What is the medical check required for a PR application?

A permanent residency (PR) medical check (known as an Immigration Medical Exam or IME) requires a physical evaluation, medical history review, and specific diagnostic tests conducted by an approved government doctor.

Because medical requirements depend on the destination country (such as Canada or the United States), the exact steps vary. Below are the general requirements for major destinations like Canada and the U.S.

What the Medical Exam Includes

• Medical History Review: Questionnaire regarding past or current illnesses, surgeries, and current medications.
• Physical Examination: Basic checks of your height, weight, eyes, ears, nose, throat, heart, lungs, abdomen, skin, and limbs.
• Routine Laboratory & Radiology Tests:
  • Chest X-ray: To screen for tuberculosis (TB).
  • Blood tests: Often screening for infectious diseases such as HIV, syphilis, or hepatitis depending on local guidelines and your age.
  • Urine tests: Commonly required for older children and adults.

Key Requirements by Country

Canada (IRCC)

• Approved Doctors: You must use an official IRCC-approved Panel Physician; your regular family doctor cannot perform the exam.
• Upfront Exams: For Express Entry streams, an upfront medical exam is typically required.
• Cost: Generally ranges between CAD $140 and $280 depending on age and required tests.
• Validity: Standard medical exam results are valid for 12 months.

United States (USCIS)

• Approved Doctors: You must complete Form I-693 through a designated USCIS Civil Surgeon if applying from inside the U.S., or an overseas panel physician if using consular processing.
• Vaccinations: You must provide proof of required vaccinations (such as MMR, polio, tetanus, and COVID-19) alongside the physical exam and blood tests for diseases like tuberculosis and syphilis.

Certain untreated infectious diseases, active substance abuse, and mental disorders tied to harmful behavior can disqualify you from getting a green card.

The U.S. government reviews your health during a required exam on Form I-693. Medical issues that cause a denial are called Class A conditions. According to the 2026 Medical Guide, these main health grounds include:

1. Dangerous Contagious Diseases

• Active tuberculosis (TB): Latent TB is allowed, but an active, contagious form must be treated first.
• Syphilis and gonorrhea: These sexually transmitted infections must be treated and cured before approval.
• Infectious leprosy: Also known as Hansen's disease, if it is active and contagious.
• Note: HIV/AIDS, common colds, and well-managed chronic illnesses like diabetes or high blood pressure do not disqualify you.

2. Mental or Physical Disorders with Harmful Behavior

• Having a physical or mental health condition is fine unless it leads to violent or harmful behavior that threatens others or property.
• Standard diagnoses like depression or anxiety do not disqualify you if they do not cause harmful actions.

3. Drug Abuse or Addiction

• Current, ongoing abuse or addiction to illegal drugs, prescription medications, or alcohol can cause a denial.
• Past substance use that stopped more than three years ago is usually acceptable.

4. Missing Required Vaccinations

• You must prove you received age-appropriate vaccinations like polio, measles, and tetanus.
• You can get any missing shots during your medical appointment to fix this issue.

Yes, a permanent residency (PR) application can be rejected after you complete your medical exam. Passing or submitting a medical exam only means immigration authorities have received your health results; it is not a final approval for your entire application.

Common Reasons for Rejection After Medicals

• Medical Inadmissibility: Immigration officers can refuse an application if a health condition poses a danger to public health (such as active tuberculosis) or public safety.
• Excessive Demand: An application can be rejected if a condition is expected to place an excessive demand on health or social services, meaning the projected treatment costs exceed government thresholds.
• Expired Results: Immigration medical exams typically expire after 12 months. If your processing takes longer than a year and your medical results lapse, you may be asked to retake the exam. Failing to provide new results or clear a re-examination can lead to a refusal.
• Other Eligibility Issues: Even if your medical passes, the IRCC can still reject your file based on background checks, security screenings, insufficient funds, or incomplete documentation.

The medical check-up required for Singapore Permanent Resident (PR) formalities typically includes a chest X-ray to screen for active tuberculosis (TB) and a blood test for HIV.

According to the Ministry of Health guidelines, this screening is compulsory for successful applicants during the final formalities stage.

What to Bring to Your Appointment

• Your In-Principle Approval (IPA) letter from the Immigration & Checkpoints Authority (ICA).
• The official Medical Examination Report form.
• Your passport or valid travel document.

What to Expect

• Tests: A chest X-ray and an HIV blood test.
• Duration: The physical visit takes about 20 to 45 minutes.
• Results: Results and the completed medical report are usually ready within 24 to 48 hours.
• Validity: The medical report must generally be submitted within 3 months of its issuance.

You can review the official guidelines and download documents directly via the ICA Medical Examination Report Form.

The USCIS medical exam checks for communicable public health diseases, required vaccinations, physical or mental disorders with harmful behaviors, and substance abuse or addiction. It must be performed by a USCIS-designated Civil Surgeon and recorded on Form I-693.

Key Screenings and Tests

• Communicable Diseases: Screens for tuberculosis (TB via IGRA blood test), syphilis (blood test), and gonorrhea (urine test) based on age requirements.
• Physical Examination: A basic hands-on evaluation of your heart, lungs, eyes, ears, nose, throat, skin, extremities, and neurological system.
• Vaccination Audit: Verifies compliance with required immunizations (such as MMR, polio, Tdap, varicella, and seasonal flu) and administers missing doses.
• Mental and Behavioral Health: Evaluates whether you have a physical or mental disorder accompanied by harmful behavior that could pose a threat to yourself or others.
• Substance Abuse/Addiction: Assesses your history of drug and alcohol use to rule out active abuse or addiction.