A reference letter is a letter from a
physician that speaks to your skills, abilities, interests, and
suitability for the profession/specialty you have selected.
Who Should I Ask for a Letter?
Whether you are decided or not regarding your specialty choice, you should request a letter from any clerkship or elective supervisor with whom you have good contact and who gives you a sense that he/she feels positively about you and your skills. If you do know the discipline(s) to which you will be applying, certainly seek letters in those fields, but in case you change your mind (and many do!!), it’s always a good idea to have made reference letter contacts with any supervisors who could potentially write you a strong letter.
Letters from experiences prior to clerkship are not very highly valued by residency program directors, nor are letters from non-clinical experiences. Unless specifically noted otherwise, letters should be written by attending staff or other licensed physicians (NOT residents/fellows).
How Do I Request a Letter?
At the end of your rotation, approach the
physician and ask him if he/she would feel comfortable writing
you a strong letter of reference for your residency
If he/she hesitates at all, it is likely
that this person will not write the strongest letter; accept the
letter if offered, but you may not use it.
If the supervisor
agrees enthusiastically, provide him/her with a copy of your CV,
a brief cover letter outlining your interests and specialty
choice (if decided), and a photograph. Encourage him/her to jot
a few notes about you down so he/she doesn’t forget you!
will begin soliciting letters at the beginning of Core Clerkship
(CCP), and some supervisors may wish to write a letter
immediately following clinical contact with you. Since you only
have access to the electronic residency application systems
starting in the fall of fourth year, you have a couple of
The supervisor can write the letter and keep it on
file at his/her office – this is the most preferable since match
agencies like to receive letters directly from referees. Once
you have access to your electronic residency application dossier
in the fall of fourth year, you will be able to print off the
appropriate, personalized reference letter cover sheet from the
system and give it to the referee to attach to his/her letter
for sending to the appropriate match agency.
can write the letter, seal it in an envelope, sign across the
seal, and give the envelope to you – then, once you have access
to the electronic application system, you can print off your
cover sheet, attach it to the outside of the sealed reference
letter envelope, and send it in a larger envelope to the
appropriate match agency; just ensure that you never break the
seal on the original reference letter envelope.
Should a Reference Letter Have?
CaRMS has developed a “primer” for
referees to indicate the type of material that should be
included in a reference letter.
Exception: Some programs
(primarily some programs at the francophone universities but
several at other Canadian schools as well) do not accept
standard reference letters and instead require referees to fill
out a university or program specific standardized form. If this
is the case for a program to which you are applying, you will
find the link to the form on the CaRMS program description page
for that program. Be sure to verify this early.
Reference Letters Should I Get?
Most residency programs will
request that you submit at least three (3) reference letters as
part of your application, but some will permit up to five (5).
For a standard, 3-letter application, we tend to recommend that
two letters be from physicians in the field to which you are
applying and one from a complementary discipline. At least one
should be from a physician at the institution to which you are
applying (if you have done an elective there). For example, an
applicant to Dermatology might choose to submit two
letters from dermatologists and one from an Infectious Diseases
To ensure that you will have enough reference
letters at the match agency on time to cover all of your bases
in case you change your mind regarding specialty choice, and to
give yourself some leeway in terms of using letters that you
think will likely be the strongest, it is always a good idea to
have requested more reference letters than you will be able to