Things like the medical have a specific shelf-life as far as CIC is concerned. For example, the medical exam results expire after either 6 months or 1 year after being done (I forget which). After that expiration date, you have to get a new one (and pay the costs for it again), unless the IO decides to extend the results of the medical, which is completely their discretion. That being said, the CIC package does state that it'll probably speed up the processing time if the medical is handed in with the application, as opposed to sending it in later, or when CIC asks for it. Just don't take the medical months and months prior to handing it in, get it done just before you plan on sending in the package.