Very unlikely to happen. Canada wants to ensure that applicants for PGP don’t have any “recent” health changes before they get PR. This is primarily for those who have had access to provincial healthcare system while they’ve been in Canada. They can see whether you have been using the healthcare system by looking at the billing records. More accurate than doing an immigration medical exam.
The person who asked, his parents got medical passed without doing any pgp medicals. So thats why I shared thia policy because i thought IRCC might have given them exemption under this policy.
You are right that they would consider it based on each case, a lot of people whose parents are in Canada and they did previous medicals inside Canada, they have been asked for re-medicals and some people got extension (my parents got extension too).
The policy i think will most likely apply to young people already in Canada i.e. work permit holders.