On September 20, 2017 Immigration, Refugees and Citizenship Canada affirmed that upfront medical examinations are no longer available for Family Class applicants.
http://www.cic.gc.ca/english/resources/tools/updates/2017/09110950.asp
The inability of Family Class applicants to do upfront medical examinations was one of the changes introduced when the Liberal Government of Canada announced that it had reformed the Family Class application processing system to reduce backlogs. At the time it was unclear why removing the ability of applicants to complete their medical examinations before applying for permanent residence would speed things up, and it is still not clear if (or why) this is the case.
It is also problematic for those who want to work in Canada during the processing of their application in certain occupations.
The issue involves Inside-Canada Spouse or Common-Law Partner in Canada Class (“SCPCC“) applicants who work in health or education professions and who are eligible for SCPCC work permits. Because of IRCC’s announcement, applicants have had difficulty obtaining work permits that do not have medical restrictions. Indeed, in at least one case a Panel Physician refused to do a medical exam for a nurse who needed the medical restriction on her work permit removed, on the basis of IRCC’s instructions.
I hope that if anyone at IRCC is reading they reconsider their decision to not let Family Class applicants do upfront medicals, or at least clarifies that applicants who are applying under the SCPCC are exempt from the upfront medical restriction.