Read below to find out about the types documents you may be asked to include in your applications to programs. You can find out which documents you need to include by consulting provincial criteria and individual program descriptions.

Reference materials

References are provided by physicians, professors or non-clinical individuals (also known as referees) recommending you for further medical training.

When you request a reference through CaRMS Online, your referee is notified of the request. Your referee may create and upload the reference directly in CaRMS Online, or mail a hardcopy reference to CaRMS to be scanned and uploaded to your account.

There are three types of references for this match

Letter of reference: This type of reference document is a detailed letter that describes a referee’s experiences with you and recommending you for further medical training.

Letter of reference from a program director: This type of reference document is a detailed letter that describes a program director’s experiences with the applicant and recommending them for further medical training.

Applicant support form: This type of reference document can be requested if you are applying to a program that requires it as part of their application. It is your responsibility to provide a copy of the form, as it is not provided by CaRMS.


Reference letter guidelines

In order to ensure program directors receive the information they need to evaluate applicants, we recommend letters of reference include:

  • The date the letter was written
  • The time and duration of the referee’s contact with you
  • Assessment of your:
    • Cognitive skills and knowledge
    • Problem solving and patient management skills
    • Behaviour and attitudinal skills
    • Communication skills and working relationships
    • Motivation and punctuality
    • Sense of responsibility
    • Procedural skills specific to the discipline
    • Special qualities and unique contributions

If referees are unable to comment on a specific component of an your performance in any of the above categories, they should indicate that they have not observed or do not have knowledge of that specific component in their letter.

Early letters of reference

You can contact referees and request reference letters before CaRMS Online opens for the match by printing the early letter of reference form and giving it to your referee. The form must be attached to the letter when it is received by CaRMS.

Once we receive your early letter of reference, we will email you to let you know that your letter has been received. Please note that we will only contact you to inform you of the receipt of early letters of reference when CaRMS Online is closed.

When CaRMS Online opens, you must create coversheets for any early letters of reference. Please notify the CaRMS Document Centre at when a coversheet has been created so that your early letter of reference can be scanned to your profile. When CaRMS Online opens and letters are received, the documents team will look in your file for a coversheet and scan the document. It is your responsibility to track which documents have been scanned. If no coversheet has been created, we will contact you via email.

Please note that we cannot scan an early letter of reference to your profile unless you inform us that you have created a coversheet.

Examinations and assessments

CaRMS receives select exam results and documentation directly from the source. This simplifies the process and guarantees the validity of the document and results.

The most common examination/assessment results we receive are:

  • Medical Council of Canada’s Evaluating Examination (MCCEE) and Qualifying Examinations (MCCQE I and MCCQE II)
  • National Assessment Collaboration (NAC) examination
  • United States Medical Licensing Examination (USMLE)
  • College of Family Physicians Canada (CFPC) examinations
  • Test de français international (TFI)
  • Test of English as a Foreign Language (TOEFL)
  • International English Language Testing System (IELTS)
  • Test of English for International Communication (TOEIC)
  • Computer-Based Assessment for Sampling Personal Characteristics (CASPer)

All results must be sent directly from the issuing organization or uploaded to CaRMS Online by the applicant. Examination results sent to CaRMS by applicants will be returned at the applicant’s expense.

For information on how to submit examination results, consult the document submission instructions.

International medical graduates and Osteopaths

You may be required to provide Medical Council of Canada (MCC) and/or National Assessment Collaboration (NAC) examination results as part of your application.

MCC examination data and documents, including the NAC, are only accepted as transfers from*. For information on how to connect to the custom, consult the document submission instructions.

*Note: Results prior to 2006 cannot be sent via If you wrote the MCCEE prior to 2006, contact the MCC directly to arrange for a certified copy to be sent to CaRMS.

Language examinations

If your language of instruction during medical school was not English or French, you may be required to submit a language assessment exam according to the provincial or program criteria.

Common language examinations include:

  • Test of English as a Foreign Language – Internet-based Test (TOEFL iBT)
  • Test of English for International Communication (TOEIC)
  • International English Language Testing System (IELTS) Academic Version
  • Test de français international (TFI)
  • Foundation for Advancement of International Medical Education and Research (FAIMER)
  • Language proficiency letters

Note: the IELTS does not exempt you from taking the TOEFL.

Exam expiration dates

Programs require that all submitted documents are valid – meaning that they have not expired. Some examinations expire after a specific number of years following when the exam was written and passed. You are responsible for ensuring that your examination results are currently valid.

The following table outlines typical expiration dates; however, you are responsible for verifying the expiration dates directly with the source.

Examination Expiry
TOEFL Two years after taken
USMLE Seven years to complete all exams and step three before invalid
CFPC No expiry date (conditions apply please contact CFPC)
IELTS Two years after taken
MCCEE No expiry date
MCCQE Part I & II No expiry date
NAC examination No expiry date
TOEIC** Two years after taken
TFI Two years after taken
CASPer One match cycle
UBC IMG CAP No expiry date
AIMG CAP No expiry date
CMQ Assessment Yearly

**Note: The TOEIC exam replaces the TSE exam. Results for the TSE are still valid for two years after taken.


If programs would like you to submit a photograph, they will indicate this in their program description. The photograph is intended to be used as a reminder to help programs identify applicants at the time of ranking and will not be visible to programs until the beginning of the interview period.

A professional head shot should be used wherever possible.

Your photograph, which you upload directly to your online account in JPG format, should be less than 2 MB in size.

Professional headshot
Canadian citizenship documents

You will be required to upload a notarized or certified copy of an official government-issued document identifying your citizenship status in Canada.

Many citizenship documents have an expiration date. Please ensure that any citizenship document(s) you submit are currently valid, as expired documents will not be accepted by postgraduate offices.

You may upload multiple document types as proof of your Canadian citizenship status. Acceptable citizenship documents vary by province, so you should carefully review the provincial eligibility requirements and program descriptions.

Accepted document types are:

  • Canadian birth certificate
  • Passport page showing Canadian citizenship
  • Canadian citizenship certificate
  • Record of landing (clearly showing the date of landing)
  • Confirmation of permanent residence
  • Permanent resident card (both sides)
  • Proof of pending citizenship
  • Valid Canadian visa/permit authorization

Any non-Canadian citizenship documents must be uploaded as extra documents and only assigned if requested by a program.

Personal letters

Personal letters are how you introduce yourself to programs and to express interest in a specific program and/or discipline.

Your personal letter should outline the reasons you have chosen a particular training program. Each program has preferences regarding what the personal letter should contain, so check individual program descriptions for more information.

You must enter personal letters directly into CaRMS Online. You can write them directly in the online system, or use an offline word processing program and paste the text into CaRMS Online once it is complete.

Medical school transcript

A medical school transcript is a list of marks from your undergraduate medical education.

A placeholder is automatically created in your account for a medical school transcript. If you have attended more than one medical school, please contact us at and we will create an additional medical school record in your application.

Graduates of Canadian and American medical schools

In general, CaRMS receives transcripts for graduates of Canadian medical schools and US medical schools participating in the R-1 match directly from universities. Current year Canadian graduates’ transcripts are usually transferred automatically, while prior year Canadian graduates and graduates of American medical schools applying to CaRMS for the first time must ask their university to provide their transcript to CaRMS. If you are a USMG, you may also upload your own transcript if you have it in your possession.

If you have previously participated in the R-1 match since 2013, your previous documents will appear in your current profile. If you participated in an R-1 match prior to 2013, you may be able to have your previous application material forwarded to your current profile, including documents.

If you previously participated in a CaRMS match and have had your documents forwarded to your current profile, you may not have a complete version of your undergraduate medical transcript, as it may have been submitted to CaRMS before the completion of your final training year. You must decide whether or not you wish for your medical school to provide a completed copy for your application. Incomplete documents may not be accepted by programs.

Graduates of international medical schools

International medical schools can use our Undergraduate (UG) Portal to send in your transcript. Medical schools can register for these services by contacting Or, if you are registered with, you can have your transcript transferred to CaRMS through the online portal. You may also upload your own transcript if you have it in your possession.

If you previously participated in a CaRMS match and have had your documents forwarded to your current profile, you may not have a complete version of your undergraduate medical transcript, as it may have been submitted to CaRMS before the completion of your final training year. You must decide whether or not you wish for your medical school to provide us with a completed copy for your application or upload an updated version. Incomplete documents may not be accepted by programs.

If your medical school transcript is in a language other than English or French, you must provide a certified translation. If a program requires the foreign language document, upload the document in your CaRMS Online account. Please do not submit the original foreign language document to CaRMS unless requested as an extra document by the program.

Extra documents

You can include any additional documents you feel will enhance your application, including custom resumes (CVs), evaluation rotations, etc.

If programs would like to see specific documents or do not want to review any extra documents, these preferences will be indicated in their program description so review program descriptions before assigning extra documents.

Only upload documents into the Extra Documents category if another appropriate category does not already exist.

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