What the September 1 update says
IRCC updated its program delivery instructions on processing permanent residence applications from protected persons (admissibility) on September 1, 2026. The update revised the medical examination section so that it reflects regulatory amendments that took effect on October 30, 2025.
Those amendments replaced a temporary public policy that the Minister signed on September 10, 2020. That policy exempted certain protected persons in Canada who were applying for permanent residence, together with eligible family members, from an additional immigration medical examination. The instructions say the new rules apply to all new and pending applications from people who meet the eligibility criteria.
This is a clarification of instructions for officers. It is not a new blanket exemption that began in September 2026.
Who must still do the exam
IRCC's instructions state that protected persons, including members of the protected temporary residents class, and their accompanying family members in Canada and abroad are required to undergo an immigration medical examination if they are not covered by the exemption. Officers check IRCC's system to see whether the applicant and family members in Canada have already completed an exam, and if an exam has not been completed they send medical forms.
The exact eligibility criteria for the exemption are set out in the regulations and in the medical examination section of IRCC's instructions. Do not assume that an earlier exam removes the requirement in every case. If IRCC sends medical forms, follow the instructions in your file.
Health inadmissibility still applies in one respect
Inadmissibility on health grounds because of excessive demand on health or social services does not apply to protected persons, including members of the protected temporary residents class, or to their family members in Canada and abroad. They can, however, still be inadmissible on health grounds if they are likely to be a danger to public health or public safety. An application for permanent residence from an inadmissible person is refused, but the refusal does not change the finding that the person needs protection.
Other parts of the file
The same instructions cover other admissibility steps, including security checks and biometrics. A medical-exam exemption concerns only the need for another medical examination; it does not remove the other requirements of the permanent residence process.