Upfront Medical Exam for Canada Immigration – IME without a letter

Medical inadmissibility could prevent many people from moving to Canada. Of course, the purpose of medical inadmissibility is to protect the health and safety of Canadians. Therefore, immigration officers ask a large group of applicants to undergo medical exams. However, you may sometimes do an upfront medical exam. In those situations, you do not wait for an officer to issue an Immigration Medical Exam (IME) letter.

Who needs to do an upfront medical exam?

The following applicants need to do an upfront medical exam. Nevertheless, this list is neither inclusive nor exclusive. Thus, consult with a professional for official advice:

• Express Entry applicants: As of August 21, 2025: If you’re applying under Express Entry, you must do a medical exam first.
  Outdated: From October 1, 2023, to August 20, 2025, you did not need to get an upfront medical exam before submitting your permanent residence application through Express Entry.
• The following people must complete a medical examination. While an upfront medical exam is not mandatory for them, it is in their best interest to complete it rather than hoping to receive an IME (Immigration Medical Exam) letter from an officer.
  • Applicants for parents’ or grandparents’ super visa
  • People who intend to remain in Canada for more than six months. However, they have lived in or travelled to certain countries or territories for 6 months or more in a row in the year before they come to Canada.
  • Temporary residents who intend to work in the restricted jobs, in which public health must be protected.

Note: If your immigration or visa program does not qualify for an upfront medical exam, you must wait for an official IME letter (IMM 1017).

The list of designated countries for temporary residents

IRCC’s webpage lists all countries and territories for IME. When you look up a county from that list, you must do a medical exam if there is a “Yes” under the IME column and you meet the following criteria:

• You intend to remain in Canada for more than six months, and
• You have lived or visited these countries for six months or more within the past 12 months.

Since the list of designated countries is subject to change, visit the IRCC webpage for more information. However, a screenshot shows how easily you can find the information you need.

List of jobs that require an upfront medical exam

If you are applying for a work permit and intend to work in the following jobs, you must submit an upfront medical exam (if you don’t, the officer may issue you an IME letter or refuse your application). This requirement is for temporary residents (e.g., foreign workers) and is independent of your nationality or where you have resided in the past 12 months.

• workers in health care settings
• clinical laboratory workers
• patient attendants in nursing and geriatric homes
• medical students admitted to Canada to attend university
• medical electives and physicians on short-term locums
• workers in primary or secondary school settings, or workers in child-care settings
• domestics, or rather domestic workers, namely people employed to work in a private household in roles that are not necessarily caregiving. Typical examples include a household cleaner, housekeeper, or cook.
• workers who give in-home care to children, the elderly and the disabled
• day nursery employees
• other similar jobs

How to conduct an upfront medical exam

If you intend to do an upfront medical exam, take the following steps.

1. Locate a panel physician who is close to you. Of course, you must refer to the IRCC website for the official list.
2. Call them and book an appointment. Let the panel physician know you will do an upfront medical exam. Therefore, you do not have an IME form (i.e., no IMM 1017).
3. Take the following and any other documents the physician requires:
   1. Passport or another official ID card
   2. Lenses or eyeglasses (if you wear them)
   3. A list of your medications
   4. Any evidence of your medical history
   5. Four immigration photographs (or as advised by the panel physician)
   6. If you are an Express Entry applicant, the ITA letter
4. Besides a physical exam, you may also need to go through lab tests, x-rays, etc.

Regardless, the physician will later pass the following documents to you:

• IMM 1017B Upfront Medical Report form and
• information printout sheet.

If you are applying online, you need to upload both documents. However, if you apply at a port of entry or on paper, you must present the hard copies.

What if you miss the exam?

If you do not do the upfront medical exams, any of the following scenarios could occur:

1. The officer will issue the IMM 1017 form and ask you to take the exam. Of course, this will delay the processing.
2. They wave you from the exam (unlikely, though).
3. They refuse your application (extremely unlikely).

Other than in Express Entry applications, scenario #3 is less likely. However, it is in your best interest to do the exam and avoid potential disappointment. If you have submitted your application, you may still do the medical exam and upload the documents via the IRCC web form. Nonetheless, the IRCC website is silent on this practice.

The upfront medical exam for dependent family members

When you are applying for immigration to Canada, all your dependent family members must also undergo a medical examination. Therefore, if an upfront medical exam is required for the principal applicant, it also applies to the other dependent family members. This requirement applies regardless of whether they accompany the principal applicant. However, the situation changes if the application is temporary (e.g., TRV, work permit, study permit, or TRP). In those situations, only applicants must undergo a medical examination. Of course, they must do it if the requirement applies. Read “Who needs to do an upfront medical exam?” for more information.

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Relevant article: Removing limitations on a work permit because of a missing medical exam