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Most applicants worry about the wrong part of the immigration medical exam. They fear a past illness or a shadow on an x-ray. Far more cases run into trouble for duller reasons: the wrong doctor, the wrong timing, only part of the family examined, or results that expired before the person landed.
Below: who needs an exam, when to book it, what the panel physician does, how long results last, and what medical inadmissibility means in law. Sources and dates are at the end.
Who needs a medical exam
For permanent residence the answer is everyone. IRCC states: "If you apply for permanent residence, you must have an immigration medical exam." It then adds the rule that catches families out: "Your family members must also have a medical exam, even if they're not coming with you."
A spouse who plans to stay behind, or a child who lives with a former partner, is still a family member on a permanent residence application and still has to be examined. Leaving them out is not a shortcut.
Temporary residents are different. For visitors, students and workers, IRCC says a stay of six months or less generally does not need an exam, unless you will work in a job where public health must be protected. IRCC's examples include health care, clinical laboratories, long-term care, primary or secondary schools, child care, domestic work and in-home caregiving. Agricultural workers may also need one if they lived in a listed country for six months or more in a row in the year before arriving.
For stays longer than six months, IRCC requires an exam if you lived in or travelled to a listed country for six months or more in a row in the year before you arrive, if you will work in one of those public-health-sensitive jobs, or if you are applying for a parent and grandparent super visa. Check IRCC's country list for every country you spent time in, not only your country of citizenship.
Your own doctor cannot do it
IRCC is blunt: "Your own doctor can't do the medical exam. You must find a panel physician we've approved to do medical exams." A report from your family doctor, a hospital check-up or an employer medical will not be accepted, however thorough it is. IRCC publishes a search tool for approved panel physicians by country and city.
Nor can the panel physician decide your case. IRCC's instructions state that panel members "may not give applicants an opinion on their medical admissibility. That decision rests with Canadian migration officers." A clinic that says you have passed, or will be refused, is speaking outside its role.
Upfront exam or wait to be asked
Timing depends on the program, and getting it wrong is one of the most common avoidable errors.
- Express Entry: IRCC states that "you must get a medical exam after you receive your invitation to apply, but before you apply." You contact a panel physician yourself, and you upload the confirmation document the physician gives you with your permanent residence application. This sits inside the 60 days you have after an invitation, so book early.
- Other permanent residence applications, including spouse, partner and child sponsorships: you wait. IRCC sends instructions after you submit your complete application, and you must then get the exam within 30 days of receiving those instructions.
- Temporary residence: you can get an upfront exam before you apply by contacting a panel physician directly, and IRCC says "You should get your medical exam before you apply" where one is required. You then include the physician's confirmation document. If you do not have an upfront exam, the visa office tells you what to do next.
The 30-day window for a requested exam starts when IRCC issues the instructions, not when you notice them. Make sure someone is checking the account and email address on the application.
What the exam actually involves
There is a questionnaire about past and current conditions and medication, then a physical exam covering weight, height, hearing, vision, heart and lungs, abdomen, limb movement and skin. IRCC states the physician "won't examine your genitals or rectal area", and you may ask for a chaperone at any time. Then come age-based tests.
IRCC's instructions to panel physicians list the routine tests by age:
| Test | Routinely required from |
|---|---|
| Chest x-ray | Age 11 and older |
| Syphilis screening | Age 15 and older |
| HIV test | Age 15 and older, unless the applicant has self-reported as HIV positive |
| Serum creatinine (kidney function) | Age 15 and older |
IRCC strongly recommends bringing your passport as identification, along with glasses or contact lenses, any medical reports and a list of current medication. Vaccines may be offered, but IRCC states they are voluntary and that declining them will not lead to refusal. A panel physician can also refer you to a specialist, and IRCC asks you to complete any referral promptly.
After the exam: results and how long they last
The physician sends the results to IRCC. You receive a document confirming that you had the exam, and you should keep it. For Express Entry you upload it with your application. For a requested exam you do not need to send anything.
IRCC states: "Your medical exam results are valid for 12 months." If you do not come to Canada as a permanent resident, or arrive as a student or worker, within that period, you may need another exam. Students and workers can check the expiry on their letter of introduction. This is the clock people forget. An exam taken early in a long application can run out before the visa is issued.
Some people already in Canada do not need a new exam. Under a temporary public policy that IRCC has extended until 5 October 2029, certain foreign nationals in Canada are exempt if they had an exam with a physical examination within the previous five years and their result was coded as low or no risk, among other conditions set out in the policy. If you completed an exam within five years before a new application, IRCC asks you to include the exam number from it. Whether you qualify depends on the exact coding and conditions, so check the policy rather than assume.
What medical inadmissibility actually means
Section 38 of the Immigration and Refugee Protection Act says a foreign national is inadmissible on health grounds if their condition is likely to be a danger to public health, is likely to be a danger to public safety, or "might reasonably be expected to cause excessive demand on health or social services." That is the full list. Having a medical condition is not, by itself, a ground of inadmissibility.
- Danger to public health is about the risk a condition poses to other people's health. This is why the routine tests focus on conditions such as tuberculosis and syphilis.
- Danger to public safety is about the risk a condition poses to other people's safety.
- Excessive demand is about the cost of, or the waiting lists for, the health and social services a condition is expected to need.
On excessive demand, IRCC publishes a cost threshold each year. For 2026 it is 144,390 Canadian dollars over five years, or 28,878 a year. A condition is treated as an excessive demand if the expected services would likely cost more than that, or would add to Canadian wait times.
The excessive demand rule does not apply to everyone. Under section 38(2), it does not apply to a sponsor's spouse, common-law partner or child in the family class, to Convention refugees and people in similar circumstances, to protected persons, and to their prescribed family members. Danger to public health and safety still apply to those groups.
If IRCC has a concern: the fairness letter
IRCC does not refuse on medical grounds without warning. It states that you will receive a procedural fairness letter before a final decision, and that "You'll have the opportunity to submit information to respond." Responses must be sent within 90 days of the letter's date. Where excessive demand is the concern, you may also be invited to submit a mitigation plan, but only where it applies to your situation.
If the exam finds inactive tuberculosis, you will be placed under medical surveillance in Canada. IRCC states this "is a condition of your status in Canada", and that failing to complete it may hurt current or future applications, including citizenship.
- Can my regular doctor do the medical exam if I send IRCC the results?
- No. IRCC states that your own doctor cannot do the exam. It must be done by a panel physician approved by IRCC, which you can find through IRCC's panel physician search.
- My spouse is not coming to Canada with me. Do they still need a medical exam?
- Yes, for permanent residence. IRCC states that your family members must also have a medical exam, even if they are not coming with you.
- When do I do the medical exam for Express Entry?
- After you receive your invitation to apply and before you submit your permanent residence application. You book it directly with a panel physician and upload the confirmation document with your application.
- Will a chronic condition like diabetes or HIV mean I am refused?
- Not automatically. The legal grounds are danger to public health, danger to public safety and excessive demand on health or social services. Each case is assessed by IRCC on its facts, and if there is a concern you will receive a procedural fairness letter and a chance to respond before a decision.
- Can the panel physician tell me whether I passed?
- No. IRCC's instructions say panel physicians may not give applicants an opinion on their medical admissibility. That decision is made by IRCC officers.
If a family member has a health condition, a past tuberculosis diagnosis, or you have received a procedural fairness letter, have your situation reviewed before you respond.Book a consultation
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