Panel physicians are way more stricter than outside doctors/hospitals. That’s why IRCC only have a few accredited clinics and doctors. I have my medical examinations annually for the past 20 years and everything (x-rays, ecg, blood tests, etc.) is normal. But when I applied for my SP in 2018, I was asked to undergo sputum and cardio tests. IOM found a hazy spot in my chest x-ray, even after sputum test came out negative. My blood pressure was above normal (the cardio was cleared before I left). So, I was put on medical surveillance and was required to undergo another x-ray when I reach Canada. When I did my x-ray in Canada, my chest x-ray was clear and the Canadian doctor was even surprised why I was put on medical surveillance. Just sharing my experience.