Getting into Residency: Residency Application Documents


References Letters

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 applications.

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!

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 options:

  1. 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.

  2. The supervisor 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.

What Format 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.

How Many 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 specialist.

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 use.

Next: CVs