By Dr. Bilal Akil, MD — Emergency Medicine, Schulich School of Medicine & Dentistry, Western University · founder of mccQbank
Short answer: For the 2027 CaRMS R-1 match, your referees should submit their reference letters through CaRMS Online by 25 November 2026 at 21:00 ET, and applications and documents should be submitted and assigned to programs by 26 November 2026 at 12:00 (noon) ET, when file review begins; anything later is time-stamped late, and some programs will not review it (CaRMS applicant timeline). Personal letters are typed into CaRMS Online for each program, and a custom CV can be uploaded as an “extra document”, but check each program description, because some programs say which extra documents they want or don’t want. Which documents a program wants is set out in the provincial criteria and each program description.
This guide covers the three documents international medical graduates (IMGs) ask about most: reference letters, personal letters and the CV. Every CaRMS rule below comes from CaRMS’s own pages, read on 11 November 2026; our own advice is labelled as such. If you are still mapping the whole cycle, start with our CaRMS 2027 timeline for IMGs.
The dates that matter in November 2026
CaRMS Online opened on 9 September 2026 and program selection opened on 15 October 2026. The rest of the first iteration’s document calendar, from the CaRMS reference deadlines page and the applicant timeline (both “Updated May 13, 2026”):
| Date (ET) | What happens | What it means for you |
|---|---|---|
| 5 November 2026, 17:00 | Deadline for translation requests for references | Passed. CaRMS still processes later requests but “cannot guarantee” they will be ready before file review. |
| 13 November 2026 | Deadline for transcripts and MSPRs sent by faculties | Check Document Tracking in CaRMS Online. |
| 25 November 2026, 21:00 | Reference submission deadline | Referees can submit later, but that may cut into your time to assign letters before file review. |
| 26 November 2026, 12:00 (noon) | Deadline to submit and assign applications and documents | Anything after noon is time-stamped late. “Some programs will not review late applications or documents.” |
| 26 November 2026, 12:05 | File review begins | Programs begin reviewing files. Anything assigned after noon is marked late. |
CaRMS adds that dates are “subject to change”, so check the timeline again before you act on any of them.
Reference letters: the three types CaRMS accepts
CaRMS says references can come from “physicians, professors or non-clinical individuals”. When you request one in CaRMS Online, your referee is notified and can upload it directly. You also have to say whether the request is for a generic, discipline-specific or program-specific reference. The CaRMS document types page lists three kinds of reference document:
- Letter of reference: a detailed letter describing the referee’s experience with you and recommending you for further training.
- Applicant support form: a form a specific program requires. CaRMS does not supply it; you give your referee the copy from the program description.
- Structured reference letter: completed online by the referee for Family Medicine, Emergency Medicine, Orthopedic Surgery, Physical Medicine and Rehabilitation, Psychiatry and Pediatrics. You must choose this option from the drop-down when you make the request. Family Medicine has a separate sample form for IMGs.
Anesthesiology and Dermatology have structured letters approved for national use, but CaRMS still treats them as applicant support forms during their introductory period. For those two, you provide your referee with the link to the form, which is in the program descriptions.
What CaRMS asks referees to include
The CaRMS reference guidelines for referees say a letter should include a confidentiality statement that you have not seen and will not receive a copy, the date, and how long and when the referee worked with you. It should then assess your cognitive skills and knowledge, problem solving and patient management, behaviour and attitudes, communication and working relationships, motivation and punctuality, sense of responsibility, discipline-specific procedural skills, and special qualities and unique contributions. Where a referee can’t comment on an area, they should say they did not observe it.
That list is a useful briefing tool. When you ask someone for a letter, send them the list and a one-page summary of the cases or shifts you worked on together, so they can comment on each area with examples.
Rules that apply only to IMGs
CaRMS’s document page has a section for graduates of international medical schools. In its words:
- If you already hold a reference from your home country, you “must create a reference request in CaRMS Online and email the reference and coversheet to documents@carms.ca”. CaRMS does not accept hard copies or mailed documents.
- Ideally, references come from people who worked with you “in a clinical setting in North America”, but CaRMS “will accept any reference you can provide that is written by a physician and/or professor”.
- A reference in a language other than English or French needs an official translation.
- Your medical school transcript can be transferred from physiciansapply.ca, uploaded by you, or uploaded by your school through its CaRMS Online Undergraduate Portal account.
- MCC results, including the NAC, are accepted only as transfers from physiciansapply.ca. MCCEE results from before 2006 can’t be sent that way; CaRMS says to contact the MCC to have a certified copy sent.
- If your medical school taught in a language other than English or French, a language test may be required by the provincial criteria or the program. Our guide to CaRMS language proficiency for IMGs covers which tests apply.
One more rule protects letters written early. When CaRMS Online is closed, a referee can send an early reference with CaRMS’s early reference form to documents@carms.ca. Once CaRMS Online opens, you must create a reference request and tell the Document Centre its ID number; CaRMS “cannot upload an early reference document” until you do.
Personal letters: written in CaRMS Online, tailored to each program
CaRMS describes personal letters as how you “introduce yourself to programs” and explain why you chose a particular program. You enter them directly into CaRMS Online, either writing in the system or pasting text from a word processor. CaRMS sets no single template: “Each program has preferences regarding what the personal letter should contain”, so check each program description for what it asks for.
Our advice: if a program description asks specific questions, answer them in the order asked, with short headings, so a reviewer can find each answer quickly. A letter pasted unchanged across programs will miss whatever a particular description asks for.
Your CV and other extra documents
CaRMS lists custom resumes (CVs) under extra documents, along with items such as rotation evaluations. Programs that want specific extra documents, or that don’t want to see any, say so in their program descriptions. CaRMS also asks you to use the extra documents category only “if another appropriate category does not already exist”, so a reference letter goes under references, not extras.
Other documents you may be asked for include a Medical Student Performance Record (MSPR, or dean’s letter), which IMGs can upload themselves or have their school upload, and a photograph (JPG, under 2 MB), which programs only see from the start of the interview period.
A two-week plan to 26 November
| When | Do this |
|---|---|
| Now | Open every program description on your list and record which references, support forms, letters and extras each one wants. |
| By 13 November | Confirm in Document Tracking that faculty-sent transcripts and MSPRs have arrived and that your physiciansapply.ca transfers are showing. |
| By 16 November | Send each referee a gentle reminder with the 25 November 21:00 ET deadline and the CaRMS checklist above. |
| 17–23 November | Write and paste each personal letter; assign references and extras program by program. |
| 24–25 November | Assign any references that arrive late; check every program has the documents its description asks for. |
| 26 November, before noon ET | Final check and submit. Don’t plan to work right up to the deadline. |
The dates in this plan are our suggestion, built backwards from CaRMS’s deadlines; only the CaRMS dates are fixed. Our CaRMS planner for IMGs lines the match dates up with your MCC exam results.
Frequently asked questions
How many CaRMS reference letters do I need?
CaRMS does not set one number for every program. The required references are listed in each program description, and CaRMS notes that “Not all documents are required for all programs”.
Can I see my CaRMS reference letters?
Not normally. CaRMS references are confidential: CaRMS asks referees to include a statement that the applicant “has not seen and will not receive a copy of the reference”.
Is a CaRMS personal letter the same as a personal statement?
CaRMS calls it a personal letter. It introduces you and explains why you chose a specific program, and each program sets its own expectations in its description.
Do I need a CV for CaRMS?
Not always. CaRMS treats a custom CV as an optional extra document, and some program descriptions say which extra documents they want or don’t want, so check each one.
While your letters are with your referees, keep your MCCQE practice going: try 30 free questions in English or French.
