Canada’s Express Entry system ran its first Physicians-only draw on Thursday, February 19, 2026, issuing 391 invitations to candidates in NOC 31100, 31101, 31102. The Comprehensive Ranking System cut-off landed at an unusually low CRS 169, signalling a new policy direction for physician recruitment that operates very differently from general, provincial nominee, or Canadian Experience Class rounds.
This is not simply another category-based draw. It is a targeted instrument that can materially change strategy for internationally trained doctors, including candidates who would otherwise never reach the typical CRS ranges seen in broad healthcare rounds.
What today’s Physicians draw actually means in practice
The tie-breaking cut-off was January 03, 2026 at 03:25:14 UTC, which is 47 days before the draw date. A short tie-break window like this usually indicates a relatively contained group at the cut-off score. In practical terms, it suggests fewer profiles are sitting at the same CRS 169 waiting in the pool compared to categories where the tie-break reaches many months back. That is often a sign of either: a new category with limited pool depth, strong filtering through eligibility, or both.
Because this is the first draw ever for the Physicians stream, there is not yet a meaningful historical pattern on frequency or size. Still, the CRS 169 result sets an important benchmark: IRCC is willing to invite physicians at a score level that is far below what most skilled candidates associate with Express Entry.
Position within the 2026 admissions pace
As of today, invitations issued across Express Entry in 2026 stand at 30,848 out of an annual reference level of 123,230, about 25 percent, with 315 days remaining. Physicians account for 391 invitations, roughly 1.27 percent of invitations issued so far in 2026, based on the program share snapshot.
That small share is not a weakness. In category-based selection, small shares can still be decisive because they are aimed at bottleneck occupations that provinces and employers struggle to fill quickly through other channels.
Physicians vs Healthcare and Social draws: why CRS 169 is not comparable to CRS 462 to 510
To understand today’s number, it helps to compare it to the broader Healthcare and Social category. Over the last 12 months, Healthcare and Social draws showed CRS ranges from 462 to 510, with draw sizes from 500 to 4,000, and an average cut-off around 481. Those rounds cover a wide list of occupations and attract a very large, competitive pool.
The Healthcare and Social stream also shows tie-break windows that can stretch far back. One recent example reached 347 days between the draw date and the cut-off profile creation date, which is a classic sign of deep inventory at or near the cut-off score and slower clearing of similarly scored candidates.
By contrast, the Physicians draw is narrowly scoped. When IRCC narrows eligibility and still invites at CRS 169, it usually means selection is being driven less by pure CRS ranking and more by policy priority, occupation verification, and category eligibility. The underlying message is clear: for physicians, Canada appears willing to trade CRS selectivity for occupational scarcity.
The trend to watch: what this new Physicians stream could signal next
Early indicators from the first draw
The key signals from the inaugural Physicians with Canadian work experience round are the very low CRS and the short 47-day tie-break window. Together, they point to a new intake channel that is being driven more by category eligibility and Canadian physician work experience than by the usual CRS “arms race” seen in broader rounds. A tie-break that only reaches back 47 days typically suggests a relatively tight cohort at the cut-off score, meaning the pool may not yet be deep at that level. In this early phase, that reduces the immediate likelihood of sustained CRS pressure, at least until more physicians become aware of the pathway and enter the pool.
This is also a stream where traditional profile factors may be less decisive in practice. Education assessment is not required under the Canadian Experience Class unless education points are being claimed, and many candidates can remain competitive without declaring education if they are relying on Canadian work experience and language to meet eligibility and build CRS. Similarly, foreign physician experience is not the core lever for this category because the defining requirement is at least one year of eligible Canadian work experience within the last three years, in NOC 31100, 31101, or 31102, with duties aligned to the NOC lead statement and essential duties.
At the same time, first-of-its-kind draws are often followed by adjustments. If eligible physician candidates enter the pool quickly, CRS could rise even within a category-based framework, especially if IRCC keeps draw sizes modest or narrows how it interprets proof of eligible Canadian work experience.
What is likely to happen next, without guessing a specific date
If IRCC continues with Physicians draws, the most realistic near-term outcome is a calibration period: draw sizes may remain controlled and CRS may move up or down based on how quickly qualified physicians build profiles, how tight documentation standards are applied, and how many eligible candidates exist at the margins of the category definition. Canada’s healthcare labour pressures remain persistent, so the policy logic for repeating this stream is strong, but the operational reality is that eligibility hinges on Canadian work authorization, Canadian work history, and NOC duty alignment, not on education declarations or foreign experience narratives.
Provincial realities will also shape outcomes, particularly for surgeons and other specialists. Immigration selection does not replace provincial licensing, credential verification, and hospital privileging processes. As this stream matures, it is reasonable to expect closer attention to whether the claimed physician work experience is credible, authorized, and consistent with provincial regulatory context, even though licensing itself is not the Express Entry selection test.
The broader Express Entry context matters too. In the last 12 months across all streams, IRCC has run both very large and very small rounds with widely varying CRS cut-offs, which reinforces one key point: IRCC is using multiple levers for different economic goals rather than a single predictable ladder. Physicians have now become one of those levers, and early evidence suggests the lever is designed to retain physician talent already working in Canada, with CRS acting as a secondary filter rather than the primary gate.
How to get CRS 169 in the First CEC Physician Draw: 2 Sample Profiles of Canadian Doctors
In the first physician draw under the Canadian Experience Class, licensed doctors with verified credentials and Canadian work experience were invited even with modest English scores and no education points. For these specialists, their provincial College of Physicians and Surgeons had already confirmed their medical degrees and training long before they entered the Express Entry pool, so they did not need an educational credential assessment, which is not required under CEC. With a CRS of 169, their profiles still rely mainly on age, language and Canadian work experience as physicians, and are ranked by the usual tie-breaker rule based on when the profile was submitted.
Profile 1 – Inland CEC Physician: Dr. Arjun from India, ophthalmologist, CRS 169
Dr. Arjun Patel is a 31-year-old ophthalmologist from India who now works in a busy community eye clinic in Mississauga, Ontario. After completing medical school and his ophthalmology residency in India, he went through the long process of Canadian licensing, including written exams and supervised practice in Ontario. He is now a licensed eye specialist and cataract surgeon, practising under the authority of the College of Physicians and Surgeons of Ontario. As part of that licensing journey, his medical degree and specialist training were already fully verified by the provincial regulator and the ophthalmology section of the provincial medical association. Because of this, and because he qualified under the Canadian Experience Class where education is not required, he chose not to obtain a separate educational credential assessment for immigration.
Arjun has completed one full year of full-time skilled work in Canada as an ophthalmologist. His work is a mix of clinic consultations for glaucoma and diabetic eye disease and day-surgery lists for cataracts at a nearby hospital. His English is practical and good enough for everyday clinic conversations, but not at an advanced academic level, which is reflected in his language results. He took the IELTS General Training test and scored 4.5 in speaking, 5.5 in listening, 5.5 in reading, and 4.5 in writing. On the CRS grid, these scores give him 6 points for speaking, 9 points for listening, 9 points for reading, and 6 points for writing, for a total of 30 language points.
At 31 years old, Arjun receives 99 CRS points for age. His one year of Canadian ophthalmology experience provides 40 CRS points for Canadian work experience as a specialist physician. He is applying without a spouse or common-law partner and is not claiming any points for education, skills transferability, provincial nomination, Canadian study, French, or relatives in Canada. His entire profile in this first CEC physician draw rests on being a fully licensed ophthalmologist in Ontario with verified credentials, modest but sufficient English, and a solid year of Canadian specialist work. Altogether, his CRS of 169 is built from age 99, language 30, and Canadian work experience 40, with all other categories at zero.
CRS Breakdown of 169: Age (99) | Language (30) | Canadian Experience (40)
Profile 2 – CEC Physician with spouse: Dr. Chioma from Nigeria, otolaryngologist (ENT), CRS 169
Dr. Chioma Okafor is a 31-year-old otolaryngologist from Nigeria, an ear, nose and throat specialist who treats chronic sinus issues, vocal cord problems and ear infections at a regional hospital in Calgary, Alberta. She completed medical school and ENT residency in Nigeria, then pursued Canadian licensing so she could practise as an otolaryngologist here. After passing her exams and completing a practice-ready assessment, she became a member of the College of Physicians and Surgeons of Alberta, and joined the provincial ENT specialist society. Through that process, her medical and specialist credentials were thoroughly verified. For Express Entry under the Canadian Experience Class, she did not obtain a separate educational credential assessment, since CEC does not require education for eligibility and her main strength in this physician draw is her verified specialist licence and Canadian experience.
Chioma has accumulated one full year of full-time Canadian work experience as an otolaryngologist, running a mix of outpatient ENT clinics and operating room lists for tonsillectomies, septoplasty and sinus surgery. She created her Express Entry profile with her husband Emeka as an accompanying spouse. For language, she chose the PTE Core English test. Her schedule between operating room, call shifts and clinics left little time for intensive language prep, so her scores reflect competent but not perfect English: 62 in speaking, 55 in listening, 54 in reading, and 50 in writing. On the CRS scale, these results give her 8 points for speaking, 8 points for listening, 8 points for reading, and 6 points for writing, for a total of 30 language points.
At 31, Chioma receives 90 CRS points for age. Because she is applying with a spouse, her one year of Canadian ENT experience gives her 35 CRS points for Canadian work experience. Her husband Emeka also contributes to the score. He finished secondary school (high school graduation) in Nigeria, which gives the couple 2 points for spouse education. In Canada, he has been working for three years as a nurse aide in a long-term care facility, which counts as 3 years of Canadian work experience for the spouse and adds 8 CRS points. Emeka also took the PTE Core exam and scored 55 in speaking, 55 in listening, 54 in reading, and 52 in writing, which provide 1 point per skill, for a total of 4 spouse language points.
When everything is added up, Chioma’s CRS of 169 comes from 90 points for age, 30 points for her own English results, and 35 points for Canadian work experience as an otolaryngologist, plus 14 points from her spouse: 2 for his high school completion, 8 for his three years of Canadian work, and 4 for his language results. Like many specialists in this first CEC physician draw, she is not claiming any points for formal education, transferability, provincial nomination or Canadian study, relying instead on her licensed ENT practice in Alberta and her year of Canadian specialist work.
CRS Breakdown of 169: Age (90) | Language (30) | Canadian Experience (35) | Spouse (14)
Practical legal guidance for physician candidates: how to turn eligibility into an invitation
For physicians, the strategic goal is not only to be a doctor by training, but to be clearly classifiable under the eligible NOCs and demonstrably eligible under Express Entry rules. A low CRS does not remove the need for a compliant profile. It simply lowers the ranking barrier once eligibility is secure.
How to strengthen CRS even when the cut-off is low
Language remains the fastest legal way to add points. High English scores can meaningfully lift core human capital and skill transferability. French can be especially powerful because it can add bonus points and also opens pathways in francophone selections when relevant.
Education matters because many internationally trained physicians underestimate how much CRS depends on an Educational Credential Assessment outcome. A strong ECA result can raise CRS directly and can also improve transferability in combination with language.
Experience should be framed carefully. Foreign work experience must match the claimed NOC duties and duration. Canadian experience, even limited, can create outsized CRS gains and can also support alternative pathways if category selection pauses.
Additional points can be decisive even in category-based selection. A provincial nomination remains a guaranteed route to the top of the pool, and employer-linked options may help with work authorization and future provincial alignment, even when the immediate invitation is issued through Express Entry.
For candidates whose physician work experience is mixed across roles, job titles, or jurisdictions, it is important to align duties, proof, and timelines to the correct NOC. Misclassification and weak documentation are common reasons for refusal, even after an invitation.
A reminder for physician applicants considering provincial options: “General practitioners and family physicians” frequently appear as priority occupations in provincial nomination contexts, reinforcing that physician demand is system-wide and not limited to one federal stream.
Tips for internationally trained doctors: the “health” reality behind the immigration strategy
Physician immigration does not end at invitation. Licensure is regulated provincially, and timelines, assessments, and bridging steps vary significantly by province and specialty. The smartest Express Entry strategy is one that runs in parallel with professional planning: credential verification, exam pathways where applicable, and realistic settlement choices that match provincial health workforce needs.
This is also where many candidates lose time. A profile can be competitive for immigration while the candidate is unprepared for licensure, or vice versa. Coordinated planning avoids landing in Canada without a clear route to practice, and it reduces the risk of selecting a province that is a poor fit for the physician’s training pathway.
RED Immigration Consulting routinely helps physician candidates structure an immigration plan that remains compliant at both stages: first, meeting Express Entry eligibility and documentation standards, then aligning with provincial workforce realities to support long-term settlement outcomes.
