On September 3, 2026, Immigration, Refugees and Citizenship Canada (IRCC) held Express Entry Draw #440, issuing 229 Invitations to Apply (ITAs) to candidates in the Physicians with Canadian Work Experience category. The minimum Comprehensive Ranking System (CRS) score was 198.
At 198, this is the second-lowest cut-off of any Express Entry draw in 2026 – roughly 320 points below the same week’s Canadian Experience Class round at 521. It is tempting to read that as the easiest way into Canada for a doctor. For the great majority of internationally-trained physicians, it is close to the opposite: one of the hardest categories in the entire system to become eligible for. The 198 is not an open door. It is a measurement of how few physicians clear the real barrier. Below, the Earnest Immigration team explains what that barrier is, and what to do if you are on the wrong side of it.
Express Entry Draw #440 at a Glance
| Detail | Information |
| Draw number | #440 |
| Date | September 3, 2026 |
| Category | Physicians with Canadian Work Experience (2026 – V1) |
| Invitations issued | 229 |
| CRS cut-off score | 198 |
| Tie-breaking rule | August 6, 2026 at 19:40:38 UTC |
| Draw position in 2026 | 52nd Express Entry round; 3rd Physicians round |
| Previous Physicians draw | June 24, 2026 – 271 ITAs at CRS 223 |
| Application deadline | 60 days from the date of the invitation |
Why 198 Is Not a Bar You Aim For
The physicians category has now drawn three times in 2026, and the cut-offs tell a story that looks random until you understand the mechanism: 169 in February, 223 in June, 198 in September. A score that jumps around by 54 points across three draws is not a competitive threshold. It is noise.
The reason is that this category empties its pool. The number of physicians who both qualify for an Express Entry program and hold the specific Canadian experience this category requires is very small – a few hundred at most in the pool at any time. So when IRCC runs a physicians round, it does not rank a large field and select the top scorers. It invites essentially everyone eligible, and the cut-off is simply the lowest score among whoever happened to be in that tiny pool that day. This is the same pool-clearing mechanic that governs the Provincial Nominee Program and that produced a four-invitation draw in the Skilled Military Recruits category earlier this year.
The practical consequence is unusual and worth stating plainly: if you qualify for this category, your CRS score barely matters. A qualifying physician with a modest score is about as likely to be invited as one with a high score, because the draw reaches nearly everyone eligible. The entire contest is at the eligibility gate. Once you are through it, selection is close to automatic.
The Real Gate: 12 Months of Canadian Experience as a Licensed Physician
Here is what actually stands between a doctor and this category. To be eligible, you need at least 12 months of full-time (or equivalent part-time) work experience in Canada, within the last three years, in one of three physician occupations:
- NOC 31100 – specialists in clinical and laboratory medicine
- NOC 31101 – specialists in surgery
- NOC 31102 – general practitioners and family physicians
All three are TEER 1 occupations, and the operative words are “in Canada.” This category does not reward foreign physician experience. It requires that you have already been working as a doctor in Canada – which means you have already cleared the genuinely hard part of a foreign doctor’s path to Canada: provincial medical licensure.
For an internationally-trained physician, that is the real barrier, and it has nothing to do with immigration. Practising medicine in Canada requires licensure by the medical regulator in the province where you intend to work, which typically involves credential verification, examinations, and in many cases a period of supervised practice or a residency position secured through a competitive national match. That process is run by provincial medical colleges and is entirely separate from the Express Entry system. A low CRS cut-off does nothing to lower it.
The Three Physicians Draws of 2026
| Draw | Date | ITAs | CRS |
| 1st | February 19, 2026 | 391 | 169 |
| 2nd | June 24, 2026 | 271 | 223 |
| 3rd (#440) | September 3, 2026 | 229 | 198 |
Three rounds, 891 ITAs, and cut-offs bouncing between 169 and 223 with no trend – exactly what you would expect from a category that clears a tiny pool each time. Note the declining draw sizes (391, then 271, then 229): each round invites the doctors who have accumulated eligibility since the last one, and that inflow is small. Physicians is now the fourth most active category of 2026 by invitations – behind French, healthcare, and trades – and, alongside French, one of only two categories to have drawn three times.
If You Are a Physician Without Canadian Experience
This is the situation most internationally-trained doctors are actually in, and there are real routes forward – they simply are not this specific category yet.
The Healthcare and Social Services category.
Unlike the physicians category, the broader healthcare category can consider qualifying foreign experience, not only Canadian. A physician with at least a year of foreign experience in an eligible occupation may be able to be invited through a healthcare round without first working in Canada. Healthcare has been one of the larger category-based streams of 2026, though it had not drawn since late June as of this physicians round. If you have foreign physician experience, this is often the more realistic category-based target while you work toward Canadian licensure.
Provincial physician streams.
Most provinces run dedicated pathways for doctors, and the federal government has reserved 5,000 nomination spaces for provinces to nominate physicians who hold a job offer or a letter of support from a provincial health authority. A provincial nomination adds 600 CRS points and, as recent PNP rounds have shown, all but guarantees an invitation in a subsequent PNP draw. For a foreign-trained doctor with a Canadian job offer or health-authority support, this is frequently the strongest route of all – and it can run in parallel with the licensure process rather than after it.
The standard CRS levers, while you qualify.
If neither category-based route is available yet, the usual moves still apply: strong English or French language results, which for French can additionally open the French-language category that has cleared around 100 points below CEC all year. These keep your general Express Entry profile competitive while your Canadian credentials come together.
If You Received an ITA in Draw #440
You have 60 days from the date of your invitation to submit a complete permanent residence application. For this category, the priority is documenting your Canadian physician experience precisely.
- Accept the invitation in your IRCC secure account and record your exact 60-day deadline.
- Confirm your NOC is one of the three eligible codes (31100, 31101, 31102) and that your duties match it. The category eligibility rests on this.
- Assemble evidence of at least 12 months of Canadian physician experience in the last three years: employment or contract letters, proof of licensure and practice, and pay records covering the qualifying period.
- Request police certificates from every country where you have lived six months or more since age 18. Start the same day; some jurisdictions take six to eight weeks.
- Book your medical exam with an IRCC-approved panel physician.
- Arrange certified translations for any document not in English or French.
- Budget the fees. As of April 30, 2026, an economic-class principal applicant pays $990 in processing fees plus a $600 Right of Permanent Residence Fee – $1,590 in total. Biometrics and accompanying family members are additional.
How Earnest Immigration Can Help
For physicians, the immigration question and the licensure question are separate, and it helps to be clear about which is which. Earnest works on the immigration side.
As a CICC-regulated, RCIC-licensed firm, Earnest Immigration supports physicians and other healthcare candidates with:
- Assessing which route actually fits your situation – the physicians category, a healthcare-category draw on foreign experience, or a provincial physician stream
- Confirming the correct NOC and category eligibility for your work history
- Building and optimising an Express Entry profile that claims every legitimate point
- Coordinating an Express Entry strategy alongside your provincial licensure timeline, so your immigration file is ready when your Canadian experience qualifies
- Preparing a complete, deadline-proof permanent residence application after an ITA
Note that provincial medical licensure itself is handled by the provincial medical regulator, not by an immigration consultant. What Earnest can do is make sure your immigration pathway is mapped correctly and moving in step with it. If you are a physician weighing your options, book a consultation with our team.
Frequently Asked Questions
What was the CRS cut-off for Express Entry Draw #440?
The minimum CRS score for Draw #440 on September 3, 2026 was 198 – the second-lowest physicians cut-off of 2026, behind only the February 19 inaugural round’s 169. Because the category clears its small pool each draw, this figure reflects who was eligible rather than a competitive threshold.
How many invitations were issued in Draw #440?
IRCC issued 229 Invitations to Apply to candidates in the Physicians with Canadian Work Experience category – the smallest of the three physicians rounds held in 2026.
Why is the physicians cut-off so much lower than CEC or PNP?
Because the eligible pool is tiny. Very few physicians both qualify for an Express Entry program and hold the required 12 months of Canadian physician experience. IRCC invites nearly all of them each draw, so the cut-off simply reflects the lowest score present in that small group – not how easy the category is to enter.
Does a CRS of 198 mean it is easy for a doctor to immigrate to Canada?
No – this is the key misunderstanding. The low cut-off makes the category easy to be selected from, but only after you are licensed to practise in Canada and have a year of Canadian physician experience. Securing provincial medical licensure is the real barrier, and it is entirely separate from Express Entry.
Which occupations qualify for the physicians category?
Three TEER 1 codes: NOC 31100 (specialists in clinical and laboratory medicine), 31101 (specialists in surgery), and 31102 (general practitioners and family physicians). You also need at least 12 months of Canadian work experience in one of these within the last three years.
I am a foreign-trained doctor with no Canadian experience. What are my options?
The physicians category is not your near-term route, but two others may be. The Healthcare and Social Services category can consider qualifying foreign experience. And provincial physician streams – supported by 5,000 reserved federal nomination spaces for doctors with a job offer or health-authority support – add 600 CRS points and can run alongside your licensure process.
Will there be more physicians draws in 2026?
Likely. Physicians remain an IRCC priority and the category has now drawn three times. As more doctors accumulate the required Canadian experience and enter the pool, further rounds are expected, though IRCC has not confirmed timing.
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 does a PR application cost in 2026?
As of April 30, 2026, an economic-class principal applicant pays $990 in processing fees plus a $600 Right of Permanent Residence Fee – $1,590 in total. Biometrics and accompanying family members cost extra.
Talk to a Licensed Consultant
Earnest Immigration and Citizenship Services Inc. is a CICC-regulated, RCIC-licensed Canadian immigration consultancy with offices in Windsor, Ontario and Regina, Saskatchewan, serving clients across North America and North India.
Book a consultation to have your physician immigration pathway and Express Entry eligibility assessed by a licensed consultant.
