@Rickay001
I posted this before realizing it was already answered before.
According to the document we were sent...
"Four recent photographs. You will need to bring these only if the doctor you select from the list of panel physicians does not work with IRCC via the eMedical system. Please check with the doctor’s office when you book your appointment "
My Dr. is a panel physician so I didn't have to bring photos, they just took them on the spot.
If I were you I'd give them a call in advance just to be sure.