Here's a timeline that may help someone in a similar situation. My parents' application was submitted to the Vancouver office in Nov 2021. The first medical examination took place in Oct 2022. After that, there were no updates until May 2024, when the second medical exam was passed and the opr was issued just two days later.
If you find yourself in a situation where there's no news after medical exam, I would recommend first request IRCC report to inquire about the status of your application and which steps have been completed, as well as those still in progress. Then, it might be helpful to request information from CSIS and CBSA to check if you has been C-check. If the security is still in process, unfortunately, there's not much to do but wait.
In the case of my parents, their files were in CSIS from Nov 2022 until Mar 2024. This is likely the reason for the extended processing time. Wishing you good luck with your application process!