CaRMS Reference Letter Example and Guide

What exactly is a CaRMS reference letter?

The Canadian Resident Matching Service (CaRMS) reference letters are basically detailed letters that describe the referee's experiences with you, the applicant, and recommend you for residency programs. They are very similar to an ERAS letter of recommendation. These letters are an objective reflection of your suitability for your chosen specialty. They are meant to show the program selection committee how other professionals view you, tell them about your work ethic and what you can bring to your chosen specialty in the field of medicine. Having the support of the medical community and specialists in your chosen field is a huge feat! If experienced professionals strongly support your candidacy, you will make a great impression.

Residency reference letters are an essential part of your CaRMS application that can go a long way in setting you apart from other candidates. A strong reference letter can be the deciding factor between getting called for an interview or not, so you want to pay special attention to it as you prepare for your residency application. That's where we come in. We've put together a list of Do’s and Don’ts that will help you avoid common pitfalls and help you secure the best reference letters possible.

Want to learn more about how to effectively prepare for residency applications? This infographic should help:

DO secure your reference letters early

By writing a reference letter for you, your referees are pretty much endorsing your application to a residency program. Most professionals will only do that for someone they truly believe in. This is why it's a good idea to start planning for your reference letters as early as possible. We recommend that you always put your best foot forward and start building a relationship with mentors, volunteer supervisors, research advisors, attendings, and anyone else who can eventually write you a strong reference. When you begin working with your superiors, make sure you talk to them about their expectations of you and then work hard to exceed those expectations. It is also a good idea to contact them periodically for feedback. Such eagerness will show them that you care about the work and help you connect with them.

As you work with a potential referee, consider your relationship and your improvement. Ask yourself if they were to write your reference letter, would this reference would be strong? You should make your future plans to apply for residency clear as soon as you start working with someone but do not ask for a letter right away. Only after establishing a relationship with this person and working with them for a substantial amount of time, can you ask them for a reference. Keep in mind that you can ask people long before the applications are due. For example, if you are still in the 3rd year of med school and you have a bond with one of your rotations attending, feel free to ask them now and then follow up as you start preparing for the application. 

The earlier you secure and request your letters of recommendation, the better. We recommend that you secure your letters before July because the CaRMS portal opens in the fall. You want to give your referees ample time to write a strong reference letter, and you also want to give yourself enough time to secure a different letter of recommendation if they say no or fall through. While preparing your residency application, you should craft an ideal CaRMS timeline for yourself and ensure that securing your reference letters is very early on that timeline. The earlier you ask, the sooner your writers can start working on them, and therefore, the higher your chances of getting a strong reference letter. This will also give you more time to focus on other aspects of your preparation like reviewing CaRMS interview questions, for example. 

Need to prepare residency personal statements as well? Check out these 3 examples for inspiration:

DON'T ask your referees for a reference in a text message

We understand that you might have a great relationship with your mentor or whoever writes a reference letter for you. Still, you have to remember that you are essentially asking them for a professional favor. You want to be courteous and tactful in how you do this. The CaRMS portal allows you to ask for a reference directly on the site but it is a good idea to let the person know that you will be doing this and make sure that they agree to it. We recommend asking for this letter in person whenever possible. This is typically easier to do if you request the letter while still working with them. In that case, you can simply ask to speak with them for a few moments after you've completed your daily tasks.

If you no longer work with the person, we recommend sending them an e-mail to request an in-person meeting. If you get an enthusiastic response to your e-mail, then it is very likely that this person will say yes to writing a letter on your behalf. On the other hand, if you notice that the potential referee is hesitant, you may need to reconsider.

We know that a face-to-face meeting may not always be possible. If it is not, you may request your CaRMS reference letter by e-mail. Keep in mind that an in-person meeting will allow you to answer any questions that they might have right away and allow you to provide them with additional materials. If you are sending your request by e-mail, you can try to anticipate some of the questions that could come up and answer them in your request. You could also wait for their response and schedule a call during which you can answer their questions.

In both cases, it is a good idea to make your connection to them clear in the email. Remind them how they know you and where you worked together. You should also provide your contact information so that they can reach you if they need additional information.

Here is a sample of what these e-mails should like:

SAMPLE REQUEST FOR A MEETING: 

Hello Dr. Smith,  

I hope this email finds you well.  

It was a pleasure working with you at the Dalhousie Clinic in 20xx-20xx. You were always willing to teach, and I benefited greatly from the seven months I spent working with you and your team. I am applying to residency in the Fall and would love to meet with you to discuss this process.  

If you are willing, please let me know your availability to meet.  

Thank you,

Jane Doe 

SAMPLE REQUEST FOR A REFERENCE LETTER:

Hello Dr. Smith,  

I hope this email finds you well.  

Working with you at the Dalhousie Clinic in 20XX-20XX was an absolute pleasure. Your guidance and support during my time there is truly appreciated. 

I am applying to residency in family medicine specifically, and I was hoping that you would be willing to write a strong letter of recommendation on my behalf.   

If you are willing, please let me know at your earliest convenience and we can set up a call for me to address any questions that you may have. I can provide you with supplemental documents to aid you in writing your letter. 

I understand if you aren’t able to provide me with a reference letter.  

Thank you for your consideration. 

Best Regards,

Jane Doe 

DON'T ask anyone who has not worked with you personally

You need to be very careful when deciding who will write your CaRMS reference letters. There are a few things to consider, but perhaps the most important one is that your referee should have experience working with you. Remember that your reference letter is supposed to tell the residency programs you are applying to how other medical professionals view you. If you request a letter of recommendation from someone who only worked with you for one day, even if they are a very well-known person in your chosen field, the letter will not be strong because it will likely be generic. It would be best to select individuals who know you well professionally and with whom you often interacted as a student or colleague. Ideally, you would have worked with your referee for at least a semester or a full rotation. Thus, they will be far more likely to write letters of recommendation that detail your strengths and achievements.

Keep in mind that diversity is key. You want to have letters from various supervisors who know you from different experiences. The aim is for all your letters combined to give the residency program a holistic view of who you are as a candidate, your work ethic, and what you can bring to their program. Your referees can include pre-clinical professors, research advisors, volunteer or extracurricular managers or advisors, clinical clerkship attendings, or department heads. Some programs even encourage you to include at least one reference from someone outside of medicine, so be sure to check the program's requirements.

DO have letters that support your candidacy for your chosen specialties

To improve your chances of matching, you should apply to at least two different specialties and have a minimum of one referee who works in each specialty. For instance, if you are applying to family medicine residency, then you should have at least one reference from a mentor, attending, or a department chair who works in the field. Their letter will provide support for your suitability for that specialty.

Unsure how many residency applications is too many? Take a look at this infographic:

CaRMS allows you to assign different letters to different programs but you do not need to address your reference letters to specific programs. Think about how many residency programs to apply to and estimate the number of letters your referees would need to write. It is simply not feasible to expect applicants to write program-specific letters and residency programs understand this. Instead, you should have standardized letters of recommendation that are specific to the specialties you are interested in.

DO give your referees guidelines and additional materials

Selecting someone who knows you professionally and maybe even personally is great, but you also want to give them everything they need to write the strongest letter that they can. We encourage you to provide them with supporting documents like your residency personal statement, residency CV, and a short biography to fill in any gaps in your background. You also want to make sure they have access to everything that CaRMS requires for your reference letter.

Need help with your residency CV? Check out this video:

For example, CaRMS requires that reference letters include the following information:

You need to make sure that your referees have access to this information so that it does not harm your application. We recommend that you direct them to the full list available on the official website.

DON’T forget to check program specific requirements

Some programs can request that references be submitted in a specific format and it is your responsibility to inform your referees of this. When the CaRMS portal opens, it is important to check the most recent program requirements and inform the concerned parties as soon as possible. There are three types of formats that can be accepted:

These documents may be different but ultimately, they are all designed to do the same thing: tell the program directors as much as possible about you as a professional and whether or not you are a good fit for your chosen specialty.

DO follow up

It's a good idea to follow up with your reference providers a few weeks before the reference submission deadline. You should politely remind the writers of the deadline and ask if any further information is needed. This is a good way to check in and find out if your references are ready or confirm that they will be ready on time. 

We also recommend that you thank your referees once they have submitted your CaRMS reference. You can send them an e-mail or a handwritten card for a more personal touch. Your thank you note does not need to be long or complicated. The aim is simply to let them know that you appreciate them taking the time to endorse your candidacy.  

Here is an example:  

Dear Dr. Smith 

Thank you so much for supporting my application to residency by writing a reference letter on my behalf. I really appreciate all the time you took out of your daily schedule to complete this for me. It has been a privilege working with and learning from you. 

I will keep you informed as the application season progresses.  

Sincerely, 

Jane Doe 

How to submit your letter of recommendation

It is your responsibility to make sure that all of your CaRMS reference letters are submitted on time and that they meet all the requirements. Verify that you have secured all the references required by the programs you will be applying to.

The CaRMS portal allows you to request references online and it gives you the different document types as options so you are able to let your chosen writer exactly what kind of reference you need. That said, we do not recommend that you rely solely on this. Always contact the referees directly and provide them with all the information that they need to give you a glowing reference. Contacting them will reduce the likelihood of any miscommunications.

Once the writers have completed the letters of recommendation, they must submit them through their CaRMS online account for referees. Once logged in, they will be able to either upload a document or write the reference letter directly on the CaRMS platform. You need to follow up with them to make sure they have this information and can do it before the deadline. We recommend submitting all your supporting documents, including the reference letters as soon as the portal opens in September or as close to that date as possible. 

Sample CaRMS letter of reference

Now that you know about the process of securing a letter and what it should have, let’s take a look at a sample reference letter so that you can get an even better idea of how detailed a strong letter should be:

August 17, 20xx

Dear Program Director and Selection Committee Members,

Re: CaRMS Application Ref for Ms. Jane Doe

I write this letter supporting Ms. Jane Doe's application to your family medicine residency program with great pleasure. I am a family physician at a small walk-in clinic in a primarily urban area where Ms. Doe volunteered from March 20XX to July 20XX. I supervised her and observed her work for over a year, and I can confidently say that she will make an excellent doctor.

She was with us for a relatively short time, but she made a great impression on myself and my team. While preparing to write this letter, I solicited feedback from my colleagues at the clinic, and they too were impressed by her level of professionalism and her ability to connect with even the most difficult patients. Ms. Doe's willingness to help and work ethic are things we could always rely on. She often volunteered to work longer hours when we needed the extra help, and she was always first to take on the tasks that many others shied away from, such as manning the front desk to welcome patients and take family history.

She was especially good at probing and getting patients to open up. Many walked into the clinic frowning and visibly nervous but by the time they got to me, they had been reassured by Jane telling them that we would take care of them. A part of being a family physician is building life-long bonds with your patients by showing them that you care. I can honestly tell you that Jane showed us that she is able to do this with ease during her time here. It was evident in how she interacted with patients and her colleagues that she is culturally and socially aware. Qualities that I believe are very important in family medicine, where you often have to deal with sensitive topics.

Jane Doe was in her third year of medical school when she volunteered with us. Her passion for medicine and eagerness to learn was always undeniable, and it is one of the things that impressed me the most. I recall very clearly Ms. Doe coming into my office after her second or third shift to talk about a patient who had come to the clinic earlier. She had connected the treatment that we were giving the patient to something she was learning in class, so she came to see if it would be okay to ask me a few more questions about the prognosis. Ms. Doe continued to show this same willingness to learn throughout her time at the clinic, and she often sought out the opportunity to apply what she was learning.

Overall, I strongly recommend this applicant for a Family Medicine residency position. I believe that her professionalism, positive learning attitude, and excellent bedside manner make her a great candidate for your program.

Please note that Ms. Doe did not have the opportunity to review the content of this letter before submission to CaRMS.

Sincerely,

John Smith, MD 

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