its very disturbing how they do things, over a year ago they snail mailed a request to my spouse for extra medical tests, no email or mail to me, it was sent from uk and took 6 months to recieve that letter in the mail to do those medicals, and they had given us a 30 day deadline, thankfully when I was ready to apply I noticed on the erecipt of our original medicals that nothing had gone to immigration, so he went back to iom and they informed him cic wanted addtl tests done, held us up from reapplying for 10 months, and cost an extra $1000 thank God we clued in, by the time we got the official letter, most were done or we never would have known, its crazy