Introduction
The Canadian immigration medical exam (IME) is one of the most important steps in your application — and one of the most misunderstood. Most applicants walk in not knowing what tests will be done, what to bring, or what happens to their results. Some make avoidable mistakes that delay their application by weeks.
This guide tells you exactly how to prepare, what to expect on the day, and what changed after August 2025 — when IRCC introduced the new upfront IME requirement for Express Entry applicants.
What changed in 2026 – read this first if you are applying through Express Entry
Before August 21, 2025, Express Entry applicants completed their medical exam only after receiving instructions from IRCC following their application submission. That process no longer applies.
As of August 21, 2025, all Express Entry applicants must complete an upfront IME before submitting their permanent residence application. This means your medical results need to be ready and submitted together with your application within 60 days of receiving your Invitation to Apply (ITA).
Practically, this changes how you time your preparation: do not wait for IRCC to contact you. Book your panel physician appointment the moment you receive your ITA — or even before, if you expect one soon.
If you are applying through a route other than Express Entry — family sponsorship, PNP, study permit, work permit — the existing process applies: IRCC will send you instructions after your application is received. You then have 30 days to complete the exam.
Step 1: Confirm you are booked with an IRCC-approved panel physician
The single most important rule: only a physician officially approved by IRCC can perform your immigration medical exam. Your family doctor cannot do it, regardless of their qualifications or your relationship with them.
IRCC maintains a list of approved panel physicians worldwide. Use the IRCC Doctors directory to find one near you by city or country. When you make your appointment, confirm they are currently active on the IRCC approved list — physicians can be removed or suspended, and using one who is not active will mean your exam results are rejected and you have to start over.
Book at least 30 to 45 days before your application deadline. Clinic wait times in 2026 average one to three weeks in major cities; in some countries and smaller cities, it can be longer. Do not leave this to the last minute.
Step 2: Gather your documents before the appointment
Arriving without the right documents is the most common reason appointments are delayed or cancelled. Here is exactly what to bring:
Required for everyone:
- Your original valid passport (this is the primary identity document — a photocopy is not sufficient)
- If you have received an IRCC medical request form (IMM 1017), bring it. Note: upfront Express Entry medicals do not receive this form, so if you are doing an upfront IME you will not have one
- Your current glasses or contact lenses if you wear them — vision is assessed as part of the physical exam
Bring if you have them:
- Vaccination records — these are not strictly required but the panel physician will review and record them. Bring originals and any translated copies if your records are in a language other than English or French
- Medical reports or test results for any pre-existing conditions you are aware of
- A written list of all medications you currently take, including the dosage and how often you take them
- Records of any past surgeries or hospitalisations
Refugee and asylum claimants additionally need:
- Your Acknowledgment of Claim document
- Your Refugee Protection Claimant document (this serves as photo ID)
- Blue Cross interim federal health coverage confirmation if applicable
One thing you do not need to bring: passport photos. Panel physicians using the eMedical system (which is now standard) take your photo at the clinic. Check with your specific clinic when you book, as a small number may still require photos.
Step 3: Understand what the exam actually tests
Many applicants are anxious about the exam because they do not know what it involves. Here is what actually happens, in order:
- Identity verification and photo. The clinic confirms your identity against your passport and takes a digital photo for your file.
- Medical history questionnaire. You will answer written questions about your past and current health — previous illnesses, surgeries, mental health history, medications, and whether you have ever been diagnosed with or treated for tuberculosis, HIV, syphilis, or hepatitis.
- Physical examination. The physician checks your height, weight, blood pressure, vision, hearing, lungs, heart, abdomen, lymph nodes, skin, and limbs. Genital or rectal exams are not part of the standard IME.
- Chest X-ray (required for everyone aged 11 and older, including pregnant women who receive a lead shield). This screens for active pulmonary tuberculosis.
- Blood tests (required for applicants aged 15 and older). Screens for syphilis and HIV. Blood tests do not check for drug use, COVID-19 antibodies, or genetic conditions — these are common misconceptions.
- Urine test (required for applicants aged 5 and older). Screens for kidney disease and certain infections.
The entire appointment typically takes two to four hours, depending on the clinic and how busy it is. All tests are usually done in the same visit. You do not need to make multiple appointments.
Step 4: Do not fast — but drink water
This surprises many applicants: you do not need to fast before the immigration medical exam. Eating beforehand will not affect your blood test or urine test results. Eat normally before your appointment.
What you should do is drink plenty of water in the hours before your visit. You will need to provide a urine sample, and being well-hydrated makes that easier and more comfortable.
Step 5: Be completely honest about your medical history
This is the most important piece of advice in this guide, and the one applicants are most tempted to ignore.
Concealing a medical condition or medication does not protect your application — it endangers it. If the panel physician finds evidence of a condition during the exam that you did not disclose (on bloodwork, in your X-ray, or through medication detected in your urine), IRCC treats this as withheld information, which is treated as misrepresentation. Misrepresentation carries consequences far more serious than the underlying medical condition itself, including application refusal and potential bans from reapplying.
Honesty about your mental health history is particularly important. IRCC is not automatically concerned about mental health conditions — what matters is whether a condition poses a risk to public safety or places excessive demand on Canadian health or social services. Disclosing a history of depression, anxiety, or past treatment does not automatically disqualify you. Hiding it can.
If you have a pre-existing condition and are unsure how it might affect your admissibility, speak with an immigration lawyer or consultant before your appointment — not after.
Step 6: Know what the results mean — and what happens next
You will not receive a copy of your test results. The panel physician submits results directly to IRCC electronically through the eMedical system. You will not see them.
After your exam, one of three things will happen:
- Your results are accepted and you continue your application. This is the outcome for the vast majority of applicants. IME results are valid for 12 months from the date of the exam, giving you time to complete the rest of your application.
- IRCC requests further information (a “furtherance”). This is not a refusal. IRCC may request additional tests, a specialist assessment, or more information about a specific finding. You will receive written instructions. Respond promptly — you typically have 30 days.
- A finding of medical inadmissibility. IRCC may determine that a medical condition poses a risk to public health, a risk to public safety, or would place excessive demand on Canadian health or social services. The excessive demand threshold for 2026 is CAD $28,878 per year. If you receive a finding of inadmissibility, you have the right to respond before a final decision is made, and in some cases to appeal. Seek legal advice immediately.
Step 7: If you are already in Canada, check whether you even need a new exam
IRCC’s 5-year exemption policy, extended to October 2029, may mean you do not need a new IME. If you completed an immigration medical exam within the last five years, your previous results were classified as low risk or no risk, and you are applying from within Canada, you may be exempt from a new exam. Include your previous IME number or unique medical identifier in your application to trigger this exemption.
This applies to applicants for permanent or temporary residence made from within Canada. It does not apply to Express Entry upfront medicals, where the rules are different.
Common mistakes to avoid
- Booking too late. With Express Entry’s 60-day window after an ITA, there is no room for a two-week wait to get an appointment and then another delay if something needs follow-up. Book immediately.
- Using the wrong doctor. Your family doctor, a walk-in clinic, or a hospital cannot perform your IME. Only panel physicians on the IRCC-approved list can. Verify their status before your appointment.
- Not bringing your passport. A driver’s licence or national ID card is not sufficient. Your passport is the required primary identity document.
- Assuming the IME includes everything. The IME does not include a drug test, a COVID-19 test, a genetic screen, or a general wellness check. It is a specific protocol defined by IRCC. You cannot ask the clinic to add or remove components.
- Disclosing medications inconsistently. If you take a medication, list it. If bloodwork or a urine test reveals a medication you did not mention, it looks like concealment — even if the medication itself is not a concern for IRCC.
- Not bringing your glasses. Vision is assessed as part of the physical exam. If you normally wear glasses or contact lenses, bring them.
Frequently asked questions
Ready to find a panel physician?
Use the IRCC Doctors directory to find an approved panel physician in your city or country, compare languages spoken, and check clinic contact details and pricing.
Last updated: May 2026. IRCC policies change regularly — always verify current requirements at canada.ca before your appointment.