Updated December 2023
Tuberculosis immigration medical surveillance (TB IMS) is a requirement of Immigration, Refugees and Citizenship Canada (IRCC) for specific individuals.
When you applied to come to Canada to live, work, study or visit for six months or more, you are required to have an Immigration Medical Exam (IME) by an IRCC doctor. If 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 after arrival in Canada to protect you, your family and the general public. That check-up is “TB Immigration Medical Surveillance”.
If you live in the city of Toronto (postal code begins with ‘M’), there are two ways to report for TB IMS.
You must report to the public health unit where you live. If you live outside the City of Toronto (your postal code does not start with the letter “M”), find which public health unit is for you.
Approximately six to nine months from the time you reported to TPH, a TB nurse will send you a TB medical assessment form with instructions to see a health care provider. Bring the TB medical assessment form to a doctor or nurse practitioner of your choice. TPH does not see clients for medical appointments.
Find a doctor or nurse practitioner if you don’t have one already.
The doctor/nurse practitioner will complete the form, order a chest x-ray and other tests if necessary. Ask your doctor/nurse practitioner to send your completed form and test results to TPH by fax at (416) 338-8149.
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 TB IMS. The TB nurse will send you a letter as proof of your compliance within four to six weeks after your doctor or nurse practitioner submits your medical reports.
The average time for TB IMS in Toronto is nine to twelve months. Toronto Public Health will provide you with a due date to complete your medical check-up.
The cost of TB IMS 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
If you are waiting a few months until your OHIP coverage comes into effect, you can wait to book your TB medical check-up until you have OHIP coverage.
If you develop signs and symptoms that could be active TB disease before you have your TB IMS medical check-up, speak to your doctor or nurse practitioner right away or call Toronto Health Connections at 416-338-7600 and ask to speak with a TB nurse.
If you are not eligible for OHIP and have private health insurance, contact your insurance provider directly to find out if the TB immigration medical surveillance medical check-up is covered by your policy.
If you are not eligible for OHIP and do not have any insurance coverage, you must pay for the costs of the TB IMS medical check-up and tests. Costs are variable but can be as high as $250 dollars.
For more information about finding health care if you do not have any health coverage:
IRCC will only accept TB medical assessments carried out in Canada to meet the requirements of TB immigration medical surveillance.
It can take up to twelve months to complete the TB IMS process. If you are staying in the City of Toronto now, but plan on moving to another city in the next few months, we recommend you get your TB medical check-up in the health unit you will be living in for at least six months.
It is important to tell us if you change your address, phone number, or leave the country while you are on TB immigration medical surveillance. Please notify:
In the email include your:
If you leave the country before completing TB immigration medical surveillance, the TB IMS condition of landing will still be on your immigration file. This means border officials may ask you about it when you re-enter Canada.
If IRCC refers you for TB immigration medical surveillance, there will be a “condition of landing” on your immigration file. This condition will be removed from your immigration file once you have completed TB immigration medical surveillance.
If you do not complete TB medical surveillance, it may impact your current and/or future immigration applications.
If you are diagnosed with active TB disease during the medical checkup, it will not affect your immigration status or your family’s status.
If you have any questions about why you were placed on TB medical surveillance, please contact Immigration, Refugees, and Citizenship Canada.
If you are diagnosed with active TB disease, a TB nurse from TPH will work with you and your doctor or nurse practitioner 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.
If you are diagnosed with TB infection (you are not sick, the TB bacteria is not active in your body and cannot spread it to others), there is free medication you can take to prevent you from getting sick in the future.
After your medical check-up, your doctor or nurse practitioner may recommend preventative treatment. Taking TB preventative treatment for TB Infection does not delay your TB immigration medical surveillance or affect your immigration status. TPH provides free TB medication for preventative treatment to anyone living in Toronto, regardless of health coverage or immigration status.
If you develop signs and symptoms that could be active TB disease before you have your TB IMS medical check-up, speak to your doctor/nurse practitioner right away or call Toronto Health Connections at 416-338-7600 and ask to speak with a TB nurse. We can help you get medical care, even if you don’t have health insurance. If you are diagnosed with active TB, this does not affect your immigration status.