Once you get nominated by the SINP, you can apply for Canadian PR through IRCC. If your nomination is connected to Express Entry, you'll get an extra 600 CRS points, which pretty much assures you an Invitation to Apply (ITA) in the next federal draw. If it is not through Express Entry, you are required to fill out a paper application, which usually takes more time. Everyone must go through medical exams and background checks to meet the federal rules. Once everything is approved, you will get your Confirmation of Permanent Residence (COPR) and can head to Canada as a permanent resident.