Not all documents are required for all programs. Applicants can find out which documents they 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 the applicant for further medical training.

When an applicant requests a reference letter through CaRMS Online, the referee is notified of the request. The referee may create and upload the reference letter directly in CaRMS Online, or mail a hardcopy reference letter to CaRMS to be scanned and uploaded to the applicant’s account. Applicants may request a generic, discipline-specific or program-specific reference letter.

For step-by-step instructions on how to request a reference letter in CaRMS Online for applicants, visit our Help Centre.

There are two 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 an applicant and recommends the applicant for further medical training.

Applicant support form: This type of reference document can be requested if an applicant is applying to a program that requires it as part of their application. It is the applicant’s responsibility to provide a copy of the form, as it is not provided by CaRMS. These forms can be found in the program descriptions of programs requiring them.

International medical graduates

If you are an international medical school, your students may already have reference materials that they have acquired and wish to use in the match. If you wish to submit reference letters on their behalf, please contact documents@carms.ca for further instructions.

Please note that if the reference is in a language other than English or French, students must provide an official translation. Please do not submit the original foreign language document to 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 the applicant
  • Assessment of the applicants:
    • 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 applicant’s 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

Applicants can request reference letters before CaRMS Online opens for the match by printing the early letter of reference form and requesting a letter outside of CaRMS Online.

The applicant must fill in the early reference letter form and submit it to their referee. Once the referee has written the letter, they must attach the form to the letter and send it to CaRMS at the following address:

CaRMS – Document Centre
171 Nepean Street, Suite 101
Ottawa, ON
K2P 0B4

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

When CaRMS Online opens for the match, applicants must log into their CaRMS Online account and officially create a coversheet for the reference letter. Once this is created, applicants must notify CaRMS at documents@carms.ca so we can scan the letter to the applicant’s account in CaRMS Online. It is the applicant’s responsibility to track which documents have been scanned.

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 can be sent directly from the issuing organization or uploaded to CaRMS Online by the applicant.

For information on how to submit examination results, consult the document instructions for Canadian medical graduates (CMGs) and/or the document instructions for international medical graduates (IMGs).

International medical graduates and Osteopaths

Applicants will be required to provide Medical Council of Canada (MCC) and/or National Assessment Collaboration (NAC) examination results as part of their application. MCC examination data and documents, including the NAC, are only accepted through transfers from physiciansapply.ca* on CaRMS Online. Click here to learn how applicants can connect to the custom physiciansapply.ca sharing page from their CaRMS Online account.

*Note: Results prior to 2006 cannot be sent via physiciansapply.ca. If an applicant wrote the MCCEE prior to 2006, they should contact the MCC directly to arrange for a certified copy to be sent to CaRMS.

Language examinations

If a student’s language of instruction during medical school was not English or French, they 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 applicants 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. Students are responsible for ensuring that their examination results are currently valid. The following table outlines typical expiration dates; however, students should verify 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 Yearly
UBC IMG CAP No expiry date
AIMG CAP No expiry date
AIMG MMI Yearly
CMQ Assessment Yearly

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

Canadian citizenship documents

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

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

Applicants may upload multiple document types as proof of Canadian citizenship status. Acceptable citizenship documents vary by province, so they 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.

Medical school transcript

A medical school transcript is a list of marks from a student’s undergraduate medical education. For medical school transcripts, a placeholder is automatically created in all students’ accounts in CaRMS Online for the document to be uploaded.

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’ medical school transcripts are usually transferred automatically, , but students must ensure they follow their university’s processes for their documents to be transferred to CaRMS and should check the document tracking section of CaRMS Online to ensure the documents are in place.

Prior year Canadian graduates and graduates of American medical schools applying to CaRMS for the first time must ask their university to provide their medical school transcript to CaRMS. Canadian medical schools have processes in place to send documents to CaRMS. If you are faculty of medicine outside of Canada, you can request an Undergraduate (UG) Portal account to send medical school transcripts electronically. Medical schools can register for the UG portal by contacting communication@carms.ca. USMGs can also upload their own medical school transcript directly in CaRMS Online if they have it in their possession

Graduates of international medical schools

Students can upload their own medical school transcript if they have it in their possession. International medical schools can also use our Undergraduate (UG) Portal to upload medical school transcripts. Medical schools can register for the UG portal by contacting communication@carms.ca.

Or, if students are registered with physiciansapply.ca, they can have their medical school transcripts transferred to CaRMS through the physiciansapply.ca online portal.

Medical Student Performance Record (MSPR)

The MSPR/dean’s letter is a letter of standing from the dean or principal of the medical school.

Typically, this document:

  • Reports on activities during medical school; and/or
  • Comments on performance in clinical rotations; and/or
  • Gives a recommendation for further medical training; and/or
  • Reports on time spent in each specialty or department (hours or weeks).

Graduates of Canadian and American medical schools

In general, CaRMS receives MSPRs for graduates of Canadian medical schools and US medical schools participating in the R-1 match directly from universities.

Current year Canadian graduates’ MSPRs are usually transferred automatically, but students must ensure they follow their university’s processes for their documents to be transferred to CaRMS and should check the document tracking section of CaRMS Online to ensure the documents are in place.

Prior year Canadian graduates and graduates of American medical schools applying to CaRMS for the first time must ask their university to provide their MSPR to CaRMS. Canadian medical schools have processes in place to send documents to CaRMS. If you are faculty of medicine outside of Canada, you can request an Undergraduate (UG) Portal account to send in MSPR/dean’s letters electronically. Medical schools can register for the UG portal by contacting communication@carms.ca. USMGs can also upload their own MSPRs directly in CaRMS Online if they have it in their possession.

Graduates of international medical schools

Students can upload their own MSPR/dean’s letter if they have it in their possession. International medical schools can also use our Undergraduate (UG) Portal to upload MSPR/dean’s letters. Medical schools can register for the UG portal by contacting communication@carms.ca.

Personal letters

Personal letters are how applicants introduce themselves to programs and how they express interest in a specific program and/or discipline.

Personal letters should outline the reasons an applicant has chosen a particular training program. Each program has preferences regarding what the personal letter should contain, so we encourage applicants to check individual program descriptions for more information.

Student’s must enter personal letters directly into CaRMS Online. However, they can use an offline word processing program and paste the text into CaRMS Online once it is complete.

Photograph

If programs would like to receive 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.

Students must upload their photograph directly into their CaRSMS Online account in JPG format and it should be less than 2 MB in size.

Extra documents

Applicants can include any additional documents they feel will enhance their 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 we encourage students to review program descriptions before assigning extra documents.

Applicants should only upload documents into the extra documents category if another appropriate category does not already exist.

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