BREAKING - New Upfront Medical Exam Requirement for Express Entry Applicants

Leann Sousa • August 12, 2025

BREAKING - New Upfront Medical Exam for Express Entry Applicants

If you’re planning to apply for permanent residence through Express Entry, there’s an important update you can’t afford to miss. IRCC has introduced a new rule that requires many applicants to complete an upfront medical exam Express Entry before submitting their PR application. This change impacts how you prepare your documents, your timeline, and even your application strategy.

In this guide, we’ll break down what the new upfront medical exam requirement means, who it applies to, how to complete it step by step, and how to avoid delays or refusals. Whether you’re applying for yourself or assisting clients, this article will help you stay compliant and confident.

What Changed? New Upfront Medical Exam Requirement

Starting August 21, 2025, all applicants applying for permanent residence through Express Entry will be required to complete a medical exam before submitting their application—known as an upfront medical exam. IRCC has updated the Express Entry process by introducing an  upfront Immigration Medical Exam (IME) requirement for certain applicants.

The upfront IME requirement

Under the new rule, applicants must complete their canada immigration medical examination before submitting their Express Entry permanent residence application. Proof of this exam must be uploaded along with other required documents.

Difference between previous process vs new process

Previous Process New Upfront Medical Process
Medical exam requested after PR submission Medical exam completed before PR submission
Applicants waited for IRCC instructions Applicants arrange exam proactively
Medical added later in processing Medical proof included upfront

Effective date of the change

This requirement applies to Express Entry applications submitted on or after the effective implementation date announced by IRCC. Applications submitted before that date generally follow the old process unless otherwise instructed.

What “upfront” means in practical terms

“Upfront” means you don’t wait for IRCC to ask. You book the exam yourself with an approved panel physician, complete it, and upload the confirmation as part of your Express Entry PR application. Visit IRCC’s website for full details.  

What This Means for You and Your Client

For applicants, this change means more preparation upfront, but potentially faster processing later. You’ll need to factor in medical exam availability, processing time for results, and document uploads before submitting your application.

For immigration professionals and consultants, this means guiding clients earlier in the process and ensuring they understand when and how to complete the upfront medical exam for Express Entry to avoid incomplete applications.

How to Complete an Upfront Medical Exam for Express Entry

Completing an express entry for upfront medical exam is straightforward if you follow the right steps.

Step-by-step process

1. Find an IRCC-approved panel physician
Only
doctors approved by IRCC can conduct a valid canada immigration medical examination.

2. Book the appointment
Contact the clinic directly and request an upfront medical exam for Canadian immigration.

3. Attend the medical exam
The exam usually includes:

  • Physical examination
  • Chest X-ray
  • Blood and urine tests

4. Receive IME confirmation/document
After your exam, the clinic will give you an IME confirmation or information sheet.

5. Upload proof with PR application
Upload this document in your Express Entry application as proof of completion.

Need Help with Express Entry Upfront Medical Exam? We Can Guide You

Understanding new immigration rules can be overwhelming, especially when timelines are tight. Foothills Immigration Consultant can help applicants navigate the upfront medical exam Express Entry requirement, ensure documents are correctly prepared, and reduce the risk of costly mistakes. Professional guidance can make the process smoother and more predictable from start to finish.


Get Help with Your Upfront Medical Exam

Documents Required for an Upfront Medical Exam

Before attending your medical exam, make sure you have the following:

  1. Passport or travel document
  2. IME number (if applicable, though many upfront exams don’t require one)
  3. Photos (some clinics take them on-site)
  4. Previous medical records (if you have past conditions or treatments)

Having these ready helps avoid rescheduling or delays.

Who Must Complete an Upfront Medical Exam?

The upfront medical requirement applies broadly across Express Entry streams.

Express Entry principal applicants

All principal applicants submitting a PR application under Express Entry must complete the exam if required.

Accompanying family members

Spouses or dependent children included in the application must also complete a medical exam.

Non-accompanying dependents

Even dependents who are not immigrating to Canada may still be required to undergo a medical exam.

Express Entry programs covered

The requirement applies to all programs managed under Express Entry, including:

  • Federal Skilled Worker (FSW)
  • Canadian Experience Class (CEC)
  • Federal Skilled Trades (FST)

Who Is Exempt from the Upfront Medical Exam Requirement?

Not everyone needs to complete a new medical exam.

Applicants with valid previous IMEs

If you’ve completed a medical exam within a valid timeframe and it meets IRCC standards, it may be reused.

In-Canada applicants with recent medicals

Some applicants already in Canada may qualify for medical exam reuse, depending on their status and risk factors.

Conditions under which IRCC may reuse an old IME

IRCC may accept a previous IME if:

  • It was completed recently
  • It showed no public health or safety risks
  • It is still valid at the time of review

Situations where IRCC may still request a new exam

IRCC can still ask for a new exam if:

  • Your medical has expired
  • Your health condition has changed
  • Additional assessment is required

Key Tips to Avoid Delays or Refusals

To keep your application moving smoothly:

  • Book medical exams early to avoid last-minute issues
  • Use only IRCC-approved physicians
  • Double-check uploaded documents for clarity and correctness
  • Track IME validity to ensure it doesn’t expire during processing

Being proactive can save weeks—or even months—of processing time.



Is the upfront medical exam mandatory for all Express Entry applicants?

Not always. Some applicants may be exempt if they have a valid previous medical exam that IRCC agrees to reuse.

How long is a canada immigration medical examination valid?

Medical exams are generally valid for 12 months from the date of completion.

Can I submit my Express Entry application without the upfront medical exam?

If the upfront exam is required and you don’t include proof, your application may be considered incomplete or delayed.

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