My timeline:
Spousal Sponsorship (outland)
PA : Pakistan
Applied date : 20 March 23
AOR : 17 May 23
Sponsor approval : 18 May 23
(transferred to London Visa Office)
Biometrics letter : 19 May 23
Biometrics confirmed: 29 May 23
Medical : waiting
how long after my AOR should I be expecting the medical letter?
As per my own case and observation, most of Pakistani Spousal Visa applications transferred to LVO will have their Medical Requests approx 5 months from their Date of Application. This means that you can expect Medical anytime between 5-6 months. But more towards 5 months and few days more. It could be 5 or 10 days over 5 months.