Actually it's an "OR" not an "AND" (see below).
As for the medicals, you can have them done in any country as long as it's done by an approved DMP as per the guidebook, a complete list of approved medical practitioners is available on-line at
http://www.cic.gc.ca/dmp-md/medical.aspx.
This is cut and paste directly from the sponsorship guide:
You can sponsor a person as a conjugal partner(1) if
• that person is of the opposite or same s e x
• that person is residing outside Canada (that is, has, for legal purposes, a fixed, permanent and principal home outside Canada), and
• you have maintained a conjugal relationship with that person for at least one year, that is: you have been in a committed and mutually interdependent relationship of some permanence where you have combined your affairs to the extent possible.
(1) This last category is intended for partners of Canadian sponsors who would ordinarily apply as
• common-law partners but cannot meet the definition, that is were not able to live together continuously for one year with their sponsor,
or• spouses, but marriage to their sponsor is usually not an available option to them, usually because of marital status or *censored word*ual orientation, combined with an immigration barrier (for example, rules preventing partner and sponsor of long stays in one another's countries).
If your sponsorship is successful, your conjugal partner becomes a permanent resident of Canada but cannot exercise any rights or privileges associated with common-law status until you have cohabited for at least one year.
Hope all this helps a bit...