Updated January 2020

Tuberculosis medical surveillance (TBMS) is a medical check-up for a person who is newly arrived or has applied for a change in immigration status in Canada, to check that they still do not have active TB disease. This is a requirement of Immigration, Refugee and Citizenship Canada (IRCC).

When you applied to come to Canada to live, work, study or visit for six months or more, you were required to have an Immigration Medical Exam (IME) by an IRCC doctor. Your IME showed that you have inactive TB or had TB disease in the past. This means you have a higher risk of getting sick with TB in the future. Therefore, a second TB check-up is required to protect you, your family and the general public.

1. Speak to a  Public Health TB nurse and get a TBMS package

If you live in Toronto, Toronto Public Health (TPH) will contact you by phone or by mail. If you have not been contacted after one month of arriving in Canada or being notified that you require TBMS, call TPH at (416) 338-7600 and speak with a TB nurse (translators available). The nurse will ask you some initial health questions and send you a TB medical assessment form with instructions

2. See a doctor or nurse practitioner

Bring the TB medical assessment form to a doctor or nurse practitioner of your choice. The doctor/nurse practitioner will complete the form, order a chest x-ray and other tests if necessary. Ask your doctor/nurse practitioner to fax your completed form and test results to TPH by fax at (416) 338-8149.

3. Get your TBMS compliance letter

Once all of your medical reports have been received by TPH, your TB nurse will review them. If no further follow-up is needed, the nurse will notify IRCC that you have complied with the requirements of TBMS and will send you a letter as proof of your compliance within one to two weeks after your doctor/nurse practitioner submits your medical reports.

The average time for TBMS in Toronto is four to six months. Toronto Public Health will provide you with a due date to complete your medical check-up.

The cost of tuberculosis (TB) medical surveillance in Ontario can be covered by the Ontario Health Insurance Plan (OHIP). To find out if you are eligible, please call the Service Ontario INFOline¬† at 1-800-268-1154 or visit the Ministry of Health’s Apply for OHIP and Get a Health Card web page.

If you are not eligible for OHIP and do not have any insurance coverage, you must pay the costs for the TB medical surveillance check-up. Costs are variable.

IRCC determines if you need TB medical surveillance, and it is a “condition of landing”. This condition will be removed from your immigration file once you have met the requirements.

If you do not complete TB medical surveillance, it may impact your current and/or future immigration applications.

If you leave the country before completing TB medical surveillance you may be questioned at the border/airport the next time you return to Canada.

If you are diagnosed with active TB disease, a TB nurse from TPH will work with you and your doctor while you are being treated. Being diagnosed with active TB disease does not affect your immigration status in Canada or your family’s status. TB treatment is free of charge in Ontario even if you do not have health insurance.

It is important to tell us if you change your address, phone number or leave the country while you are on TB medical surveillance.

You may also need to repeat TB medical surveillance if you renew your visa or change your immigration status.

Taking latent TB infection (LTBI) treatment does not delay your TBMS. After your medical check-up, your doctor or nurse practitioner may recommend LTBI treatment; if you start LTBI treatment, your TB nurse will notify IRCC that you have complied with TB medical surveillance and then TPH will send your doctor or nurse practitioner your free LTBI medications.

If you develop signs and symptoms of active TB before you have your TB medical surveillance check-up, speak to your doctor/nurse practitioner right away or call your TB nurse at TPH. We can help you get medical care. Symptoms of active TB may include:

  • cough for three weeks or more
  • fever
  • coughing up blood
  • sweating at night
  • constant tiredness
  • loss of weight and/or appetite