If your spouse is staying in Canada as a visitor or on some other visa, you can pick whether you want to apply outland or inland. Outland is generally faster and has appeal rights but a downside to outland is that if an interview is required, your spouse will have to travel to the visa office in the country where it's being processed. Inland has the downside that it's generally not advised that your spouse travels while you are waiting for your processing because it is a requirement of inland that they reside in Canada and if they are denied entry at the border for some reason, your application is gone. If an interview is required for inland, you may also have to wait a long time for it. The inland application would be sent to Vegreville and if all goes well, you would get a first stage approval, usually in 6 to 8 months. The current processing times can be seen here: http://www.cic.gc.ca/english/information/times/canada/process-in.asp#perm_res Then the file is forwarded to your local CIC office where you live and they will contact you for a landing appointment. Getting the PR with inland usually takes 12-18 months. If an interview is required for inland, Vegreville will not give first stage approval but instead will forward the application to the local CIC office without it and you will have to wait for them to have time for your interview. In some cases that can take a year or two. If you do get the first stage approval, your spouse will usually be eligible for health care and an open work permit. It is actually a good idea when applying inland to send an application form for a visit visa extension as well as the open work permit to be given at first stage approval all in one package so it's tied together.
