In a spousal sponsorship, the Canadian sponsor doesn't need an immigration medical exam, but the sponsored partner and any dependent children do, usually within 30 days of IRCC's request. Booking early, bringing a medication list and specialist letters, and tracking the 12-month validity date can keep the process on schedule. 

See how a family of five coordinated Express Entry upfront medicals in a single morning, with staggered check-ins so a parent was always free to stay with the kids. All five results reached IRCC within 5 to 10 business days of one appointment.