The visa medical examination from Pakistan: what it covers (2026)

What is a visa medical examination for?

Governments ask for a medical examination for two reasons, and they are different. One is public health, above all active tuberculosis. The other is money: whether treating a condition would place a significant cost or demand on the country’s own health system.

The public health side

The United Kingdom runs the narrowest version. The gov.uk guidance says you will be given a chest x-ray to test for TB, and that if the result is not clear you may be asked for a sputum sample. It then says plainly that you do not need any other tests to check for TB for your visa application. That is the whole requirement for most applicants from Pakistan.

The cost side

Australia is the clearest about the second reason. The Department of Home Affairs says meeting the health requirement protects the community from public health risks, especially active tuberculosis, helps control spending on services, and makes sure citizens and permanent residents can access services in short supply. To meet it you must be free from any disease or condition that is a significant healthcare and community service cost, or that is likely to limit access for others by placing demand on services in short supply.

The decision is not the doctor’s

One point runs through all four systems. The clinic examines you, and the government decides. IRCC says the panel physician does not make the final decision about your medical exam, and that IRCC makes that decision. In Australia a Medical Officer of the Commonwealth assesses the results. A clinic that tells you it will sort out a condition for you is not describing anything that exists.

The UK: who actually needs a TB test?

Most Pakistani students and spouses do, and a surprising number of visitors do not. The rule is a combination, and all parts have to be true.

The three-part test

The gov.uk guidance says you will need a TB test if all of the following are true: you are coming to the UK for 6 months or more, you have lived in one of the listed countries for 6 months or more, and you were living there, or in another listed country, within the last 6 months. Pakistan is a listed country with its own approved clinic page.

So a six-week UK visit visa from Pakistan does not need a TB test. A one-year master’s does. A UK visit visa for a short trip and a UK student visa are two different answers on the same question.

The routes that need it whatever the length

• a Returning Resident visa;
• a family visa as a fiancé, fiancée or proposed civil partner, which the Pakistan clinic page names specifically;
• a returning resident who has been away for more than 2 years;
• a British National (Overseas) visa applicant already in the UK who did not provide a TB certificate on arrival.

The fiancé rule catches couples out every year. The UK fiancé visa guide covers that route, and a TB certificate belongs in the file even though the visa itself is granted for six months.

Who is exempt

The exemption list on gov.uk is short. You will not need a TB test if you are a diplomat accredited to the UK, if you are a returning UK resident who has not been away for more than 2 years, or if you are coming on a scheme to support people from Ukraine. Children are not on that list.

The UK: the approved clinics in Pakistan and what they charge

The Home Office publishes the clinic list with addresses, contact details and fees, and the current version was updated on 20 February 2026. Two providers operate in Pakistan, and they do not charge the same.

The same test, a thousand rupees apart

Both providers are approved by the same Home Office for the same certificate, and the published fees differ by PKR 1,000 per adult. For a family of four travelling together that is PKR 4,000, which is worth a phone call. The fees above are what the Home Office page published in February 2026, so confirm the current figure with the clinic before you attend.

Opening hours and contact

The page lists AMC as open Monday to Friday, 9:30am to 4:30pm, and the IOM clinics as Monday to Thursday 8am to 4:45pm and Friday 8am to 12:30pm. IOM appointments for UK TB screening go through a single appointments email address and a UAN number used across all its Pakistani clinics. No fee is published for the Karachi IOM clinic, so ask it directly.

Do not pay anyone to book it

IOM’s own Pakistan page says it does not charge any fee for taking an appointment, and recommends clients call its call centre directly rather than paying anyone to take an appointment for them. Anybody offering to arrange a UK TB appointment for a fee is selling you something the clinic gives away. The guide to checking a visa consultant in Pakistan covers how to verify who you are dealing with.

The UK: validity, children and pregnancy

The validity period is the detail that costs students the most money, and it is a single sentence on the gov.uk page.

Six months from the x-ray

The guidance says you will be given a certificate which is valid for 6 months from the date of your x-ray. Not six months from when you apply, and not six months from when the certificate is printed. From the x-ray.

A student who takes the test in February for a September intake has a certificate that expires in August. A student who defers from January to September pays for the test twice. Book the test once your offer and your intake are settled, not the week you start thinking about applying.

Children

The gov.uk page says all children must see a clinician who will decide if they need a chest x-ray, and that children under 11 will not normally have a chest x-ray. Children must still attend an approved clinic in a listed country and complete a health questionnaire, and the clinician then decides whether a certificate is issued. So a child is not exempt from the appointment, only, in the normal case, from the x-ray itself.

Pregnancy

The page sets out three choices for a pregnant applicant: an x-ray with an extra shield to protect you and your unborn child in the second and third trimesters, a sputum test, or waiting until after delivery. It warns that the sputum test may carry an extra fee and that you could wait up to 8 weeks for results.

Eight weeks is long enough to miss an intake. If you are pregnant and applying on a deadline, raise it with the clinic at the booking stage, not on the day.

Australia: what you are actually tested for

Australia runs the most detailed schedule of the four, and it changes with your age, your length of stay and what you intend to do once you arrive.

Pakistan counts as a high risk country

The Department of Home Affairs publishes a list of countries considered low risk for TB, drawn from World Health Organization data and signed as a legislative instrument. Any country not on that list is treated as high risk. Pakistan does not appear on it.

The department adds that if you have been in Australia in the last 28 days, it includes time already spent in Australia when working out your length of stay for health requirement purposes. So a student extending a short course into a longer one can cross the six-month line without leaving.

Permanent and provisional applicants, by age

Extra tests that depend on what you will do there

• Anyone 15 or over who intends to work as, or study or train to be, a doctor, dentist, nurse or paramedic adds hepatitis B and C tests.
• Anyone 15 or over from a higher risk TB country who will work as a health care worker, or inside a health, aged care or disability care facility, adds latent TB infection screening.
• Anyone likely to work or train at an Australian childcare centre, preschool or creche adds a medical examination, a chest x-ray and, from 15, a kidney function test.
• A pregnant applicant who plans to have the baby in Australia adds a hepatitis B test.
• A visitor aged 75 or over on a subclass 600 adds a medical examination and a kidney function test.

That first item matters for Pakistani students in nursing and allied health. The guide to studying in Australia from Pakistan covers the wider student visa requirements.

The HAP ID and the question at the counter

Australia issues an identifier called a HAP ID, and you need it to make an appointment. If you have not yet lodged a visa application and want to do the examinations upfront, the department says you may be able to use the My Health Declarations service to obtain a HAP ID. Outside Australia you must be examined by one of the department’s approved panel physicians or clinics.

One warning from the department’s own page. When you attend the panel clinic they will ask whether you plan to apply for a permanent stay in the next 6 to 12 months, and whether you want to be assessed for a permanent stay. Saying yes means more examinations, which you pay for. Decide that before you walk in, not at the desk.

Australia: the AUD 86,000 threshold

This is the figure behind most Australian health refusals, and it is published.

What the threshold is

The department says significant cost is interpreted as a cost higher than the average health and community services cost for an Australian, that the Significant Cost Threshold underpins the policy of containing public expenditure under the Migration Regulations 1994, and that the current value of the threshold is AUD 86,000. It states that the threshold was last updated on 1 July 2024 and is reviewed every two years.

If a Medical Officer of the Commonwealth assesses your estimated costs above AUD 86,000, you do not meet the health requirement, unless you are an eligible child born and ordinarily resident in Australia or a waiver is available for the subclass and is exercised.

The period the cost is measured over

• Temporary visa. Costs are assessed for your period of stay in Australia.
• Provisional or permanent visa. Costs are generally assessed over 5 years, or 3 years if you are aged 75 or older.
• A permanent or ongoing condition. Where the course is reasonably predictable, the officer assesses costs over your remaining life expectancy, up to a maximum of 10 years.

What the officer cannot take into account

The department is explicit about this, and it surprises people. The Medical Officer of the Commonwealth considers what services a hypothetical person with the same kind and severity of condition would need, and can only consider your medical situation, not your other personal circumstances. The page says the officer cannot consider whether having private health insurance or enough money to pay for treatment would affect your use of public services.

So offering to pay privately does not answer the cost question at the medical assessment stage. A health waiver, where one is available for the subclass, is the separate stage at which personal circumstances can be weighed.

Canada: the immigration medical exam

This section is general information about published Canadian rules. Section 91 of Canada’s Immigration and Refugee Protection Act reserves paid advice and representation on a Canadian application to an authorised representative, and this site is not one. It offers general information and a free first consultation only.

Pakistan is a designated country

IRCC publishes a country requirements list, and Pakistan appears on it as a country whose residents need an immigration medical exam, with New Delhi as the medical office. The page says you need an exam if there is a yes in that column.

Who needs one

For temporary residents, IRCC says a stay of six months or less generally does not need an exam unless you plan to work in certain jobs in which public health must be protected. For a stay of more than six months, an exam is needed if at least one of these applies: you lived in or travelled to one or more listed countries for 6 months or more in a row in the year before you come to Canada, you will work in a job in which public health must be protected, or you are applying for a parent and grandparent super visa.

The super visa rule is worth noting for families. The Canada super visa guide covers that route in more detail.

Twelve months, and you pay

IRCC says medical exam results are valid for 12 months, for both temporary and permanent residents. It also says you must pay all fees related to the medical exam at your appointment, including the fee for the panel physician or radiologist, and that if the application is refused after your medical exam those fees are not refunded. IRCC does not publish a fee of its own on these pages, because the panel physician sets the charge.

What the exam covers

IRCC describes the physical examination as weighing you, measuring your height, checking hearing and vision, listening to your heart and lungs, feeling your abdomen, checking the movement of your limbs and looking at your skin. It states that the doctor will not examine your genitals or rectal area. Depending on your age you may be asked to do chest x-rays and laboratory tests at the clinic or a laboratory, and there is a medical history questionnaire. Proof of vaccination is not mandatory.

Upfront exams and forms

IRCC says you should get your exam before you apply, which it calls an upfront medical exam, and that this is available for visit, work or study. For Express Entry it says the exam comes after an invitation to apply but before you apply. For other permanent residence applications it says you must get the exam within 30 days of receiving instructions. Without an upfront exam, IRCC sends you a Medical Report form, numbered IMM 1017E or IMM 1020E. Its page also says to bring 4 recent photographs if the panel physician does not use eMedical.

New Zealand: the student exception most people miss

New Zealand splits the requirement in two, a chest X-ray and a medical examination, and treats fee-paying students differently from everyone else. Getting this right saves a student an entire appointment.

Three kinds of certificate

Immigration New Zealand says there are three types of medical certificate: a general medical certificate, a limited medical certificate and a chest X-ray certificate. What you provide depends on the visa, the length of stay, the country you are from, and whether you have given INZ a certificate with an earlier application.

The chest X-ray rules

• Staying 6 to 12 months. An X-ray is needed if you are a citizen of a country that does not have a low incidence of TB, or have spent more than 3 months in the past 5 years in such a country, or have spent more than 6 months in a row in one since your last X-ray.
• Staying more than 12 months. An X-ray is needed no matter where you are from.
• Student visa. No X-ray if you are staying less than 6 months. An X-ray if you are staying 6 months or more and are from a country without a low incidence of TB, or have spent more than 3 months in the last 5 years in one.
• Children and pregnancy. Children under 11 and pregnant women do not need a chest X-ray unless a special report is needed.

Pakistan does not appear on the INZ list of countries with a low incidence of tuberculosis, so a Pakistani student staying six months or more needs the X-ray.

The medical examination exception

Here is the part that is easy to miss. INZ says that in general you must have a medical examination if you will stay more than 12 months. But for a Fee-Paying Student Visa or a Pathway Student Visa, it says you do not need a medical examination no matter how long you are staying, unless one of four things applies: you have used intravenous drugs, you have had a blood transfusion, you have participated in or been exposed to any activity which may have exposed you to a serious infectious disease such as HIV or hepatitis B or C, or INZ asks you to have one.

A student applying for a PhD, an MFAT-funded scholarship or an exchange place staying more than 12 months is treated differently and does need the medical examination. So a Pakistani master’s student on a fee-paying visa and a Pakistani PhD student on the same campus can face different requirements.

Reusing an earlier certificate

INZ says you must send another X-ray if it has been more than 3 years since the last one, or if since the last X-ray you have spent more than 6 months in a row in a country without a low incidence of TB. For a medical examination, a new one is needed if more than 3 years have passed, if your standard of health was not assessed as acceptable at the time, or if INZ needs a different kind of certificate from the one you provided.

One more detail from the INZ page: a woman over 45 may need a physical breast examination, and the physician will say whether one is required.

Why only an approved doctor counts

Every one of these systems runs on a closed list of doctors, and a result from outside that list is worth nothing. This is where money gets wasted in Pakistan, because good private hospitals are happy to run the same tests.

What each country says

• United Kingdom. The clinic page says your test must be from a clinic approved by the Home Office, and that a TB test certificate from a clinic it has not approved will not be accepted.
• Australia. Outside Australia you must be examined by one of the department’s approved panel physicians or clinics, appointed by the department to do health examinations at an approved clinic.
• Canada. IRCC says you must see a doctor on the list of panel physicians, and that your own doctor cannot do the medical exam.
• New Zealand. INZ says you must use a panel physician and tell them what type of visa you are applying for.

Find the list yourself

Each government publishes its own list, and the lists change. The Home Office publishes the Pakistan clinics with addresses and fees on a page of its own. Australia, Canada and New Zealand each publish a panel physician search. Look your clinic up on the government page before you book, not after. An agent’s assurance that a clinic is approved is not a substitute for seeing the name on the official list.

What happens after the examination

You usually do not get the result. The clinic sends it to the government, and the government tells you if there is a problem.

Unclear results

For the UK, the guidance says that if the chest x-ray is not clear you may be asked to give a sputum sample. That is a laboratory culture, and the page notes that in the pregnancy context the wait for sputum results can be up to 8 weeks. Plan for the possibility rather than assuming the x-ray settles it the same day.

If a condition is found

IRCC says that if there is a problem with your medical exam it will contact you in writing, and its page notes that inactive tuberculosis leads to medical surveillance once in Canada. In Australia, the Medical Officer of the Commonwealth advises the department whether a significant condition is likely to threaten public health, result in significant costs, or place demand on services in short supply, and may recommend that the department ask you to sign a health undertaking.

A health condition is not automatically a refusal. The Australian page says having a condition does not automatically mean that you will exceed the threshold, and that it depends on the kind and severity of the condition and your intended period of stay. Nobody can tell you in advance how a particular case will be assessed, and anyone who promises an outcome on a medical question is guessing.

Declare it anyway

The one thing that makes a medical problem much worse is hiding it. A condition disclosed is a medical question. The same condition found after a false declaration is a credibility question across the whole application, and that is far harder to recover from. If you are worried about what a condition means, the honest answer is that it depends on the route and the assessment, and that a false answer removes your best argument.

How do you arrange it, step by step?

The sequence below works for most Pakistani applicants, and the timing step is the one that saves money.

1. 1

   Work out which examination your route actually requires

   Read the health page for the exact visa and the exact length of stay. A UK stay of six months or more from Pakistan needs a TB test. An Australian temporary visa of six months or more needs a medical examination, a chest x-ray from age 11 and a kidney function test from age 15. A New Zealand fee-paying student visa may need only a chest X-ray.

2. 2

   Time the test against your intake, not your application date

   A UK TB certificate is valid for 6 months from the date of the x-ray, and a Canadian medical for 12 months from the exam. If your course starts in September and you test in January, the certificate expires before you travel. Work backwards from the intake and book the test inside the window.

3. 3

   Get the identifier the booking system needs

   Australia issues a HAP ID, which you need before a panel clinic will give you an appointment, and My Health Declarations can produce one before you lodge a visa application. Canada uses a Medical Report form or an upfront medical exam. New Zealand uses an eMedical reference number. Find out which applies before you phone a clinic.

4. 4

   Book only at an approved clinic

   Every one of these countries refuses results from a doctor it has not approved. The UK publishes its approved Pakistan clinic list with addresses and fees. Australia and New Zealand use panel physicians. Canada requires a panel physician and says your own doctor cannot do the exam. A private hospital report is not accepted, however good the hospital.

5. 5

   Attend with the right documents and answer honestly

   Take your passport, the appointment reference and the identifier. Canada’s page says to bring 4 recent photographs if the panel physician does not use eMedical. Declare conditions and medication truthfully. A condition you hide is a misrepresentation problem on top of a medical one.

6. 6

   Keep the certificate and watch for follow-up requests

   Keep the certificate or the reference number with your application file and note the expiry date in your calendar. If a result is unclear you may be asked for a sputum sample, a specialist report or a further test, and the decision on your health is taken by the government, not by the clinic that examined you.

What goes wrong most often?

Testing too early

The expensive one. A UK TB certificate is valid for six months from the date of the x-ray. Students who test the moment they get a conditional offer, then defer or wait on a CAS, pay PKR 14,000 or 15,000 for a second test. Test when the intake is settled.

Using an unapproved hospital

A private hospital in Lahore will happily do a chest x-ray and a blood panel. The Home Office will not accept it, IRCC will not accept your own doctor, and Australia and New Zealand require panel physicians. The money is simply lost.

Paying an agent to book an appointment

IOM says it charges no fee for taking an appointment and warns clients not to pay anyone to book one. People still pay. Phone the clinic yourself using the number on the government page.

Assuming a child is exempt

For the UK, all children must see a clinician who decides whether an x-ray is needed, and must complete a health questionnaire at an approved clinic. Families who leave a young child out of the appointment arrive at the application with an incomplete set of certificates.

Agreeing to a permanent stay assessment without thinking

The Australian panel clinic asks whether you want to be assessed for a permanent stay, and extra examinations mean extra fees you pay. Decide before the appointment whether that is useful to you.

Hiding a condition or a medication

It turns one problem into two. A declared condition is assessed on its merits. A concealed one becomes a question about whether anything in your application can be relied on.

A realistic example

This is a hypothetical illustration, not a real client. Zainab is 26 and from Lahore, with an offer for a one-year master’s in the UK starting in September, and a second plan to apply to New Zealand if the UK does not work out. Her younger brother, aged 9, will travel with the family later.

• March. She reads the gov.uk guidance and sees that a course of six months or more from Pakistan needs a TB test, and that the certificate lasts six months from the x-ray. She does not book anything yet.
• May. Her CAS is issued and her intake is confirmed as September. Now the timing works, so she opens the Home Office clinic page for Pakistan.
• May, same week. She compares the two Lahore clinics on the published fees: PKR 14,000 at IOM against PKR 15,000 at AMC for an adult. She phones IOM directly on the number on the government page and pays no booking fee to anyone.
• June. She attends, has the chest x-ray, and receives a certificate. She notes the expiry, six months from the x-ray date, in her calendar.
• For her brother. The family learns he still has to see a clinician and complete the health questionnaire even though a child under 11 will not normally have an x-ray, so they book his appointment rather than skipping it.
• On the New Zealand fallback. She reads the INZ pages and finds that a Fee-Paying Student Visa needs no medical examination however long the stay, subject to four exceptions, but that a chest X-ray is still required because Pakistan is not on the low incidence list.

Nothing in that sequence is clever. She read two government pages, chose the cheaper approved clinic, and tested after the intake was fixed rather than before.

The version that goes wrong

Her cousin does it the other way round. He tests in January for a September intake, at the more expensive clinic, through an agent who charges a booking fee on top. His offer moves to the January intake the following year. The certificate expired in July, so he pays again, and the booking fee again. He also skipped his seven-year-old’s appointment, on the basis that children do not need x-rays, and has to go back.

Key takeaways

Frequently asked questions