On June 24, 2026, Immigration, Refugees and Citizenship Canada (IRCC) held Express Entry Draw #421, issuing 271 Invitations to Apply (ITAs) to candidates in the Physicians with Canadian Work Experience category. The minimum Comprehensive Ranking System (CRS) score was just 223 – one of the lowest cut-offs of the year and a clear signal that Canada continues to roll out the red carpet for internationally and domestically trained doctors.
This was only the second physicians draw ever held, and it tells us a great deal about where healthcare immigration is heading. Below, the Earnest Immigration team breaks down the numbers, what changed since the first physicians draw, and what your next move should be.
Express Entry Draw #421 at a Glance
| Draw number | #421 |
| Date | June 24, 2026 |
| Category | Physicians with Canadian Work Experience |
| Invitations issued (ITAs) | 271 |
| Minimum CRS score | 223 |
| Tie-breaking rule | May 31, 2026 at 18:13:49 UTC |
| Application deadline | 60 days from receiving the ITA |
If you submitted your Express Entry profile before 18:13:49 UTC on May 31, 2026 and scored 223 or higher, you were in the invited pool for this round.
How #421 Compares to the First Physicians Draw
The physicians category is brand new – it was added to Express Entry on December 8, 2025. Its first dedicated draw landed on February 19, 2026, inviting 391 candidates at a record-low CRS of 169, the lowest cut-off in the program’s history.
Four months later, Draw #421 looks noticeably different:
• Fewer invitations: 271 versus 391, a drop of 120 ITAs.
• A higher cut-off: 223 versus 169, a jump of 54 points.
• Same underlying message: even at 223, the bar remains extraordinarily low by Express Entry standards.
Why the shift? The February draw effectively cleared out the existing pool of eligible doctors. Since then, new physicians have hit their one-year Canadian work experience milestone and entered the pool – many of them with stronger, more mature profiles and higher CRS scores. The slightly higher cut-off reflects a fresher, more competitive pool, not a tightening of standards.
With Draw #421, the total number of physicians invited in 2026 reaches 662.
What This Means for Doctors in Canada
A cut-off of 223 is remarkable. In general Canadian Experience Class rounds this year, CRS scores have hovered well above 500. The physicians category is doing exactly what category-based selection was designed to do: letting occupation matter as much as raw CRS points.
The practical takeaway is simple. If you are a physician with at least one year of qualifying Canadian work experience, your odds of receiving an ITA in a dedicated draw are currently excellent – far better than competing in a general round.
If you received an ITA in Draw #421. Congratulations. You now have 60 days to submit a complete application for permanent residence, including all supporting documents and fees. This stage is where many physician applications stall – often because provincial medical licensing records haven’t been updated to reflect completed work terms. Getting your documentation airtight before you submit is critical, and it’s exactly where professional review pays off.
If you’re a physician but weren’t invited. Keep building toward the one-year Canadian experience threshold. Your profile is assessed automatically in every future physicians draw once you qualify. In the meantime, score-boosting moves still help: a stronger language test result (in English or French), additional education credentials, or a second-language profile can all push your CRS higher.
Below the Cut-Off? Your Options
If your CRS is under 223 – or you’re a physician without Canadian work experience – you still have real pathways:
• Provincial Nominee Programs (PNPs): Several provinces run dedicated streams for physicians. IRCC has set aside up to 5,000 federal spaces for provinces to nominate doctors holding a job offer or letter of support. A provincial nomination adds 600 points to your CRS – effectively guaranteeing an invitation.
• Healthcare and Social Services category: Physicians without Canadian experience may qualify here. Note, however, that healthcare draws run at much higher cut-offs (the June 25, 2026 healthcare round closed at CRS 475) and happen less frequently.
• Improve your base CRS: Sharpen your language scores, complete an Educational Credential Assessment, or add qualifying work experience.
Choosing between these routes depends on your specialty, your province, your licensing status, and your timeline. This is where a tailored strategy matters far more than a generic checklist.
What to Expect From Future Physicians Draws
With only two physicians draws on record – held four months apart – there isn’t yet a reliable pattern for frequency or cut-off. What we can say with confidence:
• The eligible pool is growing steadily as more doctors cross their one-year experience mark.
• IRCC has shown a consistent willingness to invite nearly every eligible physician in the pool.
• Canada’s healthcare worker shortage isn’t easing, so targeted physician selection is likely to remain a fixture of the immigration system through 2026 and beyond.
For doctors, the message is to stay ready: keep your Express Entry profile accurate, current, and fully documented so you’re never caught flat-footed when the next round opens.
How Earnest Immigration Can Help
Physician immigration sits at the intersection of two complex systems – Express Entry and provincial medical licensing – and a misstep in either can cost you months. At Earnest Immigration, we help doctors:
• Confirm eligibility and the correct NOC code for your specialty
• Build and optimize an Express Entry profile that maximizes CRS
• Navigate physician-specific PNP streams and letters of support
• Assemble a complete, deadline-proof PR application after an ITA
If you’re a physician weighing your options after Draw #421, book a consultation with our team and let’s map the fastest route to your permanent residence.
Frequently Asked Questions
What was the CRS cut-off for Express Entry Draw #421?
The minimum CRS score for Draw #421 on June 24, 2026 was 223.
How many ITAs were issued in Draw #421?
IRCC issued 271 Invitations to Apply to candidates in the Physicians with Canadian Work Experience category.
Who was eligible for the June 24, 2026 physicians draw?
Candidates in the Physicians with Canadian Work Experience category who had a CRS score of at least 223 and submitted their Express Entry profile before 18:13:49 UTC on May 31, 2026.
Why was the CRS score so low at just 223?
Category-based draws let IRCC select for priority occupations rather than top CRS scores. Because Canada faces a physician shortage and the eligible pool is still small, the cut-off remains far below general draw thresholds.
How long do I have to apply after receiving an ITA?
You have 60 days from the date of your invitation to submit a complete permanent residence application.
What can physicians do if their CRS is below 223?
Options include pursuing a Provincial Nominee Program nomination (worth 600 CRS points), qualifying through the Healthcare and Social Services category, or improving language and credential scores to raise your base CRS.
