What Happens at the Immigration Medical Exam for Canada and Australia Student Visas? (2026)

Do Pakistani students need a medical exam for a Canada study permit?

In practice, yes. Canada asks for an immigration medical exam if you plan to stay longer than six months and you have lived in or travelled to a listed country for six months or more in a row in the year before you arrive. Pakistan is one of those listed countries, so a Pakistani student going to a Canadian college for a full academic year is inside the rule from the first day, and IRCC keeps a list of approved panel physicians in Pakistan for exactly this reason. A two year diploma in Ontario, a four year bachelor degree in British Columbia, a one year postgraduate certificate in Alberta: all of them run past six months, so all of them trigger the requirement.

There is a second trigger that catches people who thought they had escaped the first. If you intend to work in a job where public health has to be protected, the exam applies no matter how short your stay or where you have lived. Nursing students on clinical placement fall into this. So do students doing practicums in schools, childcare centres or long term care homes, which is a very common shape for Canadian college programmes.

The medical office that handles Pakistani files is listed as New Delhi. You will not travel there and you will not speak to anyone in it. It is simply where your file is assessed after the clinic in Pakistan uploads it.

You must see a doctor from the list of panel physicians, and your family GP in Model Town cannot do it, however senior they are. That rule catches at least a few families every intake, usually the ones who tried to save time by getting tests done privately before reading the instructions. Those reports are not accepted. The money is gone.

If you are still assembling the wider file, our step by step Canada study permit guide for Pakistani applicants covers where the medical sits in the overall sequence.

Do Pakistani students need a health examination for an Australia student visa?

Almost always. Australia frames it differently from Canada. Rather than a country list attached to a six month rule, Home Affairs runs a single health requirement across most visas, then decides which examinations you need based on your visa, your planned length of stay, and the tuberculosis risk level of your country.

Pakistan is not on the department's list of countries with a low risk of tuberculosis. Any country not on that list is treated as high risk. Combine high risk with a stay of six months or more, which every subclass 500 student visa is, and the examinations follow automatically.

A Pakistani student staying six months or longer normally sits a medical examination, a chest x-ray from age eleven, and a serum creatinine or eGFR test from age fifteen. Under fifteen and the creatinine test drops away. Under eleven and the chest x-ray goes too, which matters for families bringing a younger child as a dependant.

Outside Australia the examination has to be done by a panel physician or panel clinic approved by the Department of Home Affairs, not by a private hospital of your choosing. There is no equivalent of the Canadian rule about your own doctor because the point is the same: the clinic has to be one the department appointed, and it has to submit electronically.

Our subclass 500 guide for Pakistani students sets out where the health examination sits alongside the confirmation of enrolment and the Genuine Student evidence.

Which tests are actually done in the room?

Both countries follow a similar shape. A history, a physical, imaging, then bloods and urine. The detail differs enough to be worth reading properly.

The Canadian immigration medical examination

The panel physician starts with a medical history questionnaire, going through previous and existing conditions and any medication you take. Tell them everything. Hiding a condition does not make it disappear from the file, it just makes the assessment take longer.

Then the physical examination. The clinic will weigh you, measure your height, check your hearing and vision, listen to your heart and lungs, feel your abdomen, check how your limbs move and look at your skin. Genital and rectal examinations are not part of an immigration medical and should not happen. You also have the right to ask for a chaperone at any point, including after you initially said no.

Depending on your age you will then be sent for chest x-rays and laboratory tests, either at the same clinic or at a laboratory it works with. Vaccination is offered but entirely voluntary, and refusing a vaccine is not a reason for refusal of your application.

The Australian health examination

Australia is more prescriptive about who gets which test, and publishes the whole grid. For a temporary visa applicant from a high tuberculosis risk country staying six months or more, the standard set is a medical examination, a chest x-ray from age eleven and a serum creatinine or eGFR test from age fifteen.

Notice what is missing. An HIV test is not part of the standard temporary student set the way it is for permanent applicants. It appears only in specific situations, most commonly if you intend to work, study or train as a doctor, dentist, nurse or paramedic. Medical and dental students from Pakistan should expect a longer list than their classmates in business or engineering, including hepatitis B and C testing.

There is one more trap in the Australian process. The clinic will ask whether you plan to apply for permanent residence in the next six to twelve months, and whether you want to be assessed on that basis now. Say yes and you sit more tests and pay more today. Say no and you may repeat the whole thing later. Neither answer is wrong, but it is a decision, not a formality, and it should not be made on the spot without thinking.

How do you book the exam from Pakistan?

The booking sequence is where the two countries genuinely diverge, and getting it wrong is the single most common way students lose a fortnight.

Canada: contact a panel physician directly

1. Open the IRCC panel physician list, choose Pakistan, and pick a clinic in your city. Islamabad, Lahore and Karachi all have approved clinics.
2. Ring the clinic and ask for an immigration medical examination for a Canadian study permit. Say Canada explicitly. Several clinics handle more than one country and the protocols differ.
3. Take your passport. IRCC strongly recommends the passport rather than a CNIC or driving licence, and you may be asked for it again when you go for the x-ray.
4. Bring any reports for existing conditions, a written list of your current medications, and your glasses or lenses if you wear them.
5. Sit the exam before you submit the study permit application if you can. IRCC calls this an upfront medical exam and it is available to student applicants.
6. Keep the confirmation document the physician hands you at the end. It carries the identifier that proves the exam happened.

Australia: get the HAP ID first, then book

1. Decide whether you are going before or after lodging the visa. The My Health Declaration service lets you complete the examinations before you lodge the visa application at all.
2. If you are going first, complete the My Health Declaration form in ImmiAccount and collect the HAP ID it generates.
3. If you are going after lodging, wait for the Request for Health Examination letter. Home Affairs issues an identifier called a HAP ID, and the panel clinic cannot see your file or start the examination without it.
4. Find an approved panel clinic through the department's own list of services outside Australia, then book using the HAP ID.
5. Attend with your passport. The clinic photographs you and matches you to the HAP ID before anything else happens.
6. If your circumstances changed after you submitted the declaration, tell the clinic on the day rather than assuming the system already knows.

One warning that applies to both. If you cannot attend within the timeframe in the request letter, say so through your account rather than simply missing the appointment. Silence reads as non compliance. A short message explaining a delay does not.

What does it cost, and who exactly do you pay?

Neither government sets or publishes the fee for a panel clinic in Pakistan. The clinic does, and it can change without notice, which is why any blog quoting you a precise rupee figure for 2026 is quoting something it cannot stand behind. Ask the clinic for its current fee when you ring to book, and ask whether the x-ray and laboratory work are inside that figure or billed separately.

What both governments do state plainly is who carries the cost. You pay everything related to the examination at the appointment itself: the panel physician or radiologist, any special tests or investigations, and any specialist you are referred to. If your visa is later refused, none of that is refunded. If you choose to accept a vaccine the clinic offers, that may also be charged separately.

Budget for it as a real line item rather than an afterthought, and remember that every accompanying family member is a separate examination at a separate fee. A student, a spouse and one child is three exams, not one. Our guide to health insurance for Pakistani students studying abroad covers the other medical cost that follows you overseas, which is a different thing entirely and often confused with this one.

• Panel physician consultation and physical examination, charged by the clinic.
• Chest x-ray, sometimes billed by a partner radiology centre rather than the clinic.
• Blood and urine work, which in Australia's case includes the creatinine or eGFR test from age fifteen.
• Any specialist referral, if the physician or the assessing officer asks for one.
• Travel and a day off, since most Pakistani applicants outside the three big cities have to move to reach an approved clinic.

How long does it take, and how long do the results last?

The appointment itself is usually a morning. The waiting afterwards is the part to plan around.

Results are submitted electronically by the clinic, not carried by you, and the clock on the application does not really start until that upload lands. Ask the clinic when it expects to submit rather than when the exam is done. Those are different dates and the gap is where files sit.

A Canadian medical certificate is valid for twelve months from the date of the last medical assessment on your file, which is the detail that decides whether a deferred intake costs you a second exam. Home Affairs says its health examination results are generally valid for about twelve months, so an early examination and a slow offer letter can leave you repeating tests you already paid for. The practical consequence is identical in both systems. If you sit the exam very early, then defer your intake by a semester, you can find the certificate has aged out before the visa is decided, and you pay again.

The safer sequencing for most Pakistani students is to complete the medical once the offer and the enrolment confirmation are genuinely settled, not while you are still deciding between two universities. An exam sat in June for a January intake is a gamble. An exam sat four to six weeks before you lodge is usually sound.

If your file is already running late, our note on what Pakistani students should do after a student visa refusal covers how a fresh application interacts with documents you have already paid for.

What happens after the exam, and what if a result is abnormal?

You will not be told whether you passed. Both systems are explicit about this and it unsettles people, so it is worth saying plainly.

In Canada the panel physician records the results and sends them to IRCC, and IRCC alone decides. The physician hands you a document confirming the exam took place, and that is all you get. If there is a problem, IRCC contacts you in writing.

In Australia the panel physician records the results and makes a recommendation, then the clinic submits both. The physician will not tell you whether you meet the health requirement. Either your case clears without further review, or it goes to a Medical Officer of the Commonwealth, who may ask for more information or further examinations.

An abnormal finding is not automatically a refusal. Tuberculosis is the classic example. An old, healed, inactive scar on a chest x-ray is common in Pakistan and is frequently cleared, sometimes with a condition attached that asks you to report to a health authority after arrival. Active disease is different and needs treatment before the file can move. What turns a manageable finding into a lost intake is almost always delay: an applicant who ignores a request for a sputum test for three weeks has added three weeks to their own timeline.

If you are asked for extra tests, treat that request as the most urgent item in your file. Book it the same week. Nothing else in the application is waiting on you the way that is.

What has changed recently, and what should you watch?

As of 26 August 2026, IRCC has extended a temporary public policy that exempts some people already inside Canada from repeating the exam, and it runs until 5 October 2029. Read the limit carefully, because Pakistani agents misquote it constantly. It is aimed at people who are already in Canada, who completed a previous exam within the last five years, and whose earlier result showed low or no risk to public health or public safety. A first time applicant sitting in Lahore does not benefit from it. A student already in Canada extending a study permit may well do.

Australia's structural rules have been stable, but the tuberculosis risk list is not fixed forever. It is set by a legislative instrument and it follows World Health Organization data, so countries do move between the low and high risk columns. Pakistan sits firmly in the high risk column today. Check the department's list yourself rather than assuming it matches what a cousin was told two years ago.

The steadier point is that neither country has softened the requirement for students. If anything, both have tightened the administration around it: electronic submission only, panel clinics only, and identity checks at the clinic door. The days of walking in with a private laboratory report are gone.

A worked example, with real dates

Take Ayesha, twenty two, from Lahore, holding an offer for a two year master's in Melbourne starting in late February 2027. She wants to lodge her subclass 500 in early October 2026.

• Late August 2026: offer accepted and the enrolment confirmation issued, so the file is finally stable enough to spend money on.
• First week of September: she completes the My Health Declaration in ImmiAccount and receives her HAP ID the same week.
• Second week of September: she books an approved panel clinic in Lahore, quoting the HAP ID, and asks whether the x-ray is billed separately. It is.
• 19 September: the appointment. Medical examination, chest x-ray, and a creatinine test because she is over fifteen. About four hours including the wait.
• 25 September: the clinic confirms it has submitted electronically. She notes the date, because that is the one that matters.
• Early October: she lodges the visa. The health case is already sitting on her file rather than being requested later.
• February 2027: she flies. Her examinations are roughly five months old, comfortably inside the twelve month window.

Now change one thing. Suppose Ayesha had sat the exam in March 2026, when she first started thinking about Australia, and then deferred from the July intake to February. By the time the visa was decided she would have been near the edge of the validity window, and a second round of tests was a real possibility. The exam is cheap to sit at the right moment and expensive to sit twice.

A Canadian version of the same story runs almost identically, with the upfront exam sat about four to six weeks before the study permit application, and the confirmation document uploaded with the submission.

Which mistakes cost Pakistani students the most time?

• Using a private hospital instead of an approved panel clinic, then discovering the report cannot be accepted.
• Booking an Australian appointment without a HAP ID, which the clinic cannot process at all.
• Sitting the exam months too early, then deferring the intake and aging the certificate out.
• Hiding a treated condition, which lengthens the assessment instead of shortening it.
• Missing the timeframe in a request letter without telling the department why.
• Assuming one exam covers the whole family when each dependant needs their own.
• Confusing this with the UK TB certificate and booking the wrong appointment entirely.
• Ignoring a request for follow up tests for weeks, which is the single most expensive delay in the whole process.

Several of these overlap with the other document Pakistani students routinely underestimate. If your file also needs one, see which student visas need a police character certificate from Pakistan, because the sequencing problems are the same.

Canada and Australia side by side

Frequently asked questions