What my understanding is, you have to enter Canada before your medical result expires. Your medical result expires in one year. Here is what I did: Sent Application Buffalo Office - Sept 2005 Returned everything because I left blank in some parts of application. (write N/A always) Resent application - Nov 2005 They transferred my file to NY office (my closest location) in Nov 2006. It takes exactly 1 year New York Office waived my interview. They ask for an interview if they suspect something or cann't easily find job in the field. Asked for my medical , FBI finger printing, landing fee (US $ 445 ) Sent them everything, but my money order was returned saying " amount was incorrect" because they reduced the price to 415 per person. Now I sent them my passport for immigrant visa stamp and right amount of landing fee. Waiting for the passport. I thought they mail us PR card only after you enter Canada. not sure. You can do everything by yourself, DONOT SPEND A PENNY ON CONSULTENT AS THEY SUGGEST. Your overall expense will be the total of application fee (450+) + medical fee (300-350 per person) + landing fee (415) plus other small expenses.. They ask too many photos.. FBI finderprint also cost some money. If you passed that evaluation (67+) then apply it ASAP.