Not all documents are required for all 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.

When you make your request, be sure to indicate whether you are requesting a generic, discipline-specific or program-specific reference.

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.

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. You can find these forms in the program descriptions of programs requiring them.

Structured reference letters: This type of reference document can be requested by programs if you are applying to one of the disciplines below. They are completed inline by reference providers, which means you must pick this option from the drop-down menu in your CaRMS Online account when requesting a reference for these disciplines specifically. You can see samples of these documents below.

International medical graduates

If you are a graduate of an international medical school, you may have reference materials from your country of origin that you have brought with you to Canada. If you already have a reference in your possession, you must create a reference request in CaRMS Online and email the reference and coversheet to CaRMS does not accept hardcopy or mailed documents.

Ideally, references should be written by people who have worked with you in a clinical setting in North America; however, we will accept any reference you can provide that is written by a physician and/or professor.

If the reference is in a language other than English or French, you must provide an official translation.

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 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 reference request

When CaRMS Online is closed, you can contact your referee(s) and request a reference, by completing the early reference form and providing it to your referee. The early reference form must be attached to the reference document when it is sent by your referee to CaRMS. Your referee must email the early reference form and reference document to Once we receive your early reference form and reference document, we will email you to let you know they have been received.

When CaRMS Online opens, you must create reference requests for any early letters of reference. Please notify the CaRMS Document Centre at when a reference request has been created and include the reference request ID number so that your early letter of reference can be uploaded to your account. The CaRMS documents team will match the request with the document and upload it to your CaRMS Online account. It is your responsibility to track which documents have been uploaded. If no request has been created, we will contact you via email.

Note that we cannot upload an early reference document to your profile unless you inform us that you have created a reference request.

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)
  • University of British Columbia’s Clinical Assessment Program (CAP)
  • 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.

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 eligibility requirements or program descriptions.

Exam expiration dates

Programs require that all submitted documents are valid – meaning that they have not expired. You are responsible for ensuring that your examination results are currently valid.

Canadian citizenship documents

CaRMS has partnered with third-party organizations to automate the verification of citizenship/legal status required by postgraduate offices for entry into residency. Third-party verification simplifies the process for applicants and programs. All applicants who do not receive third-party citizenship verification will be required to upload and assign an acceptable proof of citizenship document. Please see additional information here.

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.

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 medical schools

You can submit your medical transcript in one of two ways:

  1. Obtain and upload the document yourself into your CaRMS Online account; or
  2. Ask your medical school to upload your document using their CaRMS Online Undergraduate Portal account.

If you have previously participated in the R-1 match since 2013, your previous documents will appear in your current profile.

Graduates of international medical schools

You can submit your medical transcript in one of three ways:

  1. Transfer your document from (Log into CaRMS Online and follow the instructions in the section); or
  2. Obtain and upload the document yourself into your CaRMS Online account; or
  3. Ask your medical school to upload your document using their CaRMS Online Undergraduate Portal account.

If you have previously participated in the R-1 match since 2013, your previous documents will appear in your current profile.

International schools who do not have a CaRMS Online Undergraduate Portal account can submit a request to

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 medical schools

In general, CaRMS receives MSPRs for graduates of Canadian 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 applying to CaRMS for the first time must ask their university to transfer their MSPR to CaRMS via the school’s CaRMS Online Undergraduate Portal account.

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

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.


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
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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