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DETAILS:Conducting an Immigration Medical Examination
In conducting a Canadian immigration medical examination, the practitioner performing the examination will undertake the following activities.
Provide a routine appointment for Canadian IMEs within 14 days of a request by a person who presents with a Medical Report form IMM 1017 or
other relevant document as indicated in Appendix II, “Guide to the Completion of the Medical Report Forms for Canadian Immigration.”
DMPs performing IMEs on international students may be requested by regional medical officers to schedule IME appointments for students on shorter
notice. DMPs unable to meet these requests should discuss the issue with their responsible regional medical officer.
In rare instances, CIC will request an expedient medical examination in situations of emergency. In those situations, a DMP is expected to arrange
an appointment within 24 hours.
Verify that the person presenting for examination is the person pictured in Medical Report: Section A; Client Identification & Summary. See Section
11.2 regarding verifying identity and using the DMP stamp to authenticate the photograph.
Ensure that the applicant, or parent/guardian, completes and signs Medical Report: Section B; Functional Inquiry, Background Information and
Applicant's Declaration (IMM 5419).
Carefully review and provide details on the applicant's responses to the questions regarding functional inquiry in Medical Report: Section B (IMM 5419).
Perform a comprehensive physical and mental examination, and provide a complete report of this assessment by completing Medical Report: Section
C; Examining Doctor's Findings (IMM 5419).
Attach the applicant's photograph to the appropriate places on Medical Report: Sections D and E (IMM 5419). Using the official DMP stamp, stamp
over the right end of the required signature areas and the top right corner of the photographs of the applicant on the IMM 1017 and IMM 5419.
Ensure that the applicant or parent/guardian signs the Applicant Declaration in Medical Report: Section D (IMM 5419).
Provide appropriate age-defined laboratory investigations as specified in Medical Report: Section D; Laboratory Requisition (IMM 5419):
urinalysis (protein, glucose and blood by dipstick—if blood positive, then microscopic report required) for applicants five years and over;
serological test for syphilis for applicants 15 years and over;
HIV testing for applicants 15 years of age and over, as well as for those children who have received blood or blood products, have a known HIV-
positive mother, or have an identified risk. An ELISA HIV screening test should be done for HIV 1 and HIV 2; and
serum creatinine if the applicant has hypertension (resting blood pressure greater than 140/90 mm Hg), a history of treated hypertension,
diabetes, autoimmune disorder, persistent proteinuria, or kidney disorder.
Note: Excessive demand exempt applicants are not required to undergo serum creatinine testing even if the above-noted conditions are
present.
Provide applicants having an HIV test with HIV pre-test counselling. Ensure HIV-positive applicants receive post-test counselling and sign the
acknowledgement of HIV post-test counselling form. Further information on HIV testing issues is located in Appendix II “Guide to the Completion of
the Medical Report Forms for Canadian Immigration.”
Have the person performing the phlebotomy and/or receiving the laboratory specimen(s), sign the signature box in Medical Report: Section D;
Laboratory Requisition (IMM 5419), confirming that the sample was collected from the individual identified on the form.
Provide an adequately labeled (name, date of birth, date of exam as per Gregorian calendar) postero-anterior chest x-ray film for applicants 11
years and older, and for those under 11 years of age if there is any relevant history or clinical indication. Examples of situations where applicants
less than 11 years of age would provide a chest radiograph include an immediate family member suffering from or under treatment for tuberculosis,
chronic respiratory disease such as cystic fibrosis, previous thoracic surgery, cyanosis or respiratory insufficiency that limits activity.
Have the x-ray technician or radiographer sign the declaration (item 2, page 1) in Medical Report: Section E; Chest X-ray Report (IMM 5419), to
certify that the x-ray was taken of the person whose photograph and signature are on the form.
Have the radiologist complete the Chest X-ray Interpretation, the Record of Special Findings Noted, and the Certification in subsections 3, 4 and 5
of Medical Report: Section E; Chest X-ray Report (IMM 5419).
Unless otherwise advised, ensure that the radiologist provides the labeled image of the chest x-ray either on CD (in an envelope, not a jewel case)
or film.
Ensure that the radiologist provides sufficient detail in the examination report to substantiate a definitive diagnosis or a requirement for additional
investigation.
Complete a summary of abnormalities and provide an opinion as to prognosis in the summary blocks of Medical Report: Section A (IMM 1017) and
Section C (IMM 5419) for each applicant based on the history, mental/physical examination and diagnostic tests.
Collate the completed Medical Report forms (in order) with laboratory reports and chest x-ray(s), and then arrange for the direct and timely
transmission of these documents, by mail or courier, to the RMO. Medical office contact information is available in Appendix I.
Provide or arrange for the provision of such supplementary reports or diagnostic tests as may be requested or required by standing instructions
issued by a CIC medical officer. These supplementary reports and/or diagnostic tests should be sent directly from the laboratory or consultant to
the DMP for collation and transmission to the RMO.
Provide medical advice to an applicant with respect to any finding which is unknown to the applicant. In so doing, normal professional and ethical
standards will be upheld with respect to referral back to the applicant's usual attending physician or applicable referral to an appropriate specialist,
if the applicant so requests.
Personally conduct all clinical activities with respect to the medical examination of the applicant. When further medical reports are requested by a
medical officer, these reports must be provided by a specialist of the DMP's choosing. Reports provided by a physician of the applicant's choosing
are not acceptable, although the applicant's previous medical records can be provided in addition to the currently requested report.
Specialists or consultants preparing additional reports requested as part of the IME should be advised that their reports should be objective,
detailed and limited to the question posed. They should not include comments about their impressions regarding suitability for immigration or fitness
for travel.
These reports should be complete and contain a thorough clinical review, discussion and interpretation of clinical findings. Prognostic determination
should be based on the anticipated clinical course and likely need for intervention or treatment (medical and/or surgical) over the following several
(five) years.
It is the DMP's responsibility to select specialists and consultants who are able and willing to provide complete reports.
Note: The DMP does not provide an assessment in terms of the medical admissibility or inadmissibility of the applicant to Canada. DMPs must
take care not to make any statements or provide any indication to applicants which might be construed as implying a favourable or unfavourable
immigration assessment outcome. This is the responsibility of the visa or immigration officer.
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