This is the response I received from Delhi when I asked about if I had to do upfront medical.
Dear Client,
Thank you for your email.
You must undergo a new medical if you lived in one or more of these
countries or territories (includes India, Nepal and Bhutan) for at least 6 months within the past year and are planning to stay in Canada for longer than 6 months. When making an appointment with a
Panel Physician for a new medical exam, please request an “Upfront Medical Exam”. Once IRCC has received the medical results from the Panel Physician, they will be associated to your application. Please continue to monitor your MyCIC account. If you have additional questions regarding Medicals, please access our frequently asked questions by scanning the QR code below with your mobile phone. Once scanned the linked document will be updated automatically without scanning the QR code again..
Please note that Panel Physicians are working to serve critical needs given the COVID situation in India so please refrain from booking an appointment at this time