Well there’s two levels to it, the overmap, and the map tiles themselves. As you move towards the edge of your currently generated overmap, it adds new overmap tiles at the edge, so that’s how you can get new building types into an old world save.
But that’s just the general type of structure, like “There’s a hospital here,” the contents of a given map tile are only generated when you get close enough to have it hit your reality bubble. At that point the hospital tile stops being abstract and gets filled with zombies and loot, and an autodoc.
So all you really need is a hospital you haven’t visited yet. Even if the 3x3 H overmap was generated before the change, it’ll have an autodoc now because the new code will put one in when it creates the hospital’s floorplan.