dominico said:
what do you mean "no bearing on spousal sponsorship application"?
All immigrants have to have a medical exam. For most immigrants, refusal is possible is they will impose a heavy brurden on the health care system, but spouses are exempt from this requirement that they don't impose a heavy burden. You won't be refused because the spouse is in poor health, unless he or she poses a danger to the general public.
will a marriage license be enough to confirm the marriage?
A marriage "license" means that you have permission to get married, but it doesn't say that you
are married. For that, you need a certified copy of the license and/or a marriage "certificate". That may depend on the jurisdiction where the wedding is performed.
Aside from that, you need to show that it's a genuine marriage and not just one that you got into just for immigration purposes. They'd like to see things like wedding pictures, invitations, evidence that you went on a honeymoon if you did that, etc. They will want to know if your families attended and if they didn't why?
Have a look at the manual at
http://www.cic.gc.ca/ENGLISH/RESOURCES/manuals/op/op02-eng.pdf and read sections 12 and 12.1 on pages 44-45. That will give you an idea of what kind of evidence they look for.