Mr.Lim, the Physical Examination Record for Foreigner is not a must requirement, because when you go to China, The holder of Z Visa shall go through residential formalities in the local public security department within thirty days of entry into China, the Physical Examination Record for Foreigner should be done again at the Administration for Entry-Exit Inspection and Quarantine

I'm a British citizen, I went to work in China in 2009, I didn't do the physical examination when I apply for Z visa, I did it when I apply for Residence Permit.