Master the
CASPer Test
CASPer is a typed online situational judgment test required by many US MD programs and most DO programs via AACOMAS. Master the format, scoring, and prep strategy — and verify requirements with each school, as participation changes annually.
14
Sections
~5 min
Per section
Typed text
Response format
Q1–Q4
Scoring
The format
How CASPer works
An online, video-and-text SJT you complete from your own computer — no testing centre.
CASPer is delivered entirely online through the Acuity Insights platform (formerly Altus Suite). You need a reliable internet connection, a working webcam (for identity verification), and a microphone.
The test has 14 sections. Some present a short video clip depicting a professional, ethical, or interpersonal scenario; others present a short text vignette. After each, you have about 5 minutes to type responses to 3 open-ended questions, with a countdown timer on screen throughout.
There is no spell-check, grammar correction, or pasting from external documents. The 5-minute window applies to all 3 questions in a section — not 5 minutes per question.
Typing speed matters
At 50 WPM you can produce ~250 words in 5 minutes. With 3 questions per section, allocate roughly 1.5 minutes per question and aim for 60–80 words per response — concise and complete beats long and rambling.
Scoring
How CASPer is scored
Different raters, no halo effect, and a quartile — not a raw score — sent to schools.
Each section is scored by a different trained human rater on dimensions including professionalism, empathy, communication, and ethical reasoning. Because each section has a different rater, a weak response in one does not colour the others. Your aggregated score is converted to a quartile relative to the entire cohort that cycle — and that quartile is what schools receive.
Schools receive your quartile — they do not see your raw score or your written responses.
How to prepare
CASPer preparation strategy
Five steps that move the needle — in roughly the order you should tackle them.
Build your typing speed to 50+ WPM
Use free tools (Keybr, Typing.com, 10fastfingers) to practise. This single most actionable step determines how much you can communicate per section. Practise typing in complete sentences — that is the actual task.
Use the Altus free practice scenarios
Acuity Insights provides free samples at acuityinsights.app. Complete them under timed conditions on your actual test computer and setup to familiarise yourself with the interface, timer, and video quality before test day.
Develop a response framework
A 3-part approach works well: acknowledge the complexity and the people involved; describe what you would do and why, using a relevant ethical principle (autonomy, beneficence, non-maleficence, justice); then acknowledge your uncertainty. Avoid black-and-white conclusions where the scenario is ambiguous.
Review ethics & professionalism foundations
CASPer frequently tests informed consent, confidentiality, professional boundaries, disclosure, cultural humility, resource allocation, and conflict resolution. Review the four principles of bioethics (Beauchamp and Childress) and the AAMC Core Competencies.
Complete timed practice sessions
The countdown timer, pressure to write coherently, and unfamiliar video scenarios create a specific test anxiety. Repeated timed practice normalises it — aim for 3–5 full-length sessions before your test. Paid practice tests (BeMo, Acuity Insights, Lecturio) add scored rubrics.
What it tests
Common CASPer question themes
Scenarios cluster around a predictable set of professional and ethical themes.
Ethical dilemmas
Resource allocation, end-of-life decisions, conflicting obligations between patients, colleagues, and institutions.
Professional conduct
Observed misconduct by a colleague, an impaired provider, documentation errors, and reporting obligations.
Conflict resolution
Disagreement with a supervisor, interpersonal conflict in a team, or a difficult patient or family member.
Cultural humility
Navigating cultural or religious differences in care, interpreter access, and family decision-making dynamics.
Informed consent & autonomy
Patient refusal of treatment, capacity assessment, surrogate decision-makers, and truth-telling.
Confidentiality
Disclosure obligations (safety threats, infectious disease) and protecting patient information in social situations.
Compare
CASPer vs AAMC PREview
Two SJTs, two very different formats — many schools require one, some require both.
| Feature | CASPer | AAMC PREview |
|---|---|---|
| Administrator | Altus / Acuity Insights (third-party) | AAMC (same body as AMCAS) |
| Format | Open-ended typed text | Multiple-choice rank ordering |
| Sections / scenarios | 14 sections | 30 scenarios |
| Time | ~90–110 min total | 75 min |
| Scoring | Quartile (Q1–Q4) | 1–9 scaled score |
| Score transmission | Direct to schools (separate from AMCAS) | Via AMCAS |
| Required by | 30+ MD, most DO programs | 30+ MD programs |
| Key prep | Typing speed, response structure, ethics | Core Competencies, rank-choice logic |
Administrator
- CASPer
- Altus / Acuity Insights (third-party)
- AAMC PREview
- AAMC (same body as AMCAS)
Format
- CASPer
- Open-ended typed text
- AAMC PREview
- Multiple-choice rank ordering
Sections / scenarios
- CASPer
- 14 sections
- AAMC PREview
- 30 scenarios
Time
- CASPer
- ~90–110 min total
- AAMC PREview
- 75 min
Scoring
- CASPer
- Quartile (Q1–Q4)
- AAMC PREview
- 1–9 scaled score
Score transmission
- CASPer
- Direct to schools (separate from AMCAS)
- AAMC PREview
- Via AMCAS
Required by
- CASPer
- 30+ MD, most DO programs
- AAMC PREview
- 30+ MD programs
Key prep
- CASPer
- Typing speed, response structure, ethics
- AAMC PREview
- Core Competencies, rank-choice logic
See the full AAMC PREview guide.
Where it's required
US medical schools requiring CASPer
Representative lists for the 2025–2026 cycle. Participation changes annually — always verify on the Acuity Insights school list and each school's admissions page.
MD programs (representative)
DO programs (representative)
Source: Acuity Insights (acuityinsights.app) school list and individual school admissions pages. List is representative — confirm current requirements with each school.
Pitfalls
Common CASPer mistakes
The avoidable errors that pull responses into lower quartiles.
Exceeding the time limit
The timer is absolute — the section closes when it expires. Practise pacing so you can complete all three questions in 5 minutes. A complete answer to all three beats one polished answer and two blanks.
Generic answers
“I would talk to my supervisor” without explaining how, why, or which ethical principle is at stake reads as evasive. Be specific about what you would do and why.
Ignoring context
Each scenario has specific details — your role, the setting, the relationships. Responses that could apply to any scenario suggest you are not engaging with the actual situation presented.
Taking an extreme position
Scenarios are designed to have genuine ethical tension. An immediate absolute position without acknowledging competing considerations suggests binary thinking rather than professional judgment.
Forgetting typing practice
Low typing speed is the single most preventable CASPer failure mode — you cannot demonstrate your reasoning if you cannot type it in time.
Questions
Frequently asked questions
The CASPer details US applicants ask about most.
Mock interviews built in your school's real format.
Pick your target US medical or dental school and Prometheus assembles a mock in that school's documented format — MMI, panel or traditional. Every station comes with real questions, likely follow-ups, a full scoring rubric and annotated model answers.
- Matched to your school’s format — MMI, panel or traditional
- Hundreds of practice questions across US MD, DO & dental interviews
- Real scoring rubrics with examiner guidance — annotated model answers in the free preview
Prepare for CASPer with expert guidance
Live sessions covering response structure, ethics knowledge, and timed practice under real CASPer conditions.
Keep reading
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