Hi
thank you
Most spousal applications are completed in less than a year, that is why the instructions request you have the medical receipt submitted with the sponsorship. read:
http://www.cic.gc.ca/english/immigrate/sponsor/spouse-apply-how.asp"There are some extra steps to follow if the person(s) you want to sponsor lives outside Canada:
* Have the person(s) you want to sponsor complete the medical examination requirements. Instructions are in the application kit. There is also information about medical examinations in the Quick Find section on the right-hand side of this page.
* Assemble the final application for permanent residence, including applications, supporting documents, and proof that the medical examination has been done.
PMM