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Letter of employment means reference letter?

Not the same no, Reference letter is where your duties are detailed among other informations (like hours per week and department ...)
Letter of Employment is nothing but an official administrative letter from the institution stating the period of work
 
AOR - 23 Sep 2022
CEC Inland and upfront medicals done.
 
NL PNP Express Entry - Inland

ITA: September 14th
AOR: September 20th
UCI Update: October 5th

Is it normal to have the UCI updated but no medicals or BIL?
 
Ita August 17
Aor sept 29
Biometrics linked/uci updatedinfo req oct 27
Medicals passed - today

cec inland with up front med