Hello!
Once you get your PNP nomination then you have to submit your PR application including Application Fee.
They will send you your Immigration File No. Then you have to wait for the Medical Request.
Once they receive your medical results you have to wait if your Ecas has changed to In-Process... Usually they will send an RPRF with the Medical request. In my case I haven't got a request to pay RPRF yet.
Once everything has been reviewed by an Immigation Officer then they will make a decision accordingly.
They will send PPR and after once you've received your passport with the ViSA then you can do Landon at the boarder...