genetic conditions — these are common misconceptions.
Step 6 — Urine test
Required for applicants aged 5 and older. Screens for kidney disease and certain urinary tract infections.
The entire appointment takes two to four hours. All components are completed in a single visit at most clinics. You do not need to fast beforehand — eat normally and drink plenty of water.
How much does the immigration medical exam cost?
IRCC does not set a fixed fee. Panel physicians set their own prices, and costs vary by clinic, city, and country. There is no provincial health insurance coverage for the IME — it is classified as a non-medically necessary service, so you pay out of pocket.
As a general guide for clinics in Canada in 2026:
- Physical exam (all ages): approximately CAD $150–$200
- Chest X-ray (age 11+): approximately CAD $50–$95
- Blood tests (age 15+): approximately CAD $80–$120
- Urine test (age 5+): often bundled into the exam fee or a small additional charge
A typical adult appointment covering all components runs CAD $250–$400 depending on the clinic. Children under 11 who do not require an X-ray will pay less. International clinics vary significantly — in some countries the full exam costs the equivalent of CAD $100–$150; in high-cost cities it may exceed CAD $500.
Refugee and asylum claimants may have costs covered by the Interim Federal Health Program (IFHP) through Blue Cross. Bring your IFHP documentation to your appointment to verify coverage.
The most accurate way to know what you will pay is to contact your clinic directly. Use the IRCC Doctors directory to find panel physicians in your area — many list their fees directly on their profile.
How long are results valid?
IME results are valid for 12 months from the date of the examination. If your application is not finalized within that period, IRCC will contact you with a re-medical request — instructions to redo the exam. This is routine and does not indicate a problem with your file.
For Express Entry applicants, this 12-month window matters for timing. Complete your upfront IME after you receive your ITA, not speculatively weeks beforehand — if results expire before you can submit your application, you will need to redo the exam.
What happens after the exam
Results are submitted to IRCC
The panel physician submits your results directly to IRCC electronically, typically within five to ten business days. You will not receive a copy of your results. At the end of your appointment you will receive an information sheet with your photo and case number — keep this to track your file.
Three possible outcomes
Your results are accepted. This is the outcome for the vast majority of applicants. Your file moves forward and no further action is needed on the medical front unless results expire before the application is decided.
IRCC requests further information (a “furtherance”). IRCC may ask for additional tests, a specialist assessment, or supplementary documentation. You will receive written instructions, typically with a 30-day deadline. A furtherance is not a refusal — most applicants who receive one are ultimately approved.
A finding of medical inadmissibility. If IRCC determines that a condition poses a public health or safety risk, or would place excessive demand on Canadian health or social services beyond the CAD $28,878 annual threshold, you will receive written notification. You have the right to respond before a final decision is made. Legal options — including humanitarian and compassionate grounds — may be available. Seek advice from a licensed immigration lawyer or consultant immediately.
For applicants found to have inactive tuberculosis, a separate requirement applies: you must complete medical surveillance after arriving in Canada, reporting to the provincial or territorial public health authority in your province of settlement.
How to find an approved panel physician
Only physicians on IRCC’s current approved list can perform your immigration medical exam. The list is updated regularly — physicians can be added or removed. Using a doctor who is not currently active means your results will be rejected and you will need to redo the entire exam at your own cost.
The IRCC Doctors directory lets you search for approved panel physicians by city, province, or country worldwide. Each profile includes the clinic address, telephone number, languages spoken, and in many cases pricing and booking links. When you contact a clinic, confirm they are currently active and accepting new appointments.
Book at least 30 to 45 days before your application deadline. Wait times at popular clinics in major Canadian cities typically run one to three weeks, and longer in some international locations.
Frequently asked questions
Ready to book your exam?
Use the IRCC Doctors directory to find a panel physician in your city or country. Search by location, filter by language spoken, and access contact details and pricing directly on each clinic profile.
Last updated: May 2026. IRCC policies change regularly — always verify current requirements at canada.ca before your appointment.