Canada’s Express Entry To Require Upfront Medical Exams Starting August 21, 2025

In a significant policy shift, Immigration, Refugees and Citizenship Canada (IRCC) has announced that Express Entry applicants will now be required to complete an upfront Immigration Medical Exam (IME) effective August 21, 2025. This change aims to streamline the immigration process and reduce delays.

What’s Changing?

Starting August 21, 2025, all Express Entry applicants must undergo an IME after receiving an Invitation to Apply (ITA) but before submitting their Permanent Residence (PR) application. They must then upload proof of the completed IME directly into the Express Entry Profile Builder.

Key Details of the New Requirement

• Effective Date: Applications submitted on or after August 21, 2025, must include proof of IME completion. Submissions before this date will follow the current process, where medical instructions are provided after the application is filed.
• Who Must Complete the IME: The principal applicant and all family members, including non-accompanying dependents, must meet medical admissibility requirements and complete the IME.
• Where to Complete the IME: The exam must be conducted by an IRCC-approved panel physician. Applicants who have never had an IME must schedule one after receiving their ITA and before submitting their PR application.
• Proof Requirement: Applicants must upload proof of the completed IME, such as an e-medical information sheet or IME number, into the Profile Builder when submitting their application.
• Reuse of Prior IME: Applicants in Canada who completed an IME within the last five years (for a work or study permit, for example) may reuse their IME by providing the IME number or Unique Medical Identifier (UMI). If the results are no longer valid, IRCC will issue new instructions.
• Scope Limitation: This policy applies exclusively to Express Entry applicants. Other PR streams outside of Express Entry are not affected and will continue to follow their existing medical sequencing processes.

Why Is IRCC Making This Change?

IRCC’s stated goal is to accelerate processing times by enabling earlier medical admissibility assessments. This change is expected to support automation and reduce delays that visa officers often encounter later in the process.

How Medical Admissibility Works in Canada

All PR applicants and their family members must meet Canada’s medical admissibility standards, regardless of whether they plan to accompany the principal applicant. Medical inadmissibility can result if a condition poses a risk to public health (e.g., certain infectious diseases) or is likely to create an “excessive demand” on Canada’s health or social services. This is typically defined as exceeding three times the average annual per-capita health care cost in Canada. Applicants with chronic conditions may still be deemed admissible if they can demonstrate their condition is stable and being effectively managed.

What Applicants Need to Do

The steps applicants must take depend on their specific situation:

• If You Receive an ITA on or After August 21, 2025: Schedule an IME with a panel physician promptly after receiving your ITA. Obtain your proof of completion (e.g., e-medical sheet or IME number) and upload it to the Profile Builder before submitting your PR application.
• If You Submitted Your PR Application Before August 21, 2025: Your application will follow the current process, where medical instructions are provided after submission. No upfront IME is required.
• If You Are in Canada and Completed an IME in the Last Five Years: Include your IME number or UMI with your application. IRCC will advise if a new exam is needed.

Recent Timeline of Policy Shifts

This change marks a reversal of a previous policy. On October 1, 2023, IRCC removed the upfront IME requirement for Express Entry applicants, allowing them to submit their application first and complete medical exams upon instruction. Now, effective August 21, 2025, IRCC is reinstating the upfront IME requirement for all Express Entry applications filed on or after that date.

Coverage and Limits

It’s important to note that this policy change applies only to Express Entry PR streams. Other immigration categories outside of Express Entry will continue to follow their existing medical sequencing processes. Additionally, applications submitted before August 21, 2025, will not be affected by this change and will follow the current post-submission medical instruction model.

Media and practitioner sources, including Immigration News Canada, CIC News, and Fragomen, confirm the details of this policy update, including the effective date, scope, and exceptions for recent IMEs completed in Canada.

Source

Understanding the Transition and Requirements

The new policy introduces a significant shift in how medical exams are handled for Express Entry applicants. Starting August 21, 2025, all applicants must complete their IME after receiving an ITA but before submitting their PR application. This change aims to streamline the process and reduce delays by enabling earlier medical assessments.

Effective Date and Transition Process

Applications submitted on or after August 21, 2025, must include proof of IME completion. Those submitted before this date will follow the current process, where medical instructions are provided post-submission. This transition ensures a smooth shift without disrupting ongoing applications.

Completing the IME

The IME must be conducted by an IRCC-approved panel physician. Applicants without a prior IME should schedule one promptly after receiving their ITA. This step is crucial for meeting the new requirements and avoiding delays in processing.

Proof and Reuse of Prior IME

Applicants must upload proof, such as an e-medical sheet or IME number, into the Profile Builder. Those in Canada who completed an IME within the last five years can reuse it by providing the IME number. IRCC will determine if a new exam is needed based on the validity of the existing results.

Scope and Limitations

This policy exclusively affects Express Entry applicants. Other PR streams remain unaffected, adhering to their existing medical processes. This ensures that only Express Entry is impacted, allowing other categories to function as usual.

Why This Change?

IRCC aims to enhance efficiency by assessing medical admissibility earlier, reducing delays for visa officers. This proactive approach supports automation and faster processing, aligning with IRCC’s goals of improving immigration outcomes.

Medical Admissibility Explained

Medical admissibility is determined by assessing risks to public health and potential excessive demand on health services. Conditions like certain infectious diseases or those requiring significant healthcare resources may lead to inadmissibility. Demonstrating stable and managed chronic conditions can mitigate such concerns.

Applicant Actions Based on Situation

• ITA Received On or After August 21, 2025: Schedule an IME promptly, obtain proof, and upload it before submitting the PR application.
• Application Submitted Before August 21, 2025: Follow the current process with post-submission medical instructions.
• Completed IME in Canada Within Five Years: Provide the IME number; IRCC will advise if a new exam is required.

Policy Change Context

This change reverses the October 1, 2023, policy which removed upfront IME requirements. Now, starting August 21, 2025, Express Entry applicants must again complete IMEs upfront, ensuring a return to a more streamlined process.

Coverage and Limits

Only Express Entry applicants are affected; other PR streams continue unchanged. Applications before August 21, 2025, follow the old process, ensuring a smooth transition without disruption.

Sources confirm these details, including effective date, scope, and exceptions for recent IMEs. For more information, visit Immigration News Canada.

Conclusion

Starting August 21, 2025, Express Entry applicants must complete an upfront Immigration Medical Exam (IME) after receiving an Invitation to Apply (ITA) but before submitting their Permanent Residence (PR) application. This change aims to streamline the immigration process and reduce delays by enabling earlier medical admissibility assessments. Applicants must use an IRCC-approved panel physician and upload their IME proof to the Express Entry Profile Builder. Those who submitted their applications before the effective date will follow the current process, while others must adhere to the new requirements. This policy shift is specific to Express Entry and does not affect other PR streams. Applicants are advised to stay informed and consult official resources for the latest updates.

Frequently Asked Questions (FAQ)