Time-bound / policy-specific note: this guidance reflects an IRCC policy change around upfront medical exams that applied to Invitations to Apply (ITAs) issued after October 1, 2023. Always confirm current requirements on IRCC's official Express Entry page, since eligibility rules like this can change again.
- If your ITA falls under the policy where upfront medicals aren't required, the PR application portal will still show a document upload slot for the medical exam — this is a known quirk, not a sign you did something wrong.
- Group consensus: upload a blank document as a placeholder in that slot so the application can be submitted without the system blocking you for a missing file.
- The actual medical instruction letter is issued later, similar to how biometrics instructions are typically issued after the initial application submission — so you're not skipping the medical exam, just deferring it to when IRCC formally requests it.
If you're unsure whether your specific ITA date qualifies for this exemption, check IRCC's current instructions before assuming a blank upload is the right move for your case.