On the official record
Official / RED VERIFIEDFor Express Entry, IRCC says get the exam after the ITA and before you apply. That is an upfront medical exam. Only a panel physician can do it. Your own doctor cannot.
The completeness PDI treats medical confirmation as a mandatory upfront document, with printed transition rules for older files and a temporary public policy for some in-Canada applicants until 5 Oct 2029. Results are valid for 12 months on the PR medical page.
Source: IRCC: Medical examination for permanent residence applicants · official page Aug 4, 2026 · checked Aug 21, 2026
Source: IRCC PDI: Express Entry completeness check · official page Jan 23, 2026 · checked Aug 21, 2026 · If a public page and this PDI disagree, this PDI wins.
Source: IRCC: Apply for permanent residence through Express Entry · official page Jun 22, 2026 · checked Aug 21, 2026