Scenario: a 2021 Express Entry applicant post-ITA had every document ready except the medical, and had read that upfront medicals were no longer required because of IRCC processing changes — submit with or without?
Historical note: during the COVID-era backlog IRCC temporarily told some applicants not to do upfront medicals and to wait for a request. Current policy on upfront vs on-request medicals changes — check IRCC's instructions for your stream before deciding.
What group members advised:- If you've received an ITA and can get the medical done in time, submit with it. The strongest reply: "try everything in your power to submit with medicals." A file that's complete on day one avoids the added round-trip of a medical request months later.
- If IRCC's instructions for your stream say wait for a request, then wait — the rule of thumb offered: get it done when they request it, not before the ITA at all.
- The applicant's conclusion after canvassing multiple forums: submitted with the medical included.
The practical takeaway: unless IRCC's current instructions for your stream explicitly say to wait for a medical request, completing the panel medical before filing the e-APR keeps the file decision-ready and avoids a months-long detour.