Permanent Residency Updates: New Medical Test Requirements & Alternative Language Test

Obtaining permanent resident status in Canada is a common goal for new Canadian immigrants and foreign nationals who wish to come to Canada, as it is a crucial step in becoming a Canadian citizen. The 2025-2027 Immigration Levels Plan anticipates nearly 400,000 permanent resident admissions in 2025. There are several categories of permanent resident admissions, including family sponsorships, provincial nominee programs, express entry, and business immigration, as well as subcategories within these categories. Although all categories have different requirements that potential applicants must meet, there are some commonalities between them. The most important commonality is that applicants must adhere to the application requirements for their application to have the best chance of success.

One of the common requirements for permanent residency applications has just been changed, and another common requirement has had a new option added. New applicants need to be aware of these changes before submitting their applications.

Updated Permanent Residency Medical Test Requirements

Immigration, Refugees and Citizenship Canada announced a change to the permanent residency medical exam requirements on August 21, 2025. The change to the medical test will impact Express Entry applications, but not other applications for permanent residency, which are still subject to the previous requirements that involve Immigration, Refugees and Citizenship Canada sending the applicant instructions on how to obtain their medical exam.

However, the change will now require Express Entry applicants to do an upfront medical exam before they can apply for Express Entry. To book an upfront medical exam, potential applicants should contact an approved physician. The applicant is responsible for the cost of the exam, and if taken in Canada, the cost is typically less than $200.

Exemptions

However, a temporary public policy currently exempts certain foreign nationals in Canada from the immigration medical exam requirement until October 5, 2029. If an applicant already lives in Canada, has applied for permanent or temporary residence, has completed an immigration medical exam in the last five years, and the previous immigration medical exam indicated a low risk or no risk to public health or safety, the applicant can use their previous exam and will be exempt from having to take another one. 

Rationale for Immigration Medical Exams

The Canadian government requires immigration applicants to undergo medical examinations to determine if they are medically admissible to Canada. Individuals can be inadmissible to Canada if they are found to pose a threat to the health and safety of Canadians or if they are likely to place a significant burden on Canada’s health care system. Usually, if medical inadmissibility is found, it is because the foreign national would place an excessive demand on Canada’s health care system. This assessment is conducted by comparing the estimated cost of treating the Applicant’s health conditions in Canada with the excessive demand cost threshold. If the cost is over the threshold, the Applicant is likely to be found inadmissible. As of 2025, the cost demand threshold is $27,162 per year, or $135,810 over five years.

New Language Test Option to Be Made Available for Permanent Residence Applicants

Many permanent resident applicants are required to take a language test in either English or French. Immigration, Refugees and Citizenship Canada set out the approved tests. There are different tests and language requirements for applicants depending on whether their language proficiency is in English or French. English uses the Canadian Language Benchmarks, and French uses the Niveaux de compétence linguistique canadien.

The minimum level of proficiency required in English or French varies depending on the program being applied for, as the Canadian Experience Class, Federal Skilled Worker Program, and Federal Skilled Trades Program each have distinct requirements. For example, the Canadian Experience Class has different language proficiency requirements depending on the National Occupational Classification to which an applicant is applying, with a benchmark of 7 for some classifications and a benchmark of 5 for others. Further, the Federal Skilled Worker Program has a higher language proficiency threshold than the Federal Skilled Trades Program, as the Federal Skilled Worker Program requires a benchmark of 7 in French and English. In contrast, the Federal Skilled Trades Program requires benchmarks of 5 in speaking and listening, and 4 in reading and writing, in both French and English. 

There are three different approved language tests in English, and two in French. The English tests are CELPIP, IELTS, and PTE Core. The French tests are TEF Canada and TEC Canada. When an applicant takes one of these approved tests, they can use the test results as part of a permanent residence application, provided the test results are less than two years old.

New Test for Canadian PR Applicants

On August 21, 2025, the Education Testing Service announced that Immigration, Refugees and Citizenship Canada added them to its list of designated language testing organizations. The Education Testing Service administers the Test of English as a Foreign Language Essentials. The announcement states that the test will be available for use by applicants in Canadian permanent residence applications. 

Currently, the test is not accepted by Immigration, Refugees and Citizenship Canada. However, the Education Testing Service has indicated they are working with Immigration, Refugees and Citizenship Canada on the steps leading to acceptance. The date that the test will first be accepted, as well as timing and test location details, will be announced at a later date. 

About the Test

The test measures an applicant’s listening, reading, writing, and speaking skills in English. The test can be completed in approximately one and a half hours at a test center. Test takers can expect to receive their official results from the test within six days after taking it.

The addition of the new test should be a positive for applicants, as it represents another option applicants can use to satisfy the language requirements of their applications.

Contact Garson Immigration Law in Toronto for Trusted Immigration Solutions

Garson Immigration Law is a Toronto-based law firm that helps individuals find solutions to their immigration needs, including obtaining permanent residence in Canada and overcoming inadmissibility. Our focus on immigration allows us to understand our clients’ unique concerns and obstacles. Our skilled immigration lawyers have extensive expertise in all immigration matters, including work permits, student visas, and US immigration from Canada. If you have any questions about an immigration matter, do not hesitate to contact us online or call us at 416-321-2860.