As per new instructions by IRCC, you dont have to do upfront medical after receiving ITA if you are outside of Canada, rather you wait for them to send you a form telling you when to get medical exam. Has anyone here submitted their application without upfront medical?
https://www.canada.ca/en/immigration-refugees-citizenship/services/immigrate-canada/express-entry/documents/medical-exams.html
https://www.canada.ca/en/immigration-refugees-citizenship/services/immigrate-canada/express-entry/documents/medical-exams.html