The immigration medical exam for Canada: validity, cost and what happens

Who needs an immigration medical exam

Every permanent residence applicant needs an immigration medical exam, and so does every family member named on the application, whether or not they are coming to Canada; temporary residents need one when the length of the stay, the country they have been living in, or the job they are taking triggers it. The requirement follows the application type, not the person. Every economic and family permanent residence stream requires one, from Express Entry and the provincial nominee programs to family sponsorship; if you are still working out how to become a permanent resident of Canada, the exam sits near the end of all of those routes. On the temporary side it depends on how long you are staying, where you have been living and what you will be doing: someone arriving for a four-year degree on a study permit after a year in a designated country needs one, and so does anyone taking a job in a health or childcare occupation on a work permit, whatever their country of residence.

Two details catch people out. The first is the designated country list: it is about where you have lived for six months or more in the year before you apply, not your nationality, so a British passport holder coming from three years in Lagos is treated the same as a Nigerian applicant. The second is the occupation list: jobs with close contact with people, including hospital and clinic work, home and residential care, childcare, primary and secondary teaching, and some agricultural work, trigger an exam regardless of where you have been. The relevant NOC code and TEER level tell you which side of that line your job sits on.

How long the immigration medical exam is valid

An immigration medical exam is valid for twelve months from the date of the examination, and you must be admitted to Canada, landing as a permanent resident or having your permit issued, before that window closes. The rule is not that the application must be submitted within twelve months but that you must be admitted before the exam expires. Processing times that run past a year (parents and grandparents, inland spousal sponsorship at 26 months, some provincial nomination files) routinely outlast the first exam, and IRCC then sends a request for a new one. That repeat exam costs the full fee again and adds four to eight weeks. The way to avoid it is to do the exam when the program actually asks for it rather than at the earliest possible moment, and, for Express Entry, to check the current instruction before booking.

Upfront exam or on request?

Some programs require the exam upfront, with the results submitted alongside the application: the super visa, most temporary resident applications where an exam applies, and Express Entry when the ITA checklist says so. In an upfront exam the panel physician completes the IMM 1017 Upfront Medical Report and you upload the receipt, not the clinical file. Other programs request the exam during processing: family sponsorship, the Parents and Grandparents Program and most provincial nomination paper streams, where IRCC sends a medical request letter carrying an IME number and the deadline by which the exam must be done. IRCC has changed the Express Entry instruction more than once, pausing upfront exams in October 2023 and revising the rule since, so treat the document checklist in your e-APR after your ITA as the authority. If you have not been asked and the program requests during processing, do not book early; you will be paying twice. For more on how the medical exam fits around your AOR, since the 12-month validity window runs independently of your processing time, see our guide to the acknowledgement of receipt.

What happens at the exam

1. 01

   Find a panel physician

   IRCC publishes the list by country and city. Only a panel physician can do the exam; your own doctor cannot. Book early in busy cities, where waits of two to four weeks are normal.

2. 02

   Bring the right things

   Passport or travel document, your IME number or medical request letter if you have one, glasses or contact lenses, a list of current medications, and reports for any existing condition (a managed condition with a specialist letter is far easier for IRCC to assess than a bare diagnosis). Some clinics ask for photographs.

3. 03

   The examination

   Medical history and medications; a physical (height, weight, vision, hearing, blood pressure, heart, lungs, abdomen, limbs, skin, a mental-state check); a chest x-ray for those 11 and over; blood tests for HIV and syphilis for those 15 and over; a urine test for those 5 and over. Further tests or a specialist referral follow only if a finding needs it.

4. 04

   Results go to IRCC, not to you

   The physician uploads the file through eMedical, usually within a few days to two weeks, and gives you a receipt with the IME number. Keep it; it is your proof of an upfront exam and, for the in-Canada exemption, the number you enter next time.

5. 05

   IRCC assesses

   The application tracker shows the medical as passed, in review or requested. Most files pass without comment. A concern produces a procedural fairness letter, not a refusal.

What the immigration medical exam costs

An immigration medical exam costs $200 to $450 for an adult and $140 to $200 for a child at a Canadian panel physician, plus the chest x-ray and laboratory tests where the clinic bills them separately. Panel physicians are private clinics setting their own fees, so the price is not published by IRCC and varies between cities and countries. Budget for the whole family, remember that the x-ray and the laboratory work are sometimes billed separately, and treat a repeat exam as a real risk rather than an edge case. If you are building a full budget, our guide to the cost to immigrate to Canada puts the medical alongside the government fees, the biometrics, the language test and the credential assessment.

For a parent or grandparent coming on a super visa, the exam is only part of the bill: the mandatory private medical insurance of at least $100,000 usually costs far more than the examination itself. Our breakdown of super visa fees in Canada sets the two side by side.

The in-Canada exemption for recent exams

Since October 2024, applicants inside Canada who completed an immigration medical exam within the previous five years and were assessed as low risk to public health or safety may not need a new exam for a further in-Canada application. The exemption is applied when you enter the earlier IME number in the application; IRCC checks the previous result and tells you if a new exam is needed after all. It has been extended more than once and is a public policy rather than a permanent rule, so confirm it is still in force when you apply. It does not apply to applicants outside Canada.

Your IME number, eMedical and what "medical passed" means

Every examination is filed under an IME number (sometimes shown as an eMedical or UMI reference) printed on the receipt the clinic hands you. That number, not the clinical report, is what you give IRCC: it is how an upfront exam is matched to your application and how the in-Canada exemption is claimed later. Keep a scan of the receipt with your passport copies. The panel physician transmits the file through eMedical, IRCC's electronic system, normally within a few days, and neither you nor your representative sees the clinical detail.

In your online account the line usually moves from medical requested to medical received or in review and then to medical passed. "Passed" means no inadmissibility concern was found, not that the file is approved; the visa officer still has criminality, security and eligibility to finish. A medical that sits in review for weeks is normally waiting on a further test or a specialist report, and where the delay is unexplained, a set of GCMS notes will show what the medical officer has recorded.

What the exam is looking for, and what happens if it finds something

The panel physician records; IRCC's medical officers decide, against section 38 of the Immigration and Refugee Protection Act. Three questions are asked. Is the applicant a danger to public health (active tuberculosis, untreated syphilis)? A danger to public safety (a rare finding, tied to specific behaviours)? Or would their condition place excessive demand on health or social services, meaning an expected publicly funded cost above the per-year threshold IRCC publishes and updates annually, measured over five years? Spouses, partners and dependent children being sponsored, and refugees, are exempt from the excessive-demand ground entirely. HIV is not a bar in itself; a managed condition rarely is.

A third outcome sits between a clean pass and a concern: medical surveillance. Where the chest x-ray shows inactive or treated tuberculosis, IRCC can admit you on condition that you report to a provincial public health authority within 30 days of landing, and you sign an undertaking to that effect. It is a public health follow-up, not an inadmissibility finding, and it does not stop the application. Report on time; provincial health services expect the referral, and the appointment is usually free.

If a concern is raised, IRCC sends a procedural fairness letter, and the deadline stated in that letter governs your response, which is where files are won: specialist reports, evidence that a condition is stable, private insurance or a credible mitigation plan showing the cost will fall below the threshold, or an argument that the exemption applies. Our medical inadmissibility guide covers the threshold, the exemptions and the response in detail.

Timing the immigration medical exam for the common programs

Book the exam when your program actually asks for it, not at the earliest possible moment: an upfront program wants it with the application, while a program that requests during processing sends a medical request letter partway through, and an exam done too early expires before you land.

Five mistakes that cost people months

• Booking too early. An exam taken the week you submit an inland sponsorship will expire long before the decision, and you will pay twice.
• Missing the 30-day request deadline. A medical request letter carries a short deadline; if the clinic cannot see you in time, book what you can, keep the confirmation, and tell IRCC in writing rather than letting the deadline pass in silence.
• Leaving a family member out. Non-accompanying spouses and dependent children still need the exam. A family member who is not examined makes the principal applicant inadmissible.
• Turning up with nothing. A managed condition documented by a specialist letter is routine; the same condition discovered cold in the examination room invites a request for more evidence and adds months.
• Losing the IME receipt. Without the number you cannot prove an upfront exam or claim the in-Canada exemption, and the clinic may charge for a copy.

How we help

Wild Mountain Immigration is a licensed RCIC practice (CICC R706497) in Canmore, Alberta, working with clients across Canada and overseas. We time the exam against the real processing time for your program so it is still valid on the day you land, tell you exactly what to bring so a known condition is documented rather than discovered, and, if IRCC raises a concern, prepare the fairness letter response and the specialist evidence behind it. Once you are here, our guide to healthcare for newcomers in Canada covers the provincial waiting periods that follow. The examination itself is between you and the panel physician, and nothing on this page is medical advice: if you want a second opinion on when to book your immigration medical exam, book a call with a licensed consultant first.