Express Entry Applications: Upfront Medical Exam Results and Key Requirements

Immigration, Refugees and Citizenship Canada (IRCC) has updated its operational guidance on Express Entry applications, emphasizing the importance of submitting a complete electronic application for permanent residence (e-APR) within 60 days of receiving an Invitation to Apply (ITA). Applications are assessed for completeness up front, and incomplete applications will be rejected with fees refunded.

What Counts as a Complete Application?

A complete Express Entry application must include:

• The e-APR submitted online
• Payment of all cost-recovery fees
• All required supporting documentation

Processing begins once the application is received and should be finalized within the six-month processing standard, unless exceptional delays occur outside the applicant’s control.

Mandatory Documents for All Applicants

Certain documents are always required. Missing any of these can lead to rejection:

• Medical examination confirmation – New requirement: applicants must now provide proof of an upfront medical examination at the time of application. Previously, medical results could often be submitted later in the process when IRCC requested them. While a temporary public policy allowed medicals to be deferred, that period has ended, and upfront medicals are now the rule.
• Police certificates for each country where the applicant has lived for six months or more since age 18 (excluding Canada)
• Copy of the passport biographical page
• Proof of work experience (reference letters, employer records, or proof of self-employment)

Other Commonly Required Documents

Depending on personal circumstances, applicants may also need to provide:

• Birth certificates for dependent children
• Proof of education and Educational Credential Assessments (ECAs)
• Marriage, divorce, common-law, or death certificates, if applicable
• Proof of funds from financial institutions
• Job offer letters and LMIA details (if claiming arranged employment)
• Provincial or territorial certificates of qualification (if applicable)

Translation Requirements

Any document not in English or French must be accompanied by a certified translation or a translator’s affidavit, along with a copy of the original document.

Exceptions and Flexibility

In limited situations beyond the applicant’s control (e.g., delays in obtaining police certificates or cancelled medical appointments), IRCC may accept proof of best efforts, such as confirmation of a scheduled appointment or proof of having requested documents. However, acceptance is not guaranteed, and applicants should aim to submit all required documents within the 60-day deadline.

Final Notes

Each application is assessed on its own merits, and officers have discretion when reviewing supporting documentation. If an application is rejected as incomplete, the applicant must create a new Express Entry profile and wait for another ITA.