Express Entry Draw #421: 271 ITAs at CRS 223 for Physicians

Canada ran a targeted Express Entry draw on June 24, 2026, specifically for physicians with Canadian work experience. Draw #421 issued 271 Invitations to Apply (ITAs) for permanent residence. The minimum CRS score was 223, one of the lowest cutoffs seen in any Express Entry round.

This was not a general draw. Only foreign nationals working as physicians in Canada were eligible. The draw was authorized under Ministerial Instructions signed by Minister Lena Metlege Diab, and it covers three specific physician occupation codes under Canada's National Occupational Classification system.

If you are a physician working in Canada and had an active Express Entry profile before the draw date, read on. This article explains exactly who qualified, what the cutoff means, and what you need to do next.

What Happened, Explained Simply

Canada used its category-based selection system to run a draw exclusively for physicians. Category-based draws let the government target specific occupations or groups rather than simply inviting the highest CRS scorers from the general pool. This draw is formally called "Physicians with Canadian Work Experience, 2026-Version 1."

To be eligible, you needed to meet three conditions. First, you must have completed at least one year of full-time work in Canada, or the equivalent in part-time hours, in one of the three qualifying physician occupations within the last three years. Second, you must have performed the lead-statement actions described in the National Occupational Classification for your occupation. Third, you must have carried out a substantial number of the main duties listed, including all essential duties.

The three qualifying occupations are NOC 31100 (Specialists in clinical and laboratory medicine), NOC 31101 (Specialists in surgery), and NOC 31102 (General practitioners and family physicians). These cover the full range of licensed physician work in Canada, from family doctors to surgeons to specialists.

The cutoff was a CRS score of 223. That number is strikingly low compared to general pool draws, which have recently required scores in the 470s or higher. The low cutoff reflects how targeted this draw was, the eligible pool is small, because Canada does not have a large number of foreign-trained physicians with exactly one year of Canadian experience sitting in the Express Entry pool at any given time.

If your score was 223 or above, and you had an active Express Entry profile as a qualifying physician before June 24, 2026, you likely received an ITA. If more than one candidate shared the score of 223, the tie-breaker applies: priority went to profiles submitted before May 31, 2026 at 18:13:49 UTC.

What Does a CRS Score of 223 Mean?

A CRS score of 223 is very achievable for most physician candidates in the Express Entry pool. The table below shows how a typical applicant in this category might reach that score. These are illustrative ranges based on the standard CRS point structure.

For most physicians, the score of 223 is well within reach simply by holding a medical degree, having at least one year of Canadian experience, and speaking English or French at a functional professional level. You do not need a perfect language score or a Canadian-born spouse to clear this bar.

The low cutoff also tells you something important about the size of the eligible pool. Canada set aside exactly 271 spots for this draw. The fact that the score dropped to 223 suggests the government invited everyone in the pool who qualified, or came very close to it. This is a focused, supply-limited draw, not a mass invitation round.

For context, general pool draws for the Canadian Experience Class or Federal Skilled Worker Program routinely require CRS scores above 470. A score of 223 in a general draw would never result in an invitation. This draw only works for you if you are specifically a physician with Canadian experience who was already in the pool.

What This Means For You

If your CRS score is 223 or above and you work as a physician in Canada, check your IRCC account immediately. ITAs are time-sensitive. You have 60 days from the date of your invitation to submit a complete permanent residence application. Missing that deadline means your ITA expires and you would need to wait for another draw.

If your score is just below 223, this particular draw has passed. But your situation is not hopeless. Category-based draws for physicians are relatively new, and Canada has shown it is willing to run them when labour market conditions warrant. Keep your profile active, update your job experience as new months accumulate, and watch for future physician-specific draws.

If you are a physician who was not yet in the Express Entry pool when this draw ran, create your profile now. The next physician draw could come at any time. Having an active profile means you are in position to receive an ITA the moment another round runs. You cannot receive an invitation if you do not have a current profile in the pool.

If you work in a physician-adjacent role, such as a nurse practitioner, dentist, or pharmacist, this draw did not include you. Only NOC 31100, 31101, and 31102 qualified. Watch for separate targeted draws that may cover your occupation. IRCC publishes draw results and processing times on canada.ca as they happen.

✅ If You Got an ITA, What To Do Now

Congratulations. Receiving an ITA for permanent residence as a physician is a significant milestone. Now the clock is running. You have exactly 60 days from June 24, 2026 to submit your complete application. Here is what you need to do.

1. Log in to your IRCC account: Find your ITA in your account inbox. Read every instruction carefully before doing anything else. The system will show your exact deadline date.
2. Gather your identity documents: You need a valid passport for every family member included in your application. Make sure your passport does not expire within the processing period, typically 12 to 24 months after submission.
3. Get police certificates: You need a police clearance certificate from every country where you have lived for six months or more since the age of 18. Some countries take weeks to issue these. Start immediately.
4. Complete your medical exam: Book an appointment with an IRCC-designated physician. Medical exams are valid for 12 months. If you had a previous exam done more than 12 months ago, you need a new one.
5. Collect employment records: You need a reference letter or employment letter from your Canadian employer confirming your job title, duties, hours per week, and dates of employment. For physicians, this often means a letter from your hospital, clinic, or provincial health authority.
6. Prepare your language test results: Your IELTS or CELPIP results must still be valid at the time of submission. Most language tests are valid for two years from the test date.
7. Pay the application fee: The current fee for a principal applicant is $1,525 CAD, which includes the $515 processing fee and the $1,010 right of permanent residence fee. Spouse or partner adds another $1,525. Each dependent child adds $260.
8. Submit before your deadline: A complete application submitted on day 59 is better than an incomplete one submitted on day 30. Double-check every document before you click submit.

One more thing: do not leave your job during this process. Your permanent residence application is tied to the work experience that qualified you for this draw. A sudden gap in employment or a change to a non-physician role could complicate your application if IRCC asks for updated documentation.

📈 If You Didn't Get Invited

This draw was unusually narrow. If you did not receive an ITA, it likely means one of three things: you are not in the Express Entry pool yet, your occupation does not fall under NOC 31100, 31101, or 31102, or you had not yet accumulated one year of Canadian physician experience before June 24, 2026. Understanding which situation applies to you shapes your next move.

If you are a physician who is close to the one-year Canadian experience mark, keep working and update your Express Entry profile the moment you qualify. Canada has now demonstrated it will run physician-specific draws, which means future rounds are plausible. Being in the pool is the only way to be considered.

If you are a physician but your experience is entirely outside Canada, consider whether a Provincial Nominee Program (PNP) makes more sense for you right now. Several provinces actively recruit physicians through their own streams, and a provincial nomination adds 600 points to your CRS score, virtually guaranteeing an ITA in any subsequent draw.

If your language scores are dragging your CRS down, retaking the IELTS or CELPIP could help. Moving from a CLB 7 to a CLB 9 in your first language can add dozens of points to your CRS score. Even small gains matter in targeted draws where the eligible pool is thin and every profile counts.

Finally, consider whether you qualify under the Federal Skilled Worker Program in parallel. If your foreign physician credentials and experience meet FSW requirements, you may be eligible for general pool draws as well as future physician-specific rounds. Holding a profile that qualifies for multiple pathways gives you the best chance of receiving an ITA regardless of which type of draw Canada runs next.

Frequently Asked Questions

Was Draw #421 open to all Express Entry candidates?

No. Draw #421 was a targeted, category-based draw exclusively for physicians with Canadian work experience. Only candidates in NOC 31100, 31101, or 31102 with at least one year of Canadian experience in the last three years were eligible.

Why was the CRS cutoff so low at 223?

The eligible pool for this draw was small. Canada set a cap of 271 invitations, and the cutoff reflects the size of the qualifying pool of physician candidates already in Express Entry. A small, occupation-specific pool naturally produces a lower cutoff than a general draw.

Can a general practitioner and a surgeon both qualify for this draw?

Yes. The draw covers all three physician NOC codes: 31100 (specialists in clinical and laboratory medicine), 31101 (specialists in surgery), and 31102 (general practitioners and family physicians). All three groups were eligible under Draw #421.

What happens if I received an ITA but cannot complete my application in 60 days?

An ITA expires after 60 days and cannot be extended. If you cannot submit a complete application in time, your ITA is cancelled. You would need to remain in the Express Entry pool and wait to be selected in a future draw.

Will Canada run more physician-specific draws in the future?

This draw was issued as "2026-Version 1," which suggests additional versions are possible. Canada has also run repeat draws in other targeted categories. There is no guarantee of a future physician draw, but the naming convention and Canada's healthcare labour needs make it plausible. Monitor IRCC's official results page for announcements.

Sources: Government of Canada (canada.ca), IRCC Help Centre. Last verified: June 25, 2026. This article is general information, not legal advice. Consult IRCC or a qualified legal aid service for guidance on your specific situation.