It is a frustrating process and unbelievably slow. People's freedom to move jobs is restricted for 2-3 years because of this. I just lost two job offers because I can't confirm I have my PR yet: I got the jobs, but the minute the hiring committees knew I am on work permit expiring in 4 months, they retracted the offers. I mean I am still lucky I have a job for the coming 4 months, but if I don't secure another one, it means I might have a few months of no work.
Oct. 27 applicant here, my medicals got extended for one full year last month, and agents say you still got a few weeks for the 18 months "suggested" processing time! As if our life can just be simply put on hold.