Post By

Ryan Brownlee

– Founder of AspiringMD

Learn what the CASPer test is, how it is formatted and scored, how much it matters, how to prepare, and which medical schools require it.

What Is the CASPer Test? A Complete Guide for Medical School Applicants

Applying to medical school already involves the MCAT, a primary application, personal statement, activity descriptions, secondary essays, letters of recommendation, and interviews, so learning that you may also need to take something called the CASPer test can understandably feel frustrating. When I was applying, I remember wondering why there was suddenly another test to schedule, pay for, and prepare for when medical schools already had so much information about me.

Fortunately, CASPer is not another MCAT, and you do not need to memorize months of content to prepare for it. It is a situational judgment test that asks how you would respond to ethical, interpersonal, and professional situations. Your responses are intended to help medical schools evaluate qualities that are difficult to measure through your GPA or MCAT score, including empathy, communication, collaboration, fairness, professionalism, and judgment.

This guide explains what the CASPer test is, what the current test looks like, how it is scored, how much it may matter in medical school admissions, and which MD and DO medical schools currently require it. I will also share how I prepared, what I learned from taking CASPer and AAMC PREview, and several free resources you can use without purchasing an expensive preparation course.

For a broader comparison of all the situational judgment tests you may encounter, read my guide to CASPer vs. AAMC PREview vs. Duet. You can also read my separate AAMC PREview exam guide and work through my free CASPer sample questions and answers.

What Is the CASPer Test?

CASPer, which originally stood for Computer-Based Assessment for Sampling Personal Characteristics, is an online, open-response situational judgment test administered by Acuity Insights. The organization now generally styles the name as “Casper,” although applicants and medical schools still frequently write it as “CASPer.”

A situational judgment test presents you with a difficult situation and asks how you would respond. The situation might involve a disagreement between group members, an ethical concern, someone being treated unfairly, a conflict between rules and compassion, or a time when you made a mistake. The test is not primarily asking whether you know a specific policy. It is asking whether you can recognize the important issue, consider the people affected, gather missing information, choose a reasonable response, and explain why you would respond that way.

The U.S. Office of Personnel Management describes situational judgment tests as assessments that present applicants with workplace problems or critical situations and evaluate how they would handle them. These assessments can measure conflict management, interpersonal skills, problem-solving, teamwork, negotiation, and cultural awareness. CASPer applies this general SJT concept to the qualities that professional schools want to see in future students. (OPM’s explanation of situational judgment tests)

According to Acuity Insights, CASPer is intended to provide admissions programs with additional information beyond grades, standardized examination scores, personal statements, and recommendation letters. The test uses short scenarios followed by open-ended questions that you answer through typed and recorded video responses.

Start Here: My CASPer and Situational Judgment Test Guides

CASPer can become confusing because applicants usually have several different questions at once. You may be trying to understand the test format, determine which medical schools require it, learn how to answer the video questions, interpret your quartile, or figure out whether your application will be considered complete while your score is still pending. I have created separate guides for each of these questions so you can focus on the part of the process that matters most to you right now.

If you are still deciding which situational judgment tests you need to take, begin with my comparison of CASPer, AAMC PREview, and Duet. That guide explains the differences between the assessments and includes a medical school SJT requirements database that can help you plan your application cycle.

Applicants who are hoping to reduce the number of additional tests they need to complete can also review my guide to medical schools that do not require CASPer or PREview. I would not build an entire school list around avoiding situational judgment tests, but this resource can help you understand which schools require them and whether you actually need to register based on your current list.

Once you know that you need CASPer, use my CASPer test practice questions and answers to work through 10 free sample scenarios. The guide covers common question types such as teamwork, ethical concerns, accountability, equity, confidentiality, and personal reflection, while also explaining what makes a response thoughtful and professionally appropriate.

The video portion deserves separate preparation because you cannot erase or revise an answer after you begin speaking. My guide to CASPer video-response tips and answering in 60 seconds explains how I practiced with flashcards, a webcam, a phone timer, and friends or family members until I became more comfortable speaking clearly without freezing or rambling.

After your score is released, my guide explaining what makes a good CASPer score and what each quartile means can help you interpret the result. I explain whether a second-quartile score is bad, whether a first-quartile score ruins an application, what medical schools receive, and why you should not immediately remove CASPer schools from your list after a disappointing quartile.

Finally, if you are already completing secondary applications, read my guide explaining whether your medical school application is complete without CASPer, PREview, or Duet. Submitting a secondary and becoming complete are not always the same thing, and some medical schools will wait for a required situational judgment test result before reviewing your file.

Why Do Medical Schools Use CASPer?

Medical schools need students who can succeed academically, but they also need students who can communicate with patients, work with classmates, respond appropriately to mistakes, manage conflict, and make thoughtful decisions under pressure. A high GPA or MCAT score can demonstrate academic preparation, but neither one necessarily shows how an applicant might respond when a classmate is struggling, a supervisor gives an unethical instruction, or a patient is being treated disrespectfully.

CASPer gives schools another way to evaluate interpersonal and professional reasoning before deciding whom to interview. The scenarios commonly involve qualities such as empathy, ethics, communication, collaboration, problem-solving, equity, accountability, resilience, and self-awareness.

These qualities are not separate from the rest of medical school admissions. The AAMC explains that medical schools look for evidence of judgment, compassion, selflessness, integrity, adaptability, collaboration, service, and other personal qualities throughout the application. Schools may find that evidence in your activities, personal statement, recommendation letters, secondary essays, and interviews. CASPer is simply another place where you may be asked to demonstrate similar qualities. (How medical schools review applications)

What Does the CASPer Test Measure?

CASPer is designed to evaluate how you think through complicated interpersonal and professional situations rather than how many scientific facts you know. The scenarios may examine your ability to demonstrate empathy, communication, collaboration, ethics, fairness, professionalism, problem-solving, resilience, self-awareness, and motivation.

You may encounter a scenario in which a group member has stopped contributing, but you do not know why. A weak response might immediately label that person as lazy and recommend punishment. A stronger response would recognize that the group has a legitimate problem while also acknowledging that the person may be dealing with an emergency, illness, misunderstanding, or another issue that has not yet been disclosed.

That does not mean CASPer wants you to remain neutral about everything. If a scenario involves a serious safety problem, discrimination, harassment, dishonesty, or another clear professional violation, you should be prepared to take action. The goal is to remain thoughtful and nonjudgmental without becoming so hesitant that you never make a decision.

What Is the Current CASPer Test Format?

For the 2026–2027 admissions cycle, CASPer contains 11 scenarios divided between video responses and typed responses.

The video-response section contains four scenarios. Each scenario has two open-ended questions, and you have one minute to record each response.

The typed-response section contains seven scenarios. Each scenario has two open-ended questions presented together, and you have three and a half minutes to answer both questions.

The complete assessment takes approximately 65 to 85 minutes, including two optional breaks. The exact format can vary for certain nonmedical programs, so medical school applicants should always confirm that they have selected the correct U.S. professional health sciences test type.

Some applicants prepare using older YouTube videos or articles that describe a longer test, three questions per scenario, or a different division between typed and video responses. The ethical reasoning in those resources may still be useful, but you should practice with the current timing before test day.

The video portion can be the most uncomfortable part for applicants who are used to editing their thoughts before submitting them. You have only one minute for each response and cannot go back to replace something you already said. In my complete guide to CASPer video-response tips, I explain the practice method I used with my computer camera, flashcards, a phone timer, and family members who asked me questions without letting me see the countdown.

What Types of Questions Are on the CASPer Test?

CASPer scenarios are not necessarily set in hospitals or medical schools. In fact, many involve ordinary workplaces, classrooms, community organizations, friendships, or group projects. This allows the test to evaluate your general reasoning without expecting you to understand medical ethics or hospital policy before you have even started medical school.

Ethical and Professional Dilemmas

These questions may involve dishonesty, confidentiality, conflicts of interest, misuse of authority, or pressure to ignore an important rule. You will usually need to balance compassion for the individual with your responsibility to protect others and maintain professional standards.

Teamwork and Conflict Questions

You may be asked how you would respond to an uncooperative group member, a disagreement between coworkers, or an unfair distribution of work. Strong answers generally include private communication, an effort to understand the situation, clear expectations, and reasonable escalation if the problem cannot be resolved.

Empathy and Support Questions

Some scenarios involve someone who appears distressed, overwhelmed, isolated, or unable to meet an obligation. You should acknowledge the person’s difficulty without assuming that you can diagnose their problem or solve everything yourself.

Equity, Inclusion, and Bias Questions

These scenarios may involve discrimination, accessibility, unequal treatment, cultural differences, or barriers that affect one person differently from another. You may need to distinguish between treating everyone identically and giving people a fair opportunity to participate.

Accountability and Mistake Questions

You might be asked what you would do after making a mistake or discovering that someone else made one. Strong responses usually focus on acknowledging the error, reducing harm, informing the appropriate person, and preventing the problem from happening again.

Policy and Rule-Based Questions

Some situations intentionally place a reasonable rule in conflict with unusual circumstances. You should avoid ignoring policies whenever they become inconvenient, but you can ask whether an authorized exception or accommodation is available.

Personal Reflection Questions

CASPer can also ask you to describe a time when you failed, faced conflict, made a sacrifice, received criticism, or changed your opinion. These questions evaluate self-awareness and growth rather than whether you can present yourself as someone who has never made a mistake.

The best way to become comfortable with these categories is to answer realistic questions rather than only reading about them. You can practice each major category in my collection of 10 free CASPer practice questions and sample answers. The scenarios are original and include explanations of what a strong response should consider without encouraging you to memorize one rigid script. Many of the same reasoning skills also appear during medical school interviews, so my free MMI practice tool with a scenario bank and timer can provide additional practice.

How Is the CASPer Test Scored?

CASPer responses are scored by trained human raters rather than artificial intelligence. Your identifying information is removed before your responses are evaluated, and different scenarios are assigned to different raters. This helps reduce the possibility that one rater’s initial impression of you will influence the scoring of your entire examination.

Both questions within a scenario are reviewed with the scenario’s full context, but the questions are scored individually. Your typed and video responses are then combined into one overall score that is distributed to the programs you selected. Raters are instructed to focus on the substance, thoughtfulness, judgment, and communication in your response rather than minor spelling or grammar errors.

Applicants do not receive the same detailed numerical score that medical schools receive. Instead, you receive a quartile showing how your performance compared with other applicants completing the same test type.

A first-quartile result does not officially mean that you failed. CASPer is not a pass-or-fail examination, and Acuity Insights states that programs consider applicants from all quartiles. The quartile only describes the relative strength of your responses within the comparison group.

It is also worth clarifying how the comparison works. Applicants sometimes describe CASPer as comparing you only with everyone who takes the test on the same day. The official explanation is somewhat broader: scores are standardized to represent your standing within the relevant applicant pool or test instance, and your performance is judged relative to others who responded to the same scenarios.

What Is a Good CASPer Score?

The fourth quartile is obviously the most favorable result because it means your responses were rated among the strongest. A third-quartile score is also generally reassuring.

A second-quartile result places you within the broad middle portion of applicants. I would not panic over that score, especially when the rest of your application is strong. An average CASPer result is unlikely to become the most memorable feature of an otherwise compelling application, although no one outside an individual admissions committee can promise exactly how a particular school will use it.

A first-quartile score may be more concerning at a school that places significant weight on CASPer, but it does not automatically disqualify you. Acuity Insights specifically states that applicants should not allow any quartile result to dissuade them from applying and that most programs use CASPer as one data point among many.

Receiving a lower quartile can feel discouraging, but the result needs to be interpreted in the context of your complete application. My guide to CASPer score quartiles and low scores explains what each quartile means, why a quartile is not the percentage of questions you answered correctly, whether medical schools see more than applicants do, and why I would not remove otherwise appropriate schools solely because of a first- or second-quartile result.

How Much Does CASPer Matter for Medical School Admissions?

This is one of the most important questions applicants have, and unfortunately, there is no universal percentage that applies to every medical school.

Acuity Insights states that each program independently determines how and when it will use CASPer. One school may use the score as a relatively small part of holistic review, another may consider it when choosing whom to interview, and another could use it to add context to the rest of an applicant’s file. The weight and role of the score vary by program.

Some schools explicitly require a score before an applicant can be considered for an interview. For example, TMDSAS states that Baylor and McGovern require CASPer before interview consideration, while other Texas schools require it to maintain screening or admission eligibility. At those schools, completing the test on time is clearly important even when the school does not publicly reveal the exact weight assigned to the score.

However, I would not place CASPer in the same category as your GPA or MCAT score. Medical schools still review your academic record, clinical experiences, service, research, personal statement, secondary essays, recommendation letters, and interview performance. The AAMC describes medical school admissions as a comprehensive process that evaluates academic preparation alongside experiences, attributes, goals, judgment, compassion, service, essays, and letters.

My Experience With How Much CASPer Matters

When I applied to medical school in 2023, the general feeling among many applicants was that CASPer, PREview, and Duet were still relatively new additions to the application process. Schools and applicants were still trying to understand how the scores should be interpreted, how consistent they were, and how much they should influence admissions decisions.

I heard from many applicants who scored very well on one situational judgment test and surprisingly poorly on another. That was also my experience. My CASPer score was much better than my PREview score, and the two results almost felt opposite even though both tests were supposedly evaluating professional judgment.

Part of this may be explained by the fact that the examinations ask you to do different things. CASPer requires you to generate, explain, and communicate your own response, while PREview gives you potential actions and asks you to evaluate how effective they would be. Someone who is good at explaining nuanced reasoning may perform better on CASPer, while someone who recognizes the AAMC’s preferred ranking of predefined actions may perform better on PREview.

There was also a common criticism that these tests could reward applicants for learning to say what evaluators want to hear rather than revealing what applicants genuinely think. I understand that concern. After practicing enough scenarios, you begin to recognize that CASPer generally rewards answers that gather more information, consider multiple perspectives, avoid unnecessary judgment, protect safety, communicate privately, and escalate concerns appropriately.

That does not necessarily make those principles wrong. In fact, they are usually sensible ways to approach a difficult situation. However, applicants should recognize that CASPer is not simply detecting an unfiltered inner personality. It is evaluating what you choose to communicate in response to a structured situation under time pressure.

Research on open-response SJTs has found that response depth, justification, consideration of multiple perspectives, and clear communication can affect how answers are rated. One recent study examining CASPer scoring reported that stronger responses tended to include more explanation, context, justification, and consideration of different viewpoints, although the authors included employees of Acuity Insights and that relationship should be considered when interpreting the findings. (Read the study through PubMed)

Broader reviews of CASPer have reported evidence supporting its feasibility and reliability, along with some predictive validity, but they have also identified unanswered questions involving equity, coaching, implementation, and exactly what the test adds to admissions decisions. It is reasonable to view CASPer as a developing admissions tool rather than a perfectly settled measurement of who will become a good physician. (Read an NIH-hosted review of CASPer)

I am still not sure whether my own CASPer and PREview scores meaningfully helped or hurt my application. My impression was that schools focused much more heavily on my personal statement, GPA, MCAT score, experiences, recommendation letters, secondary essays, and interviews.

My practical advice is not to let a situational judgment test become the obvious weakness in your application, but also not to treat it like another MCAT. There is no official pass-or-fail cutoff, so you cannot literally “fail” CASPer in the traditional sense. However, you should prepare enough to avoid submitting rushed, incomplete, or unnecessarily judgmental responses.

If your score is around average, I would not expect most schools to immediately reject an otherwise qualified applicant solely because of that result. That is my practical interpretation based on my application experience, not a guarantee about every school. If you land in a lower quartile, continue applying to schools that fit your goals rather than assuming your entire cycle is over.

My Personal Experience Preparing for CASPer

I began looking at CASPer practice materials approximately two weeks before my test date. I found sample scenarios from across the internet, watched YouTube videos in which other applicants worked through questions, and started doing typing exercises because I knew the written section would require me to communicate my reasoning quickly.

Although I started looking at resources two weeks ahead, I probably spent only two or three days seriously studying. I do not think most applicants need much more than that. The exception would be someone who struggles significantly with typing, speaking on camera, or organizing answers under time pressure, because those skills may improve more comfortably with shorter practice sessions spread across several weeks.

Practicing showed me that CASPer tends to reward a particular response structure. Strong answers usually avoid jumping to conclusions, seek additional information, consider the perspectives of everyone involved, address people privately when appropriate, protect safety, and take proportionate action.

I tried to practice as many potential scenarios as possible and train myself to come across as nonjudgmental while still choosing the professionally responsible action. Sometimes the appropriate response on CASPer may not match behavior you have personally witnessed in school, work, or everyday life. You should answer from the perspective of a future healthcare professional who values honesty, fairness, empathy, communication, accountability, and safety.

Typing practice was one of the most helpful parts of my preparation. You cannot receive credit for reasoning that remains in your head because you did not have time to type it. If you can type quickly enough to explain another perspective, include a conditional response, or justify why you would involve a supervisor, you are giving the rater more useful information to evaluate.

That does not mean writing twice as many words automatically produces twice the score. Repetition and filler do not make an answer stronger. However, when two applicants have similarly good ideas, the applicant who can communicate more of those relevant ideas may provide stronger evidence of their judgment.

Acuity’s own preparation guidance encourages applicants to use the available time, provide as much relevant detail as possible, and explain why they would take a particular action rather than only stating what they would do. It also confirms that bullet points are acceptable and that minor spelling or grammatical mistakes are not the focus of scoring.

How Should You Structure a CASPer Response?

You do not need to memorize a rigid script, but you should have a reliable way to organize your thoughts.

Begin by identifying the central concern. This may be a conflict, safety issue, ethical problem, breakdown in communication, or competing set of responsibilities.

Next, identify who is affected. A decision that appears simple may influence a classmate, patient, customer, supervisor, organization, or wider community.

Then determine what information is missing. Unless there is an immediate safety concern, you can often speak with the person privately and ask open-ended questions before assuming why they behaved a certain way.

After gathering context, explain what you would do. Conditional reasoning can be very useful because CASPer scenarios intentionally leave out information. You might explain that if the situation resulted from an isolated misunderstanding, you would clarify expectations, but if the behavior was intentional or continued, you would involve the appropriate supervisor.

Finally, explain why your response is fair, ethical, or effective and describe how you would follow up.

A helpful mental progression is:

Identify the concern → consider the stakeholders → gather context → choose a proportionate action → explain why → follow up.

Use that as a guide rather than forcing every response into identical wording. Raters should hear your reasoning, not a memorized paragraph that could apply to any situation.

How Long Should You Study for CASPer?

I spent only two or three focused days preparing, and I think that is enough for many applicants. You can begin typing practice earlier while saving the more intensive scenario work for the final week.

On the first day, learn the current format and complete several untimed scenarios. Focus on identifying the main concern, stakeholders, missing information, and possible responses.

On the second day, practice typed and video responses under the actual time limits. Review whether you answered both questions, explained your reasoning, and reached a clear decision.

On the final day, complete the official practice assessment in your Acuity Insights account using the same computer, webcam, microphone, keyboard, browser, and environment that you plan to use on test day.

Acuity Insights recommends completing its full 11-scenario practice test because it simulates the current testing experience. The organization also advises running the technical system check at least three days before your scheduled test.

Should You Practice Typing for CASPer?

Typing speed is not officially scored as a separate competency, but it can influence how much of your reasoning you communicate before time expires.

Start with a one-minute typing test and look at both your speed and accuracy. You do not need to achieve an arbitrary score to perform well, and you should not type so quickly that your response becomes impossible to understand. Your goal is to become comfortable enough that typing does not consume all of your mental attention.

These free websites can help:

Typing.com offers structured lessons, timed tests, and targeted exercises.

TypingClub provides progressive touch-typing lessons and hand-position practice.

Keybr identifies letter combinations that slow you down and generates targeted practice.

Monkeytype provides customizable timed tests that can help you track speed, consistency, and accuracy.

Rather than spending an hour completing random typing tests, try typing responses to actual CASPer-style scenarios. Ethical and interpersonal responses use different vocabulary and sentence patterns than a standard typing passage, so scenario-based typing will more closely resemble the real test.

How to Prepare for the Video-Response Section

Video responses can feel uncomfortable because you have limited time to think, organize your answer, and speak. The best way to become more comfortable is to record yourself repeatedly.

Read a CASPer-style question, take a brief moment to organize your response, and then speak for one minute. When you watch the recording, ask whether you answered the actual question, explained why you chose your approach, considered another perspective, and reached a conclusion.

Do not worry about sounding like a professional broadcaster. CASPer raters are evaluating the substance of your response rather than your clothing or production quality. You should still choose a quiet, well-lit room, position your camera appropriately, and make sure your microphone records clearly.

Acuity Insights recommends practicing with your computer’s recording software, reviewing your recordings, and asking trusted people for feedback if speaking on camera makes you uncomfortable.

Free YouTube Resources for CASPer Preparation

YouTube was useful during my own preparation because I could pause a scenario, answer it independently, and then compare my approach with someone else’s reasoning.

The official Acuity Insights overview of CASPer is a useful place to begin because it explains the test from the organization that administers it.

The video CASPer Real-Time Answer Examples From a Top-Quartile Scorer demonstrates how an applicant organizes responses under the current typed-response time pressure.

The video How to Answer CASPer Questions With a Six-Step Framework walks through a repeatable thought process and applies it to sample scenarios.

The video Five CASPer Questions You Need to Know and Expert Sample Answers gives you additional scenarios that you can pause and answer before listening to the explanation.

Med School Insiders’ guide to preparing for CASPer provides another overview of the test and common preparation strategies.

Always check when a video was uploaded. An older video may still teach good ethical reasoning while showing a test format or time limit that is no longer current.

When Should You Take CASPer?

You should take CASPer early enough for your scores to arrive before the earliest deadline among the schools requiring it. Programs typically receive results before applicants receive their quartile, and Acuity advises applicants to review each program’s score-distribution deadline through its official dates and fees directory.

Results are generally distributed to programs approximately two to three weeks after the test, while an applicant’s quartile usually becomes available around four to five weeks after the test date.

You do not necessarily need to take CASPer before submitting your AMCAS, AACOMAS, or TMDSAS primary application. However, some schools will not consider your file complete, screen you, or invite you to interview until the score has been received.

You can read my guide explaining whether a medical school secondary is complete without CASPer, PREview, or Duet and use my free medical school application tracker to record the SJT requirement and deadline for each school.

Taking CASPer before or during early secondary season can prevent a required score from delaying review of an otherwise finished application. A secondary may be successfully submitted while the school still considers the overall file incomplete, so I recommend reading my guide to whether your secondary application is complete without CASPer, PREview, or Duet and checking each applicant portal until it clearly says that all required materials have been received.

Can You Retake CASPer?

You generally cannot take the same CASPer test type more than once during a single admissions cycle. You should therefore treat your selected test date seriously and complete the system check and official practice test beforehand.

CASPer scores are valid for only one admissions cycle and one test type. If you reapply during a later cycle, you will need to take the appropriate CASPer test again.

How Much Does CASPer Cost?

CASPer charges a base testing fee and may charge additional fees depending on how many programs receive your score. The amount can vary by country, test type, and admissions cycle, so the safest approach is to use the official Acuity Insights dates and fees directory after selecting the correct program type.

Applicants who have been approved for certain application fee-assistance programs may qualify to have CASPer fees waived. Check the Acuity Insights fee-assistance instructions before paying if you have received AAMC Fee Assistance Program or another qualifying approval.

Can You Receive Accommodations for CASPer?

Acuity Insights offers testing accommodations for applicants with qualifying disabilities, medical conditions, or functional limitations. Possible accommodations may include additional time, assistive technology, speech-to-text software, a reader, or a scribe depending on the applicant’s documented needs.

The process requires documentation and should be started well before the test date. Acuity generally advises applicants to submit accommodation requests at least four weeks before the assessment. Review the current Acuity Insights accommodations information and do not wait until the final available testing date to begin the process.

MD Medical Schools That Require CASPer in 2026–2027

The following table was reviewed on July 30, 2026 for applicants seeking 2027 matriculation. It includes 22 U.S. MD programs identified as requiring CASPer rather than merely recommending or accepting it.

Requirements can change during an application cycle. Before registering or deciding that you do not need the test, verify your school list through the official Acuity Insights dates and program directory, each school’s admissions website, and the AAMC Medical School Admission Requirements database.

The current list was cross-checked against an updated July 2026 school compilation, official school information, and the TMDSAS CASPer requirements for Texas programs.

Several official medical school pages can help you see how individual schools describe the requirement. For example, review the current application information from Quinnipiac University, New York Medical College, California University of Science and Medicine, and UT Southwestern Medical School.

MD Schools That Accept CASPer or PREview

Two additional MD programs currently allow applicants to satisfy an SJT expectation through CASPer or an alternative assessment.

When a school gives you a choice, review the requirements for every other program on your list before deciding which test to take. If several other schools already require PREview, taking PREview may be more efficient. If your list includes several CASPer schools, CASPer may cover more of your applications.

Use my CASPer vs. PREview vs. Duet comparison to compare the formats before choosing.

DO Medical Schools That Require CASPer in 2026–2027

CASPer is currently much less common among U.S. osteopathic medical schools. Four DO programs appear in the current 2026–2027 CASPer program list. Because the University of Northern Colorado College of Osteopathic Medicine is a new program and William Carey has published conflicting information about related Acuity assessments, applicants to those schools should verify the current requirement directly before paying.

Touro’s New York and Montana locations are part of the same osteopathic medical school system but represent separate campus options, so they are shown separately in the table.

TMDSAS officially states that applicants to Sam Houston State University College of Osteopathic Medicine should complete CASPer.

You should not assume that every medical school requires a situational judgment test simply because several schools on your list do. My guide to medical schools that do not require CASPer or PREview can help you identify programs without either requirement and understand how to build an SJT-smart school list. I would still choose schools based primarily on academic fit, mission, location, cost, residency preferences, and the populations you hope to serve rather than allowing one additional test to determine your entire list.

Be Careful With Outdated CASPer School Lists

CASPer requirements change frequently, and many lists appearing near the top of Google include schools that previously required the examination but have since dropped it, replaced it with PREview, or made it optional.

As of July 2026, Rush Medical College states that CASPer is no longer required or recommended for Fall 2027 matriculation. The University of Nevada, Reno and Hackensack Meridian have moved toward PREview requirements, Texas A&M is no longer included on the TMDSAS medical-school CASPer list, and Central Michigan describes CASPer as optional.

Drexel University has used CASPer for certain special or combined programs, but that does not necessarily mean it is required for every regular MD applicant. Tulane encourages applicants to complete CASPer but states that applications can be reviewed without it.

CASPer is only one of the situational judgment assessments you may encounter during a medical school application cycle. Some schools require CASPer, some require AAMC PREview, a smaller number use Duet, and others allow applicants to choose between assessments. My complete guide to CASPer vs. AAMC PREview vs. Duet compares their formats, scoring systems, purposes, and current medical school requirements so you can determine which combination actually applies to your school list.

CASPer vs. AAMC PREview

CASPer and PREview are both situational judgment tests, but the testing experience is very different.

CASPer asks you to generate your own typed and video responses. You must decide what you would do, explain your reasoning, and communicate as much useful detail as possible within a short period.

PREview gives you a scenario followed by several potential actions. You rate how effective each action would be according to the AAMC’s professional expectations.

CASPer therefore places more pressure on typing, speaking, and spontaneous organization, while PREview places more pressure on recognizing how the AAMC wants predefined actions classified.

The AAMC describes PREview as an assessment of preprofessional knowledge and judgment related to competencies needed for medical school. You can review the official AAMC PREview overview and read my complete PREview guide for premeds.

CASPer vs. Duet

CASPer evaluates how you respond to interpersonal and professional scenarios. Duet has historically focused on alignment between the values and characteristics you prioritize and those emphasized by participating programs.

Duet has never been as widely required as CASPer, and its use has continued to change. Do not assume that taking CASPer automatically means every school requires Duet as well. Check each program individually and review my CASPer, PREview, and Duet comparison guide for the broader differences.

Trusted Official CASPer and SJT Resources

The official Acuity Insights CASPer overview provides the current format, registration information, and basic scoring explanation.

The official Acuity Insights preparation page includes sample scenarios, technical requirements, and access to the full practice assessment.

The AAMC guide to how medical schools review applications explains how schools evaluate academics, experiences, attributes, essays, letters, and judgment.

The AAMC Premed Competencies provide a useful framework for thinking about the qualities schools expect applicants to demonstrate.

The AAMC PREview overview explains the other major situational judgment test used by U.S. MD programs.

The U.S. Office of Personnel Management’s situational judgment test guide explains the general purpose, format, and evidence behind SJTs.

The NIH-hosted review of CASPer research provides a more academic discussion of its validity, implementation, limitations, and unanswered questions.

The TMDSAS CASPer requirements page should be reviewed by anyone applying to Texas medical schools.

Frequently Asked Questions About the CASPer Test

Is CASPer required for medical school?

CASPer is required by some medical schools, but most U.S. MD and DO programs do not currently require it. Whether you need to take it depends entirely on your school list.

Can you fail the CASPer test?

CASPer does not have an official pass-or-fail cutoff. Applicants receive a quartile indicating how their responses compared with others completing the same test type.

A lower quartile may be less favorable, but it is not formally labeled as a failing score and does not automatically prevent you from applying.

Do medical schools see your CASPer quartile?

Applicants receive a quartile, while programs receive the score information distributed by Acuity Insights. The school then decides how to incorporate that result into its admissions process.

Is a second-quartile CASPer score bad?

A second-quartile result means your responses fell within the lower half of the comparison group, but it is still broadly within the middle portion of applicants. I would not withdraw from schools or assume your application is ruined because of a second-quartile result.

Is a first-quartile CASPer score an automatic rejection?

No universal rule makes a first-quartile score an automatic rejection. Schools determine independently how much weight to give CASPer, and Acuity states that programs consider applicants from all quartiles.

Does CASPer matter more than the MCAT?

There is no evidence that CASPer generally carries more weight than the MCAT in U.S. medical school admissions. Medical schools use the MCAT and academic record to evaluate readiness for demanding coursework, while CASPer contributes information about interpersonal and professional judgment.

The precise weight varies by school, but my experience was that my GPA, MCAT, experiences, essays, letters, and interviews appeared to matter considerably more.

Do you need to study for CASPer?

You do not need months of content review, but you should prepare. Learn the format, practice common scenario types, complete timed typed and video responses, and take the official practice assessment.

How many days should you study for CASPer?

I spent approximately two or three focused days preparing, although I began typing exercises around two weeks before my test. Applicants who already type and speak comfortably may need only a few days, while others may benefit from beginning earlier.

Does typing speed matter on CASPer?

Typing speed is not separately scored, but it affects how much reasoning you can communicate within the available time. Practice enough that typing does not prevent you from explaining your decision, considering multiple perspectives, and answering both questions.

Can you use bullet points on CASPer?

Yes. Acuity Insights allows bullet points in the typed-response section and instructs raters to prioritize content over paragraph structure, minor grammar issues, or spelling mistakes.

Should every CASPer response be nonjudgmental?

You should avoid making unsupported assumptions and should try to understand why someone acted a particular way. However, being nonjudgmental does not mean ignoring dangerous, dishonest, discriminatory, or unethical behavior.

A strong response can remain respectful while protecting the people affected, following policy, documenting concerns, and involving the appropriate supervisor.

Can you take CASPer after submitting AMCAS?

Yes, as long as you take it before the testing and score-distribution deadlines established by your schools. However, a school may delay reviewing your application until the score arrives.

Can you add medical schools after taking CASPer?

You can generally add eligible programs to your distribution list after completing the examination, provided their distribution deadlines have not passed. Programs added after scores are available typically receive the result much more quickly than the initial processing period.

Should you take both CASPer and PREview?

Take both only when your school list requires or meaningfully benefits from both. Some schools require CASPer, others require PREview, and a small number allow you to choose between them.

Use my medical school SJT requirements database before registering.

Final Thoughts on the CASPer Test

CASPer is another task added to an already demanding medical school application process, but it does not need to consume months of your time or become a major source of anxiety. Learn the current format, practice responding under time pressure, work on your typing if it limits how much you can communicate, and become comfortable explaining both what you would do and why.

Try to approach each scenario with empathy and without immediately assuming the worst about someone. Gather additional information when it is safe, consider the perspectives of the people affected, remain decisive when safety or integrity is involved, and describe a realistic next step.

My own CASPer result was much better than my PREview result, which reminded me that these assessments do not always produce consistent outcomes for the same applicant. I cannot say with certainty whether either score significantly affected my admissions results. My impression was that schools remained much more interested in the complete picture created by my academic record, MCAT score, clinical and service experiences, personal statement, secondary essays, letters of recommendation, and interviews.

Prepare enough that CASPer does not become an avoidable weakness, but do not allow it to distract you from the much larger parts of your application. If you receive an average score, take a breath and continue with your cycle. One quartile does not define your judgment, your character, or your ability to become an excellent physician.