Medical is usually the last step. If you have applied from Inside Canada , then your OWP must follow in one or two days but you will have to complete medical in a defined time , which will be mentioned on permit. If you are applying from outside then it last step needed before they Issue workpermit.Similar questions - I applied for my husband on Sept 19, 2018 and just received the medical request (online) today too. I am confused about how this is related to the OWP - is the medical needed to approve OWP? Or does it just mean they are processing our file and will approve the OWP soon?