国外申請ガイド(IMM 3998 E)の4ページ目のMedical Requirementsに以下の様に書いてあります。 The visa office will send you detailed instructions explaining what you and your dependants must do to complete your medical examination.
Visa office specific instructions マニラ(IMM 3025 E)のAppendix D Medical Instructionsにも以下の様に書いてあります。 This office will forward medical instructions as soon as we receive your completed Application for Permanent Residence in Canada form and have reviewed your application.
病院の方も新しい方法に少し戸惑っているようでしたので、ねこさんの行こうとしている病院にも、ねこさんの方から新しい方法になった旨を伝えた方が良いかもしれないですね。General Asia(IMM3097) の中のAppendix D Medical instructions を持って行って説明してみてはどうでしょう。
その中のFAQの記述です。 Q. What is an up-front medical examination?
A. An up-front medical examination allows applicants (your spouse, common-law partner, conjugal partner, or dependent children) to take the medical examination before the applications for sponsorship and permanent residence are submitted to Case Processing Centre (CPC) Mississauga.
With the examinations done at the beginning of the process, Citizenship and Immigration Canada (CIC) will be able to process the permanent residence application faster.
Q. What are the benefits of the up-front medical examination?
A. When CIC tested the joint application and up-front medical examination process, processing times were reduced by over 50% for routine cases.