Understanding what to look for in an OMSAS referee is a lot easier after checking out some OMSAS reference examples.

The Ontario Medical School Application System (OMSAS) is a centralised system for the six medical schools in Ontario. This gives prospective students access to an extremely effective tool that will help navigate the application process. Understanding OMSAS is crucial if you are going to be applying to any or all of these six schools.

In-particular, it can be useful to understand what is being asked of a referee. If you are a student, this can help you to select the very best referees to give you application the desired “edge”. If you are a referee, it can help to know what your student needs and what will best suit the application.

This applies to OMSAS schools, not all medical schools in Canada.

In this article, we will take a look at who makes for a good OMSAS reference, what makes a good OMSAS letter, what is unique about them, the different types of letters and references you’ll need, and how to approach potential referees. Plus, we will provide you with OMSAS reference examples!

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Article Contents
10 min read

What Makes an OMSAS Letter of Reference Unique OMSAS Reference Format Who Can Be Your OMSAS Referees? Additional Letters Structure of CAFs OMSAS Reference Example FAQs

What Makes an OMSAS Letter of Reference Unique

The first thing you need to know about an OMSAS letter of reference is that is that they follow a specific structure. They use a form called a confidential assessment form, or CAF. This form means that referees must hit certain prompt points instead of just writing a general reference letter of praise.

There are three of them. It isn’t just one letter; you need three separate letters from three separate people. These letters will cover different aspects of who you are and the potential that you have to become one of the medical field’s strongest assets.

In addition to OMSAS’ own requirements for referees, make sure that you are selecting referees who will fulfill any specific program requirements for any – or all – of the programs you are applying to.

Check out this infographic for more information on the OMSAS application:

OMSAS Reference Format

You cannot have one referee write all three medical school recommendation letters. You must have three different referees, each one of whom must know you.

Find referees who not only know you, but who will communicate this well to the admissions committee. The more exciting things they’ve seen you do, the farther they’ve seen you grow, the better. They must know you well enough, in fact, to answer the confidential assessment form (CAF).

Confidential Assessment Form

The CAF is comprised of four questions, one of which – question 2 – has subheadings.

1. Would this applicant make a good physician?

2. Rate the applicant on each of the following attributes:

  • Communication skills
  • Problem-solving skills
  • Professionalism (e.g., commitment to ethical practice, standards of behaviour, and accountability to others.)
  • Empathy (e.g., demonstrating consideration of others’ perspectives).

3. Identify and comment on one area of improvement for the applicant.

4. Share any other information you feel may be relevant to a medical school’s admission committee.

Some important tips:

First, make sure you contact your referees and let them know how to fill out the form. This is your responsibility, not OMSAS’.

Second, use a business or university email address, not a personal one, just for reasons of professionalism.

Include your contact information when emailing your referees, to ensure that they can reach you if need be.

Who Can Be Your OMSAS Referees?

The first referee and letter must be academic or employment-related.

The second referee is non-academic.

The third is one referee of your choosing.

The first will be the easiest to select. You should have several employers or professors who would be capable of presenting you with a well-written letter of reference, speaking to your academic or professional acumen. A suggestion: why not both? If you have such a person in your life, it’s possible that you have interned for a lab where you studied, or perhaps you have been a TA. This won’t be possible for everybody, but if you have a reference who can simultaneously speak to your work ethic and your academic potential, you have an excellent referee.

If you don’t have somebody like that, you can pick one or the other and be just fine. Choose somebody who knows you best in the capacity of academia or as a worker.

Second, you will find a non-academic referee. If you selected an academic referee first, you could use this non-academic slot to find a professional referee. You might want to separate the two deliberately, as well. Perhaps the person best suited to discuss your academics isn’t ideally positioned to talk about your professional life, and vice-versa. In that case, divide the two up to have the best information come before the admissions committee.

The third reference is a reference of your choosing. This is open-ended enough to be tricky. But with a little thought, it could be your best of all references.

What the committee wants to see is what makes you uniquely you and what will make you the right candidate for a career in medicine.

Some suggestions:

Have you ever been involved in a major artistic undertaking? Had a band that went past the garage doors and into actually gigging or recording? If you have somebody who can speak to your professionalism, musicianship, and perseverance, they might be the perfect candidate for referee number three. Outside of music, any artistic endeavour will feel at home here. Having a painting hang in a gallery, producing a theatre show, or getting something published. Can you talk to a mentor, gallery owner, or editor? Remember, they will have to know you well enough to fill out the CAF!

If you aren’t going that route, think about volunteer work you might have done. Some humanitarian aid, social cause you supported, or political undertake you helped bring about? If you have a supervisor who can speak to your compassion, logic, debating skills, or just stamina as you cold-call people for donations to save the rain forest – because it’s all for a great cause – you could have a really thoughtful third essay.

Another route would be if you are a member of an underrepresented community. Many medical schools want to recognise diversity and inclusion. This blends with the above idea a bit, but maybe you helped out at a rally or protest. Or maybe you can just have somebody from your community speak to how you have become a champion for diversity, in your life and in your academic world. Remember that they will need to use concrete examples of actions that demonstrate this commitment.

There will be clues in medical school requirements. The requirements your schools-of-choice emphasize can be used to show what you should focus on.

Or perhaps something else, something even more unique and unanticipated, not mentioned here. You could find any number of things. Thing about the thing that makes you intrinsically, irreplaceably you, and then figure out who the mentor is. Do avoid family, however. Even if they are technically suitable and reliable, they will appear nepotistic and suspect if they write you a glowing letter of recommendation.

Looking for more help with your OMSAS application? Check out this video:

Additional Letters

There are two schools that require additional referees. They are Queen’s University medical school and the University of Toronto Faculty of Medicine. These schools want referees that speak to other, specific areas of your life. In addition to the first three letters, they would like two more – for Queen’s - and one more – for Toronto – referees and lair.

Structure of CAFs

Question one on the CAF form should follow a standard essay writing structure and style. The writer of the letter should open with an introduction paragraph and an attention-grabbing sentence. The body is formed by several paragraphs describing detailed, specific qualities of the applicant. These should speak directly to the applicant’s qualities as related to the kind of referee who is writing the letter – academic, non-academic, professional, and so forth.

Detail is excellent, as long as it isn’t too much. The main thing is to emphasize the applicant’s capabilities. The best characteristics to speak of are perseverance, kindness, ethical decision making, critical thinking, and sympathy. These qualities cannot just appear in a list, but be demonstrated by examples. The old adage tells us that actions speak louder than words. Is it more effective to tell somebody, “My friend Eliza is loyal,” or to tell a story of how she faithfully stuck with you through hardship? Referees should use examples to demonstrate your qualities.

Finally, a concluding paragraph wraps up the essay.

The second question has the referee rating the applicant. Instead of just providing a number, it would be most helpful to provide the ranking with context. Eight out of ten means little without knowing why the applicant is an eight out of ten.

For the third section – identifying an area of improvement – take a little space to explain the kinds of things that the applicant is missing, but also couch it in a context that won’t cut the applicant’s process off at the knees, as it were. Make sure that the committee knows that there is growth and a promising future in this context, so that they won’t be stuck with no choice but to think about the applicant as severely lacking in a critical area. Ideally, the writer can demonstrate how you have grown in this regard and what you have done to improve your shortcomings.

Finally, use the section at the end – anything to add that might be relevant – to come up with something that the committee would like to hear that maybe isn’t as easily contained within the other sections. You can use this to show off other, unique aspects of the person so that they feel more genuine, human, and invaluable to the committee. If you know of a personal hardship that the student has undergone, for instance, you might list it here. Or, if your student comes from a background – such as a rural upbringing – that will give them insight into a specific area of medical practice, you might want to include that in the final section.

The primary requirement is to follow the instructions on the form. Fill out the CAF properly. Do this succinctly, but without losing any of the necessary details.

The only other requirements to make sure that the information remains confidential, and that everything from recruitment of referees to final submissions, stays above-board.

OMSAS Reference Example

1. Would this applicant make a good physician?

The greatest assets that Michael has is a selfless attitude that serves him as well as those he helps. As his laboratory instructor, I have gotten to know Michael the student, Michael the scientist, and Michael the helper.

Throughout the years, I have been impressed by Michael’s willingness to help others in the lab. I can surely attest to his excellent academic track record, but I believe he is suited to be a physician because of his empathy as much or more than any other quality he possesses. Frequently, he has remained behind after class and assisted me in performing the final clean on the lab.

Additionally, Michael is a fine student, achieving excellent scores, and finding insightful solutions to any problems set before him. His attention to detail is superb. For example, in one lab, I set out a set of four experiments. One was a bit of a trick question; I wanted to see which students would answer accurately and which students would answer as though the experiment succeeded – what they thought I “wanted” to hear. Not only did Michael give me an accurate answer, he also explained why it didn’t work, and alluded to the trick; he found me out!

There is no reason I can think of why Michael would not make an excellent physician. His laboratory skills are near-perfect, and he has a way with people which is comforting and friendly without being unprofessional or crossing any lines. I can unreservedly give Michael my highest recommendation.

2. Rate the applicant on each of the following attributes:

Communication skills - 8/10 - Michael readily asks questions and can explain himself clearly and concisely. I docked a couple points because sometimes I find his independence means that he sometimes misses updating me, but for the most part, he has excellent lines of communication.

Problem-solving skills - 10/10 - Rarely is Michael stumped by anything in class. I frequently assign extra credit “bonus” assignments for lab students to complete after they have finished with their other work. Michael has completed these bonuses more than any other student in class.

Professionalism (e.g., commitment to ethical practice, standards of behaviour, and accountability to others.) - 9/10 - Always well put-together, never rude, and deferential without being obsequious, Michael exhibits all hallmarks of professional behaviour. It is rare for Michael to cross any sort of line, even in a small way. I have seen him interact with standardized patients, as well, and he is always courteous without being overly familiar.

Empathy (e.g., demonstrating consideration of others’ perspectives). - 10/10 - Michael’s strongest attribute. He displays tremendous amounts of empathy and sympathy for others.

3. Identify and comment on one area of improvement for the applicant.

Perhaps linked to his willingness and eagerness to assist others, Michael sometimes is rushed. I believe that this is partly linked to time management, but other contributing factors are his decisions to put aside his own goals for those of others, and a friendly, outgoing personality which has him socializing and losing track of time.

This is not to say that Michael is late – rarely, if ever is he late – but that he sometimes seems rushed. I have noticed an improvement over the last few months, however, and I think he will soon have overcome this problem.

I spoke with Michael about it at the beginning of the last semester, and recommended he use a time management app on his phone. He has employed the app, which seems to help give him that little boost he needs to keep his day’s flow going.

4. Share any other information you feel may be relevant to a medical school’s admission committee.

Michael’s mother took a bad turn of health two semesters ago. He is not one to make excuses, but his grades dipped at that time. They always remained excellent, but they did go slightly down as he took time to deal with his family’s problems. I had to ask Michael a bit before he spoke of this. It is possible he won’t want to make excuses in his application, either. If he doesn’t explain this grade dip, I do it for him here.


1. Does OMSAS contact my referees once I fill out the form?

You need to click on the “send email” button after you have added a referee to your list. Once you click the send email button, the referee is notified. But do note that until you click that button, your referee is not notified. It is your responsibility to both find referees and send that email.

2. Can I have more than three letters submitted?

No. OMSAS doesn’t allow more than three. Make sure that the three you get count for everything, because nothing after letter number three is submissible.

The exception to this is with University of Toronto and Queen’s University, which have extra letters required. In those cases, you will have two references for Queen’s and one for University of Toronto, but those are capped, too. The number is the number, you can’t add more.

3. Which schools use OMSAS?

McMaster Medical School, the Northern Ontario School of Medicine, the University of Ottawa, Queen’s University School of Medicine, University of Toronto, and the Schulich School of Medicine and Dentistry.

4. Do you have to be Canadian to go to those schools?

Not all of these institutions are Canadian medical schools that accept US students, but some are. The University of Toronto’s faculty of medicine takes on US students, as does McMaster University in Hamilton.

5. How long can the letters be?

There is no given page limit or word count. This, theoretically gives your referees carte blanche to write as much as they want. With that said, they probably shouldn’t go over a page or so. If they ask, tell them to aim for 750 words for the main part – question one – and use shorter lengths for the other questions. Aside from a little context, question two shouldn’t need a lot – for instance. You can let them know that a little room on either side is available, so they don’t need to hit 750 words or one page on the mark. A little over is fine.

6. Do I contact the referees myself?

Yes, respectfully and politely. No matter how well you know the referee, no matter how friendly you are with them, make sure you ask politely if they will be a reference for you, and if they say yes, be sure to send them the CAF notification promptly – meaning immediately. Use the “send email” button to notify them. After that, thank them for their help.

7. Can I switch referees?

You can switch out referees as long as they have not yet begun to work on the CAF. The best idea here is to be sure of your referees before you even ask them.

If a referee starts the CAF, but becomes too busy to continue, contact OMSAS for how to change referees, explaining the circumstances as exactly and tactfully as you can.

8. Are there application fees? What are they?

OMSAS itself has a $200 CAD application fee. Each school has an application fee as well. All of the schools are $125 CAD, except for the University of Toronto, which is $130 CAD.

To your success,

Your friends at BeMo

BeMo Academic Consulting

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Very informative article. One question. Do other provinces have a similar thing to OMSAS?


BeMo Academic Consulting

Hi Al! Thanks for your question. No, other provinces in Canada do not have a unified application system. You will need to apply to each school separately.