Medical surveillance is a follow-up health check for new Canadian immigrants who had inactive tuberculosis (TB) detected during their immigration medical exam. It involves appointments over 6-12 months to confirm that TB remains inactive, protecting your health and your community's wellbeing.
Key Takeaways
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Understanding Your Medical Surveillance Requirement
Moving to Canada involves many health requirements, and if your immigration medical examination reveals inactive tuberculosis, you'll need one additional step: medical surveillance.
Medical surveillance is a medical check-up for a newly arrived person in Canada to ensure their inactive tuberculosis hasn't progressed to active tuberculosis.
It is required for anyone who was assessed as having inactive tuberculosis on their immigration medical examination (IME). This requirement helps protect both your health and those in your new Canadian community.
Who Needs This Follow-Up?
You'll need medical surveillance if your immigration medical screening showed:
- Inactive tuberculosis in your lungs or elsewhere in your body
- Previous TB infection that's now dormant
- Positive TB skin test, combined with chest X-ray changes consistent with TB
Inactive tuberculosis is the only medical condition for which medical surveillance is currently required. If you had other health issues during your immigration exam, those won't require this specific follow-up.
Important Exception: If you had an immigration medical examination inside Canada and were seen by a tuberculosis clinic, you may not need medical surveillance and may not be contacted by the public health authority.
Your family members only need surveillance if they also had inactive TB detected during their own medical exams.
What to Expect From the Medical Surveillance Process
Step 1: Receive Your Medical Surveillance Undertaking Form
If you are placed on medical surveillance, Immigration, Refugees, and Citizenship Canada will provide you with a Medical Surveillance Undertaking Form (IMM0535) upon arrival in Canada. Individuals already in Canada will receive this form by email.
Step 2: Understand Your Reporting Timeline
The IMM0535 form instructs individuals to contact their local public health authority within 30 days of their arrival. However, different timelines depend on your case:
- Standard cases: 30 days to contact the public health authority
- Complex/urgent cases: complex inactive pulmonary tuberculosis and other complex, non-infectious tuberculosis cases should be reviewed by provincial or territorial public health authorities within 7 days of entry to Canada
Important Note: If you were given a document at the port of entry telling you to report to your provincial or territorial public health authority in Canada within 7 or 30 days after arriving in Canada, you can disregard it. The current process uses the IMM0535 form system.
Step 3: Provide Your Canadian Contact Information
IRCC needs your contact information in Canada to start the medical surveillance process. Email your details to the Public Health Liaison Unit at
IRCC.MHBSurveillance-SurveillanceDGMS.IRCC@cic.gc.ca, including:
- Your full name
- Your UCI (Unique Client Identifier) number
- Your complete Canadian address
- Your phone number
Step 4: Wait for the Local Health Authority Contact
The public health authority is responsible for arranging your medical surveillance appointment. Each public health authority has its own procedure and timeline for managing these appointments. It's possible that it may take months for them to contact you.
Step 5: Attend Your Medical Consultation
Based on protocols from health authorities like Ottawa Public Health, your appointment will include:
History and physician exam to assess for TB symptoms for both pulmonary and extra-pulmonary TB (e.g., TB of the lymph nodes). Chest X-ray to rule out active pulmonary TB – anterior/posterior and lateral.
Additional components include a comprehensive health status evaluation:
- Health questionnaire about any new symptoms
- Physical examination focusing on your respiratory system
- Discussion about your overall health since immigration
Step 6: Receive Confirmation
Once you've had your appointment, the public health authority will inform the Public Health Liaison Unit at IRCC that you comply with your medical surveillance requirement. The Public Health Liaison Unit will email you within 2 months to confirm this.
Why Does Surveillance Matter for Someone With Inactive Tuberculosis?
Many people feel anxious about having inactive TB, but understanding the difference can ease your concerns.
Inactive TB Means
- You may not have any TB symptoms since inactive TB doesn't make you feel sick
- You cannot spread TB to others
- The bacteria are "sleeping" in your body
- While you may not have active TB now, you may still get it at some time in your life
Active TB Means
- Someone with active TB in the lungs and throat can spread it to others through coughing and sneezing
- You would have symptoms like a persistent cough, fever, or weight loss
- You need immediate treatment
TB is treatable, whether active or inactive.
Regional Implementation Across Canada
Medical surveillance works slightly differently depending on where you live in Canada:
Greater Toronto Area
- Toronto (Postal Codes Starting with 'M'): You can complete reporting online. You can call Toronto Health Connections at 416-338-7600 to report by phone (interpreters are available if you speak another language).
- Toronto Process: 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.
Southwestern Ontario
London and Middlesex County: Call 519-663-5317 (Monday to Friday between 8:30 a.m. and 4:30 p.m.) and ask to speak with the Infectious Disease Control Team.
Timeline Expectations
Important: Timeline varies significantly by location and individual circumstances:
- Toronto: The average time for TB IMS in Toronto is nine to twelve months
- Middlesex-London: In Middlesex-London, the medical surveillance program usually takes 6 months to complete
- General: It can take up to twelve months to complete the TB IMS process
What Are the Costs and Insurance Coverage?
The financial aspect of medical surveillance varies based on your insurance status:
Provincial Health Coverage (OHIP in Ontario)
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.
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.
Private Insurance Options
If you are not eligible for OHIP and have private health insurance, contact your insurance provider directly to determine if your policy covers the TB immigration medical surveillance check-up.
Specific Coverage Notes
Most health insurance plans, such as the Ontario Health Insurance Plan (OHIP), Interim Federal Health Program (IFHP), and some school or university insurance plans (UHIP), will cover any other doctor visits or chest X-ray exams. Please note that MorecCare and UHIP do not usually cover the X-ray cost for IMS purposes.
Out-of-Pocket Costs
If you are not eligible for OHIP and do not have insurance coverage, you must pay for the TB IMS medical check-up and tests. The costs are variable but can be as high as $250.
Free Treatment Guarantee
Critical Information: TB treatment is free of charge in Ontario, even if you do not have health insurance. If active TB is discovered, treatment won't cost you anything.
TPH provides free TB medication for preventative treatment to anyone living in Toronto, regardless of health coverage or immigration status.
Impact on Your Immigration Status
Medical surveillance isn't optional, but it's a legal requirement that affects your status in Canada.
Medical surveillance is a condition of your status in Canada. You must complete your medical surveillance requirement as soon as possible.
Consequences of Non-Compliance
- Your Canadian citizenship application could be delayed until the provincial or territorial public health authority confirms with IRCC that you've complied with the conditions of your medical surveillance.
- Future immigration applications may face delays.
- If you leave the country before completing the 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.
Common Concerns and Practical Solutions
"I'm worried about the language barrier."
If you need someone who speaks your language for your initial appointment (usually by phone), a professional interpreter can be provided at no cost.
"I need to move to another city."
If you plan on moving to another city in the next few months, we recommend that you get your TB medical check-up in the health unit where you will be living for at least six months.
"I'm scared about what they might find."
Remember that being diagnosed with active TB disease does not affect your immigration status in Canada or your family's status. The goal is to keep you healthy, not to penalize you.
Moving Forward After Completion
Once you successfully complete medical surveillance, you'll receive confirmation that this condition has been removed from your immigration file. This enables:
- Applying for Canadian citizenship without delays
- Pursuing other immigration applications
- Full integration into Canada's healthcare system
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.
Your Action Plan
- Wait for your IMM0535 form or contact IRCC if you haven't received it
- Contact IRCC immediately with your Canadian address information
- Contact your local public health authority within 30 days (or 7 days for complex cases)
- Respond quickly when your local health authority contacts you for appointments
- Prepare for your consultation by gathering any relevant medical documents
- Ask questions during your visit—healthcare providers are there to help
- Keep records of all communications and appointments
Complete Your Immigration Medical Journey with Expert Care
Understanding medical surveillance is just one part of your immigration health requirements. Whether you need your initial immigration medical exam or follow-up care, GTA Immigration Medical Markham provides comprehensive, professional service from IRCC-approved panel physicians who understand your unique needs.
Our caring team supports you through the complete immigration medical exam process with same-day testing, multilingual services in Cantonese and Mandarin, and a convenient Markham location serving the entire GTA. With 100% e-medical processing and direct submission to Immigration, Refugees and Citizenship Canada, we make your medical requirements simple and stress-free.
Ready to complete your immigration medical requirements? Book your appointment online or call (365) 509-2311 today. Located at 3603 Highway 7 E, Unit 102, Markham – easily accessible from Toronto, Scarborough, Richmond Hill, and Vaughan, with free parking available.
