One of the many universal immigration steps is the immigration medical exam, or IME. I wasn't able to find a list of what countries do and do not require a medical exam in order to move there, but I have to assume that it's a pretty good number of them. A Google search found that they were required by at least most of the big guys: China, India, (recently) Russia, the United Kingdom, and all the countries on the eMedical platform (a consortium and online program that stores immigrant medical data), including the United States, Australia, and of course, Canada.
Finding a doctor to perform the exam
According to the official IRCC guide, the IME must performed by a certified panel doctor, who can be in any country (this is a difference compared to some countries, which require you to get the exam in your country of origin). Basically, if you get your doctor from the list on the website, you're in the clear.
Now, being a certified panel doctor for IRCC does not mean the doctor has to study and pass exams in some sort of "special Canadian medicine;" rather, the certification process basically entails the doctor being a properly licensed physician in the given jurisdiction, and being nominated by IRCC to be an IME doctor for a certain area. Because IRCC tracks what parts of the world immigrants are coming from most often, they nominate different numbers of doctors for different areas as needed.
I live in New York State, and it just so happens that there are two doctors in New York that are certified to perform the exam: one in New York City, and one in Buffalo. My neighboring states had one or two doctors in each as well, which I think is reasonable.
There were also several panel doctors in Canada, of course, and this is the option I went for first. There were several doctors in the Ottawa area (the closest major Canadian city to me), as well as two in Kingston, my destination. Most of the doctors performing the IME inside Canada are doctors who do so for a living. They work at public clinics or offices that specialize in immigration services. I thought this would be a good thing because they are specialists in their field, but unfortunately, my experience dealing with these offices was cumbersome.
I called four clinics: one in Ottawa, two in Kingston, and one in Niagara Falls, Ontario. The one in Ottawa hasn't gotten back to me as of the time of writing. The two in Kingston were kind of terse with me on the phone, and for some reason both had a weird scheduling system that one could only access after being sent a secure email, which you could only get by in turn calling them. The bigger problem about these offices, though, was that they were scheduling appointments out several weeks, as they had very sporadic hours and were booking quite quickly. For example, one office I called was only open one day in the next two months, May 26. Now remember, I received the letter on May 5 and had 30 days to complete it. 21 days was already cutting it a little close, and it was my only shot at this place before the deadline. Perhaps most obnoxious, these clinics also only performed the initial exam (basically a medical history questionnaire and a very brief physical), and they wanted to send me out to other offsite labs to perform the other parts of the exam, which are a urinalysis, bloodwork and chest x-ray. There is usually an additional expense for each of these. These offices also wanted to me to go somewhere and get passport photos of myself taken to bring in with me (every step of the immigration process requires another passport photo of you), even though the photos are perfectly capable of being taken right at the office and uploaded into Canada's eMedical system. I had heard a lot of horror stories from the folks in the Canada Spousal Sponsorship Support Group on Facebook (which I highly recommend you join if you are navigating the process of moving to Canada on a spousal visa) about doctors offices with this sort of patchwork setup, because files get lost in transit between the several offices, there are delays, the lab has different hours, etc.
Needless to say, there was a headache brewing. I turned my focus elsewhere and had scheduled an appointment at the clinic in Niagara Falls, but then I realized I need not bother, when there was another office in New York that did not require me crossing the border! Unlike the offices that perform the IME in Canada, most of the ones in the US are other types of doctors offices, including family doctors. The certified panel doctor in Buffalo was actually at an occupational health office (the kind of place that does government/military physicals, handles worker's comp claims, etc.). The staff at this office were a bit more friendly, though the doctor in charge of the exams actually tried to persuade me to go elsewhere:
"If you really want to get this done, I would recommend going over the border to Ontario. Because of their nationalized healthcare system, they perform the exam at a fraction of the cost as private places in the US, usually around $250 Canadian [$200 US]."
I told him that even though he was more expensive, I appreciated having an office that made the process so convenient and quick, compared to the hoops others were making me jump through. He said, "welcome to the difference between American and Canadian healthcare." Take from that what you wish, I guess?
Completing the exam
The vaccination card is an interesting one. At some point I'll probably make a post about Canada's COVID-19 measures. But for now, I'll put it like this: as of the time of writing, nobody in Canada, or anybody moving to Canada is required to be vaccinated; however, you are required to be vaccinated to enter the country, with very few exceptions. So, let's just say if you were moving to Canada, it would really not behoove you to be unvaccinated, since you could get approved for permanent residence and then show up at the border and be denied entry. My understanding is that the government has anticipated this being a problem, so they have begun offering the COVID-19 vaccine at IME appointments to help people get it out of the way. This may be beneficial to folks living somewhere where the vaccine is not as widely available as the US. I brought my vaccine card to show that I did not need the jab.
The appointment itself really couldn't have gone much smoother, so I'm sorry to disappoint that this isn't really the bread and butter of the story. I guess I was expecting the appointment to be more...erm...official? I thought back to drug screenings I had gotten done for employers, or pre-op appointments for surgeries, but this was really more laid back, and surprisingly very little paperwork.
They checked my height and weight in the basic manner (didn't even take my clothes off), and the doctor acknowledged that IRCC would want all my measurements in Metric, so he opened up a Chrome tab on his laptop and Googled 5 foot 10 inches in centimeters. I won't be sharing my weight, though ;)
I then went and did the urinalysis (pee in a cup). He said, "all we're looking for is blood, glucose/sugar, and protein." I'll be honest, I barely know what any of those things are, but I didn't think I had any in my system. I was surprised there would be no screenings for any kinds of drugs, etc. (though I didn't have any of those in my system either). I also was worried that whatever they were testing for, it would take days to get the results back. Nope! In five minutes, the doctor came back to confirm I didn't have any of the three, um, things.
After that was a blood pressure check, and a rapid-fire questionnaire about my personal and family medical history. Any:
- prescription medications?
- recent surgeries?
- heart problems?
- breathing problems?
- addiction to drugs or alcohol?
The doctor didn't know what exactly the immigration officers look for, but in my own research I found, and he agreed that, they more than likely are looking for any conditions that 1) pose a public health threat, like a communicable disease that could spread to Canadians, or 2) put an excessive demand on the Canadian healthcare system (that is, unfortunately, diseases that are extremely expensive or complicated to treat and will put a strain on taxpayers and healthcare workers).
One piece of advice doc did give me, though, was that most people need not worry. I asked him what he thought my chances were of passing the exam, and he said "I've seen people twice your size who are smokers with diabetes and hepatitis who have gotten approved." This leads me to believe that, for whatever reason(s), IRCC is at least fair with these exams, if not lenient. He also showed me my profile in the eMedical system, loaded up on his laptop. My classification was "IME - EDE" (Immigration Medical Exam - Excessive Demand Exempt). For immigrants applying as part of a family or spousal process, your IME is usually not scanned to see if you are an excessive demand on the healthcare system, so I hope that is a stress relief for you!
The exams are also much less invasive than they have been in previous years, apparently. It seems the Trudeau government made several reforms when they came into office in 2015 that made the exams quicker and less thorough. Let's just say there are no longer any genital, rectal, or breast exams, which I'm sure is a relief to everyone.
A nurse came in and took two vials of blood, which I believe was mostly to test for HIV, and a x-ray tech led me across the hall from my exam room into the x-ray room, where I took off my shirt and they took two quick pictures of my chest, and I was back in five minutes.
Last was a brief physical; in fact, the most brief physical I've ever had. Doc checked my joints, reflexes, eyes, ears, mouth, listened to my heart, and confirmed all was normal. And that was, well, it. I couldn't believe they had done the whole process in under an hour. We even had some time to chat, and the doctor and I had a great, candid conversation about family and work and heritage, as Americans often do, and then he sent me on my way.
Getting the results
The other complication, which is not so much a complication as it is just a confusion, was that the eMedical system that they use to upload all of this medical data in, is actually a product developed by the government of Australia and shared by several other countries. And so, because it is hosted on the Australian government website and using Australian servers, the dates and times and all of your IME information will appear to be completely different than when you actually went. I'm told IRCC is aware of these issues and does not bother people about any discrepancies, though it is probably still good to know.
Based on the progress of other people's applications I had looked at in our Facebook support group, I saw that when most people completed their IMEs, they got the results back in a week or less. I had my appointment first thing Monday morning, so I had really hoped that the results would be in by end of the day Friday.
Well, much like with anything and everything when it comes to immigration, it is best not to have too many solid expectations. A week came and went, and I heard nothing. The following Monday, I called the office back to see what was going on, and the doctor confirmed for me that that pesky radiologist had gotten the best of us. In the entire week, they still did not have the time to review my two x-rays. He promised to politely put pressure on them to look that day and have the results in by the end of the day. Close! The next day, I finally got an email confirmation from the office that they had uploaded all my finalized data into the eMedical system, and that this had been transmitted to IRCC through whatever magic process they use.
Some more patience, and the following Friday, 9 business days after my appointment, I finally got word by logging into the IRCC's ECAS* system that my medical results had been received. Received, sure, but did I pass? That's what we're all wondering, right?
Well, if you're depending on the website to tell you, don't. Upon logging in, the website (in my case, ECAS) will display the following message:
Medical results have been received.
You passed! I passed!
My understanding is that if you have any complex medical issues, IRCC will contact you about those. But if they don't contact you, this is a good thing! No news is good news, and, as some experts in the support Facebook group reiterated to me, it is quite difficult to fail your IME.
That said, it really irks me when people see me, or these posts I make, and say, "Oh my God I would never go through that. That's too much work, that takes too much time, that costs too much!" Sure, it's a lot of work, and a lot of time, and a lot of money, and a lot of other things, too. But wouldn't you go through it to be with the one you love? If you told me I had to go complete a medical exam, complete with pee in a cup and draw some blood for $440, in order to be with my wife of course I'd do it. Of course I did it. Any number of other things I've had to do and will have to do still, of course I will do it.
All in all, the exam itself was painless; I'd even go so far as to call it a positive experience. It's not something to worry about, and it's certainly not something to dismiss as being too much of an inconvenience that it's worth not being with your family over.
If you're going through the process of moving to Canada, depending on what country you're coming from, I'd really recommend you do the exam in your country of origin, if you can afford it. There is really no preparation needed; simply bring the IMM 1017 form (in the email you or your representative will receive), your passport, COVID vaccination info, and photos if they ask for them. The US is known for a million and a half issues with its healthcare system, but the good news is, if you're American or from somewhere with private health insurance, the immigration medical exam process exists largely outside all of that. You will have to pay upfront for the exam no matter where you are (with few exceptions), so if you're going to be paying for it anyway, you might as well go for a place that makes the experience as seamless as possible. Overall, all of these certified panel doctors are very knowledgeable about the process, though (they have to be), and as long as the office you go to is registered with the eMedical online records system, you shouldn't have any trouble whatsoever.
Do you have an experience with the IME process you'd like to share, for Canada or any other country? Any questions you have about the process? I'd love to hear them in the comments, or send me a message!
*For those not in the know, ECAS is one of the several online account systems that Canadian immigration applicants can use to login and look at the status of their application. Each of the many systems has their own issues, which I will go into in its own post sometime, but if you're a Canadian immigration applicant wondering where you can find out about your medical exam status, ECAS will have it.