If you received an Express Entry ITA and your last Immigration Medical Exam (IME) was done years earlier (e.g., for a study permit), you may not need a new one:
- Check the IRCC public policy for inland applicants that allows a previously passed IME to remain valid — historically IRCC has recognized an IME as valid for up to 5 years if you've continuously resided in Canada since it was done.
- Attach a Letter of Explanation (LOE) to your application citing this public policy and explaining that you're relying on your existing valid IME rather than completing a new one.
- Confirm the current validity window on IRCC's site before applying, since public policies and exemptions like this can be updated or withdrawn — one applicant successfully submitted an IME that had technically expired by a few months by citing the policy, but rules and enforcement can change.
If your IME expired well beyond 5 years, or you've left and re-entered Canada in the meantime, plan to redo the medical exam instead of relying on the exemption.