How many days before the interview in Casa is it necessary to have the medical exam? Once my fiance has his exam, how many days does it take them to send the paper work to the embassy?

i think medical exams are good for 1 year. I certainly wouldnt wait to the last minute for the exam. Best of luck to you!

My husband did his 2 weeks before, and they sent the paperwork to the consulate right away.

The doctor we used in Casablanca gave us a copy of the vaccination record, and that was all she gave. I dont even know that she sent anything directly to the cosulate herself.
I know they told him to come 2 weeks before and that should be sufficient enough.
Pay close attention to how much they say to bring for that appointment and bring double that amount.
Be prepared to run around town to get the Xrays, copies of things, vaccinations from pharmacy and your lab work, the lab for us was right there in her building.
It certainly will tie you up for at least 3-4 hours.
Good Luck
Good tip, when you make your appointment ask alot of questions about what EXACTLY you should bring...passport, passport size pix and ID card are a must.
Sandrila