Express Entry Guide · Updated October 2026
Medical Exam for Express Entry: When to Book It and What Happens (Real Cases)
The medical is the one document you cannot prepare years ahead. Book too early and it expires. Book too late and you miss the deadline. Here is when to do it, who has to go, and what applicants ran into.
The medical exam for Express Entry is an immigration medical exam done by an IRCC-approved panel physician. If you have never had one, IRCC says to get it after you are invited to apply. The results are valid for 12 months, and they must be valid both when you submit your application and when you become a permanent resident.
Your family members need the exam too, even if they are not coming with you. And your own family doctor cannot do it.
Those few lines cover most of the rules. The trouble is in the timing. We read IRCC’s current instructions and forum threads from 2018 to 2025 where applicants were asked to redo exams, saw their results expire a week before the finish line, or could not tell whether an exam was needed at all.
Quick answer: the Express Entry medical exam
Book an immigration medical exam with a panel physician after your invitation, as close as possible to the date you apply. Results last 12 months. Every family member must be examined, even those not coming. If you had an immigration medical in the past 5 years and you live in Canada, you may not need a new one. Give IRCC your old exam number instead. Do not book more than one appointment.
Key takeaways
What the Medical Exam for Express Entry Is
IRCC calls it an immigration medical exam, or IME. It is a requirement for permanent residence. The purpose is to check that your health is not a danger to public health or public safety in Canada, and that it would not cause too much demand on health or social services. Those are the health grounds on which an application can be refused.
The exam is not done by your regular doctor. IRCC’s wording is plain: you must see a doctor on the list of panel physicians, and your own doctor cannot do the medical exam. Panel physicians do not make the decision. They carry out the exam and send the results to IRCC.
Question | IRCC’s rule |
|---|---|
Who does the exam? | A panel physician from IRCC’s list |
When? | After you are invited to apply, if you have never had one |
How long are results valid? | 12 months |
Who pays? | You pay all fees at the appointment |
Who must be examined? | You and your family members, even if they are not coming |
Source: IRCC medical exam pages for Express Entry (modified June 22, 2026) and permanent residence applicants (modified August 4, 2026).
When to Book Your Medical Exam
Timing is the hard part, because the results have a shelf life. IRCC’s Express Entry page says that if you have never had an immigration medical exam, you should get one after you are invited to apply. It adds two more points. Schedule it as close as possible to the date you apply online. And do not book more than one appointment.
The reason for booking late is the validity rule. Your results must be valid at two moments: when you submit the application, and when you actually get permanent residence.
Work the dates through and the logic is clear.
Exam taken | Application submitted | Months left for processing |
|---|---|---|
3 months before the invitation | Day 50 after invitation | About 7 |
Day 10 after invitation | Day 50 after invitation | About 10.5 |
Day 40 after invitation | Day 50 after invitation | About 11.5 |
Our arithmetic, using the 12 month validity and the 60 day window after an invitation.
An exam done months before your invitation is not wrong. It just leaves less room if processing runs long. That is how applicants end up being asked for a second exam.
Book the appointment early, sit the exam late
Panel physicians in some cities are booked weeks ahead. Find your nearest one while you are still in the pool, and learn how long their wait is. Then book the date as soon as the invitation arrives. You get an early slot without burning months of validity.
Who Needs the Exam
This rule catches families off guard. IRCC states that your family members must also have a medical exam, even if they are not coming with you. Its help centre answer is even more direct: all of your dependants must be examined by an approved panel physician, regardless of whether or not they are coming to Canada.
The reason given is future sponsorship. A dependant must be medically admissible to be sponsored later. IRCC also notes that an inadmissible dependant could affect your own application.
Who goes to the panel physician
If you are listing a partner who is staying behind, read our guide to a non-accompanying spouse in Express Entry. The medical is one of the duties that does not go away.
If You Already Had an Immigration Medical
Many candidates in Canada already did an exam for a work or study permit. IRCC’s page says that if you completed an immigration medical exam as part of a previous application in the past 5 years, and you are currently living in Canada, you may not need to complete another one.
What to give IRCC in that case
IRCC’s permanent residence page describes this as a temporary measure for certain applicants in Canada whose earlier exam showed low or no risk to public health or safety. The page says it runs until October 5, 2029. It is a may, not a will. Keep the option of a fresh exam in your plans.
What Happens at the Appointment
The exam itself is routine. IRCC lists what to bring and what the doctor checks.
Bring | Why |
|---|---|
Proper identification, ideally your passport | The clinic confirms who you are |
Glasses or contact lenses, if you wear them | For the vision check |
Medical reports or test results for past or existing conditions | Saves follow-up requests |
A list of your current medications | Part of your medical history |
Source: IRCC, medical exam for permanent resident applicants.
The doctor confirms your identity, takes a medical history and does a physical exam: weight, height, hearing, vision, heart and lungs, abdomen, limbs and skin. Depending on your age, you may be asked to do chest x-rays and laboratory tests.
You pay all fees at the appointment, including the fee for the physician or radiologist and any special tests or treatment that are needed. IRCC does not set one price, so ask the clinic when you book. Afterward you receive a document confirming the exam. That is what you upload.
When Results Expire During Processing
IRCC’s rule is short: results are valid for 12 months, and if you do not come to Canada as a permanent resident within that time, you may need another exam. The forum shows what that looks like in practice.
Real case: passport requested, medical expiring in 8 days
In April 2022, an applicant received the passport request but their medical was due to expire in eight days. A member suggested sending the passport anyway. The applicant came back in October 2022 to report that a re-medical request arrived about a month after the passport was sent, and they had to repeat the exam.
Real case: asked to redo it with a month still left
In April 2018, an applicant was asked to repeat the exam although the first one was valid for more than another month. Others in the thread had seen the same thing. Their explanation was that the deadline for landing is tied to the medical expiry date, so officers want enough time left on it. One member reported a re-medical cleared in about 15 days.
Two things stand out. Officers look ahead, so a medical with only weeks left can trigger a request even though it has not expired. And a re-medical is a delay, not a refusal. The advice across these threads was consistent: do it quickly, and do not argue.
Signs you may be asked for a second exam
Rules Have Changed, So Check the Date
Medical instructions for Express Entry have been rewritten more than once. Older forum advice can be wrong today.
Real case: was an exam even required?
In February 2025, an invited applicant in their 40s found that the guidance of the time said upfront exams were no longer required as of October 1, 2023, yet the upload field still asked for proof. The nearest panel physician was hundreds of kilometres away. They found the instruction then in force: upload a blank document and wait for directions.
That was the rule in early 2025. The current IRCC page, modified in June 2026, says something different: if you have never had an exam, you should get one after you are invited to apply, and the results must be valid when you submit. Always read the live IRCC page and check its date modified line before you follow a forum post or an old checklist.
How the Medical Fits Your 60 Days
After an invitation you have 60 days to submit everything. The medical is one of several documents on that clock, along with your police certificates, reference letters and proof of funds.
A sensible order
If your language test is also near its end date, plan both together. See what happens when IELTS expires after an ITA.
Frequently Asked Questions
When should I do the medical exam for Express Entry?
If you have never had an immigration medical exam, IRCC says to get one after you are invited to apply, as close as possible to the date you apply online.
How long is the Express Entry medical exam valid?
Results are valid for 12 months. If you do not become a permanent resident within that time, you may need another exam.
Can my family doctor do the immigration medical exam?
No. You must see a doctor on IRCC’s list of panel physicians. Your own doctor cannot do it.
Does my spouse need a medical exam if they are not coming to Canada?
Yes. IRCC says family members must have a medical exam even if they are not coming with you.
I had a medical exam for my work permit. Do I need another one?
Maybe not. If the exam was within the past 5 years and you live in Canada, you may not need a new one. Give IRCC the information sheet or IME number from the earlier exam.
What happens if my medical expires during processing?
IRCC can ask you to do another exam. Applicants on forums report these requests when little validity is left. It adds time, but it is not a refusal.
Check your score before you book anything
The medical only matters after an invitation. See how your CRS score compares with the latest cutoffs.
Final Thoughts
The medical exam for Express Entry is simple on the day and tricky on the calendar. Use a panel physician, take the exam after your invitation, and make sure every family member is examined, including anyone staying behind.
Then watch the 12 months. If processing runs long and IRCC asks for a second exam, treat it as routine and get it done fast. And because these instructions keep changing, trust the current IRCC page over anything older.
