Immigration, Refugees and Citizenship Canada (IRCC) updated its standard Immigration Medical Examination (IME) guidelines on October 16, 2025. These protocols provide the basis for assessing the health conditions of foreign nationals applying to come to Canada. The IME is a mandatory process for most applicants and is designed to determine whether individuals are admissible to Canada on health grounds.

This article summarizes the current IRCC IME requirements, focusing exclusively on the official definitions and processes outlined by IRCC.

What Is Included in the Immigration Medical Examination (IME)?

The IRCC requires a comprehensive medical examination by a designated panel physician. According to the official definitions, the IME generally consists of all of the following:

• Review of Past Medical History: Applicants must answer questions regarding their previous and existing medical conditions, hospitalizations, surgeries, treatments, and medications.
• Physical Examination: The panel physician assesses major systems, including vital signs, heart, lungs, abdomen, skin, and limbs.
• Mental Examination: The panel physician observes the applicant’s cognitive function, mood, and behavior, and may refer for further psychiatric assessment if indicated.
• Age-Related Tests:
  • Syphilis and HIV Screening: Required for applicants aged 15 years and older.
  • Chest X-ray: Required for applicants aged 11 years and older to screen for tuberculosis.
• Additional Tests: Further investigations may be ordered at the discretion of the panel physician if necessary to clarify any health issues.

Panel Physicians and Medical Assessment

Only panel physicians approved by IRCC can conduct the IME. Examinations performed by other doctors are not accepted. The panel physician conducts the required assessments and submits the results to IRCC, but the final decision on medical admissibility is made by an IRCC medical officer.

Medical Inadmissibility Criteria

IRCC may find an individual medically inadmissible to Canada on one or more of the following grounds, according to the Immigration and Refugee Protection Regulations:

1. Danger to Public Health

An applicant may be inadmissible if their health condition poses a danger to public health. This assessment is based on the communicability and potential impact of the disease, for example, active pulmonary tuberculosis or untreated syphilis.

2. Danger to Public Safety

Medical inadmissibility can also result from conditions that create a risk of sudden incapacity, unpredictable or violent behavior. This includes certain mental health disorders that could pose a safety risk to people in Canada.

3. Excessive Demand on Health or Social Services

An applicant may be inadmissible if their health condition is likely to cause excessive demand on Canada’s health or social services. “Excessive demand” means a need that could add to existing wait times or cost more than the average per capita health services, as described in IRCC’s operational definitions.

However, certain categories of applicants are exempt from this consideration. Exemptions include:

• A spouse, common-law partner, or conjugal partner
• A dependent child (including adopted children) of the sponsor, spouse, or partner
• Convention refugees (and their spouses/partners/dependent children)
• Protected persons (and their spouses/partners/dependent children)

These individuals must still complete the IME but are not assessed for excessive demand.

Additional Points

• Medical Surveillance: Applicants found to have a medical condition of public health significance (e.g., active tuberculosis) may be required to undergo medical surveillance upon arrival in Canada.
• Validity: The outcome of an immigration medical examination is reflected in the medical profile used by IRCC to make the final admissibility decision.

Key Takeaways for Practitioners

• Ensure clients use an IRCC-approved panel physician for their IME.
• Advise clients to prepare documentation on their medical history and to answer all questions fully.
• All necessary laboratory and diagnostic tests—especially age-based syphilis/HIV screening and chest X-ray—must be completed as per IRCC definitions.
• Be aware of the exemptions from excessive demand assessments for specific categories of applicants.
• The final determination of admissibility is made by an IRCC medical officer, not the panel physician.

For the full and up-to-date details, practitioners should always refer directly to the IRCC’s official definitions and guidelines.