Just got my Medical request in the mail. I had sent them the additional supporting documents (IELTS scores, proof of status in the US and bank statements) on Oct 27th 2010 and the medical request letter is dated Nov 5th 2010. That was a pretty quick turnaround!
The new letter looks just like the one they sent earlier asking for the IELTS, proof of status in the US and bank statement but this time it is instructing me to go to a DMP and also to pay the Right of Permanent Residence Fee within 60 days.