Quebec-selected skilled workers
You must apply in two stages.
First: You must apply to the Quebec government for a certificate of selection (Certificat de sélection du Québec). This shows that Quebec has accepted you as an immigrant. Quebec will assess you using its own rules.
Second: If Quebec chooses you, you must then apply to Citizenship and Immigration Canada (CIC) for permanent residence.
As part of the process, you will need to have a medical exam and get a police check (certificate). All immigrants must have these checks, no matter where they plan to live in Canada.