Most people don't get rejected after medical. On the contrary most people get accepted after getting the medical call, provided that you are citizen from a country which require medical. But now are there cases where they rejected after medical? Yes there are. And the reason varies from being medically unfit to last minute background check. See there is almost infinite number of reason that a VO can state to refuse visa. And if the VO find out something or anything that convince him/her to refuse visa after even giving out the medical call then the VO will do so. They have to be absolutely sure whom they are allowing in Canada. There are even cases where they refused candidate entry at the Point of Entry(POE) on ground of inadmissibility! NOW DO YOU WANT TO LOOSE YOUR SLEEP ON THAT? I DON'T THINK SO !!!!! In essence, if you are a genuine candidate with proper papers and other requirements that is needed to convince CIC to grant you a visa, you will get it whether you need medical or medical. Medical is a required selective procedure for individual from selected nation. This Medical with other factor determines the fate of candidate. Early medical call or delays of decision after medical call SHOULD NOT be considered as signs of either positive or negative visa application results.