Quick Answer
The Immigration Medical Exam (IME) is required for permanent residence applications and for some temporary residents (healthcare workers, agricultural workers, long stays, certain countries). It must be done by an IRCC-approved panel physician — your own family doctor cannot do it. Cost: roughly $200–$420 CAD depending on location and tests. Results are valid for 12 months.
Who Needs an IME
| Situation | IME required? |
|---|---|
| All PR applications (Express Entry, PNP, sponsorship) | Yes — every family member, even those not coming to Canada |
| Work in healthcare, childcare, or primary/secondary education | Yes |
| Agricultural worker from certain designated countries | Yes |
| Visitor/student/worker staying 6+ months who lived in a designated country for 6+ months in the past year | Yes |
| Standard work or study permit, no designated-country history | No |
Upfront vs. On-Request Medical
For Express Entry, you previously could do an upfront medical before applying. IRCC’s standard flow now is: submit your application first, then wait for the instruction letter telling you to complete the IME within 30 days. Exception: some applicants are told to do an upfront IME — follow whatever your specific instruction says, not what a friend did in a previous year.
This guide explains the standard IME process. It is not medical or legal advice. If you have a chronic condition, a past TB diagnosis, or any health situation you worry could affect your application, speak with an immigration lawyer before the exam — medical inadmissibility rules (excessive demand) have specific thresholds and many exemptions, especially for spouses and dependants.
What Happens at the Exam
- Find a panel physician on IRCC’s “Find a panel physician” tool. Only listed doctors count.
- Book and bring: passport, the IME instruction letter (or IMM 1017), glasses/contacts, any medical reports for existing conditions, list of current medications, and photos if the clinic requests them.
- The exam includes: height/weight, vision, blood pressure, urine test (age 5+), blood tests for syphilis and HIV (age 15+), and a chest X-ray for TB (age 11+).
- The physician uploads results directly to IRCC through eMedical — you do not receive or submit the results yourself. You get a printed proof-of-completion sheet. Keep it.
Costs in 2026
| Location | Approximate cost per adult |
|---|---|
| Canada (Toronto, Vancouver, Calgary) | $280–$420 CAD |
| India | $60–$120 CAD equivalent |
| Philippines | $150–$250 CAD equivalent |
| Nigeria | $120–$220 CAD equivalent |
| UAE | $200–$350 CAD equivalent |
Children cost less. Fees are paid directly to the clinic and are not refundable if your application is refused.
Medical Inadmissibility: What Can Actually Go Wrong
Three grounds exist, and two of them are rarer than applicants fear:
- Danger to public health — essentially active infectious TB or untreated syphilis. Treatable: complete treatment, then you proceed.
- Danger to public safety — rare; serious conditions involving unpredictable violent behaviour.
- Excessive demand on health services — the condition would cost more than the threshold (roughly three times the average Canadian per-capita health cost, in the high-$20,000s per year as of recent updates). Key exemptions: spouses, common-law partners, and dependent children being sponsored are EXEMPT from excessive demand. Refugees are exempt too.
HIV-positive status alone does not make you inadmissible. Diabetes does not. Most managed chronic conditions do not. The fear is usually worse than the rule.
Timing and Validity
- IME results are valid 12 months from the exam date
- If your PR is not finalized within 12 months, IRCC may ask you to redo the exam (and pay again)
- You must land in Canada before your medical expires — this is why COPR validity is often tied to your medical date
- After receiving the IME instruction letter, you typically have 30 days to complete it
Common Mistakes
- Using a non-panel doctor — the results are worthless to IRCC
- Doing the exam too early so it expires before landing
- Not disclosing a known condition — the X-ray and bloodwork will reveal it anyway, and non-disclosure reads as misrepresentation
- Skipping the exam for a family member not accompanying you — ALL family members must be examined for PR, even if they stay behind
- Booking at a clinic with a long backlog when your 30-day deadline is running
FAQ
Can I see my results?
The panel physician transmits them directly to IRCC. You can request your own copy from the clinic for your records, but you cannot edit or choose what is sent.
I had TB years ago. Will I be refused?
Treated, inactive TB does not make you inadmissible. You may be asked for additional sputum tests or specialist reports, and you may be placed on post-landing medical surveillance. Bring your old treatment records to the exam.
Is pregnancy a problem for the IME?
Pregnant applicants can defer the chest X-ray until after delivery, or have it with shielding if they consent. This can delay your application timeline; discuss with the panel physician.
Canadianow is an independent publisher, not a law firm or medical provider. Last reviewed: June 2026.
Sources
- IRCC — Medical exams for permanent residence and temporary residence
- IRCC — Find a panel physician tool
- IRPA — section 38 (medical inadmissibility) and excessive demand exemptions
Written by Canadianow Editorial Team. Last reviewed: June 2026.
