Do you need a medical examination for Express Entry from within Canada

When applying for permanent residence through Express Entry, medical examination requirements depend on whether you are inside or outside Canada. For those already in the country, a temporary policy may exempt you from an upfront medical exam.

Two types of Express Entry medical requirements

Canadian immigration authorities require medical examinations in two forms. First, there is an upfront medical exam that a candidate undergoes before submitting the complete document package. Second, there is an examination requested after the application has been submitted.

For Express Entry, a candidate who receives an Invitation to Apply (ITA) must undergo an examination within 60 days of receiving the invitation. However, having an upfront medical examination can streamline the process if it meets the authorities’ requirements.

Exemption for candidates inside Canada

Since April 2024, a temporary public health policy has been in effect for candidates inside Canada, valid until October 2025.

If you are applying for permanent residence from within Canada AND you have undergone a medical examination within the last five years for immigration purposes AND the results were successful with a low risk level, then you do not need to undergo an upfront examination.

This condition applies exclusively to applicants from Canada. For foreign candidates, this policy does not apply.

Importance of documentary evidence

If you are submitting your application independently and are in Canada, you must attach a Letter of Explanation and a PDF copy of the relevant public health policy. In the letter, you must clearly indicate that you fall under the exemption: you underwent a medical examination within the last five years and passed it successfully.

Many foreign candidates make the mistake of thinking the policy applies to them as well. It applies only to those inside Canada. If you are applying from outside the country, this exemption does not apply.

Documents received from your doctor

When undergoing an upfront medical examination, a physician authorized by the authorities (panel physician) will issue you a document confirming completion of the examination and an IME (Immigration Medical Examination) number. This number and the doctor’s document must be attached to your permanent residence application.

A medical certificate is typically valid for 12 months. If you still underwent an upfront examination, ensure that its results fall within this validity period.

What to attach to your application inside Canada

When submitting your application independently from within Canada, attach:

— a letter of explanation in English or French; — a PDF copy of the public health policy; — the IME number from your doctor (if you underwent an examination).

Ensure that all documents are uploaded in the correct location of your application package and that you have specified the IME number when submitting.

Difference between candidates inside and outside Canada

The main difference is straightforward: if you are in Canada and meet the policy conditions, a medical examination is not required. If you are outside Canada, you need to undergo an examination before submitting your complete application or shortly after receiving an invitation. This difference is critical for planning your application timeline and budget.