Medical Certificates for Immigration, Employers and Licensing in Canada: When a Foreign Doctor's Note Needs Translating

For 2026, IRCC's excessive demand threshold is CA$144,390 over five years, or CA$28,878 a year. If a medical officer thinks your health condition may cost more, IRCC sends a procedural fairness letter, and everything you send back must be sent "within 90 days from the date of the letter."

Much of that evidence is medical certificates and specialist reports written abroad, and IRCC reads English and French only. The same problem shows up at work, at Service Canada and at the driver licensing counter: a foreign doctor's note is evidence only once its reader can understand it.

This guide covers which medical documents IRCC, employers, Service Canada and licensing bodies ask for, when a foreign certificate is accepted at all, and what a translation of one must show.

Do I need to translate medical documents for the IRCC medical exam?

No, not for the exam itself. IRCC's immigration medical exam (IME) is done by a panel physician IRCC has approved; in IRCC's words, "Your own doctor can't do the medical exam." The panel physician sends the results to IRCC electronically.

IRCC asks you to bring "any medical reports or test results that you have for any previous or existing medical conditions", along with identification and a list of your current medications. Its guide for panel physicians, the Canadian Panel Member Guide to Immigration Medical Examinations, puts the language duty on them: specialist reports submitted as part of an exam must be in English or French, and if a specialist reports in another language, the panel member must have it translated.

Who needs an immigration medical exam?

Results are valid for 12 months. If you do not land or enter Canada in that time, you may need a new exam.

What happens if IRCC finds a medical issue?

IRCC can refuse an applicant on three medical grounds: danger to public health, danger to public safety, and excessive demand on health or social services. A condition causes excessive demand if its expected cost exceeds the threshold or if the services needed would "negatively affect wait times for services in Canada".

The excessive demand rules do not apply to refugees and their dependants, protected persons, or sponsored spouses, common-law partners and dependent children.

Before refusing, IRCC sends a procedural fairness letter. You may answer with information and evidence on your diagnosis, the medication and services you need, and their cost, for example if a doctor has switched you to a lower-cost equivalent. IRCC may also invite a mitigation plan.

This is where translations decide outcomes. A specialist report from Lahore, a pharmacy invoice from Bogotá or a treatment summary from Kyiv is a supporting document like any other, so IRCC's translation rule applies: a translation by a certified translator or, when the translator is not certified, a translation with the translator's affidavit sworn before a person authorized to administer oaths, such as a notary public or commissioner of oaths. See IRCC translation requirements.

Medical surveillance for inactive tuberculosis

If your exam shows inactive tuberculosis, you are placed on medical surveillance, the only condition for which IRCC currently requires it. You email IRCC's Public Health Liaison Unit your contact details, and the provincial or territorial public health authority contacts you, which "may take months". IRCC calls surveillance a condition of your status; ignoring it can delay later applications such as citizenship.

Can my employer ask for a medical certificate?

Sometimes, and the rules limit what it can see.

Ontario. Since October 28, 2024, employers "cannot require employees to provide a certificate from a qualified health practitioner" for the 3 days of job-protected sick leave under the Employment Standards Act. They may still ask for evidence "reasonable in the circumstances".

Federally regulated workplaces. Under the Canada Labour Code, s. 239(2), after a medical leave of at least five consecutive days, the employer may, in writing within 15 days of your return, ask for a certificate from a health care practitioner. The Code defines that practitioner by reference to "the laws of a province", so ask your employer before relying on a note written abroad.

Accommodation. The Ontario Human Rights Commission says an employer generally "does not have the right to know a person's confidential medical information, such as the cause of the disability, diagnosis, symptoms or treatment". What it can usually expect is that you have a disability, your limitations or needs, and whether you can do the job's essential duties. The Commission also says the employer should bear the cost of required medical documentation, such as doctors' notes.

Health care, education and child care jobs

Hospitals and clinics check immunity before you start. The Canadian Immunization Guide recommends that all health care workers be immune to measles, mumps, rubella and varicella and immunized against hepatitis B, and for measles it accepts "documented evidence of receiving 2 doses of measles-containing vaccine", laboratory evidence of immunity or laboratory-confirmed disease.

A foreign vaccination booklet is documented evidence only if occupational health can read the vaccine names and dates. See vaccination record translation. Remember that IRCC also requires a medical exam for these jobs, even for short work permits; see work permit documents.

Will Service Canada accept a medical certificate from a doctor abroad?

For EI sickness benefits, you need a medical certificate "signed by the treating medical practitioner", and the regulations require it to attest to your inability to work and state "the probable duration". Service Canada may ask for it later, so keep it for six years.

For caregiving benefits, the EI Regulations, s. 41.2, expressly allow a certificate from a doctor or nurse practitioner authorized in another country if the family member you care for is in that country. Service Canada works in English and French, so send a certificate in another language with a translation.

Do licensing bodies accept foreign medical certificates?

Usually not as a substitute for their own forms, but foreign reports often support a review.

• Drivers. RoadSafetyBC's main tool is the Driver's Medical Examination Report, completed by your doctor or nurse. BC requires it when you apply for a Class 1 to 4 licence and on a fixed schedule afterwards: every five years from 25 to 45, every three years from 48 to 63 and every year from 66. Alberta requires drivers by law to report conditions that may affect safe driving. A neurologist's or endocrinologist's report from your home country can help a medical review, translated in full.
• Pilots. Aviation medical certificates require an exam by an aviation medical examiner authorized by Transport Canada.
• Seafarers. Marine medical certificates require an exam by a Transport Canada-designated Marine Medical Examiner.

What must a translated medical certificate show?

Everything the reader checks, exactly as issued:

• The issuer: clinic or hospital, doctor's name, specialty and licence or registration number.
• The patient's name as in the passport, and the date of birth.
• The date of the examination and the date the certificate was issued.
• The period of incapacity, restrictions and fitness statements, word for word.
• Diagnoses, codes and results exactly as written, with units unchanged.
• Vaccine names, doses, dates and batch numbers for immunization records.
• Stamps, seals and signatures, described in brackets.

For longer clinical files, see medical records translation.

Why medical documents get questioned or returned

A summary instead of the report. A one-line note saying "patient is stable" does not answer a procedural fairness letter that asked about medication and cost.

A relative translated it. For IRCC that makes the translation unusable, whatever its quality.

No affidavit for IRCC. A translator's signed certificate without a sworn affidavit does not meet IRCC's rule unless the translator is certified.

Dates misread. Day/month and month/day formats turn 03/04 into two different dates.

Missing licence numbers or stamps. An employer or insurer cannot verify a doctor it cannot identify.

Too much disclosed. Sending a full diagnosis where dates and limitations would do.

Checklist: before you submit a foreign medical certificate

Questions people ask