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Situational judgement test · MD & DO

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.

Q1
Bottom 25%
Q2
25th–50th
Q3
50th–75th
Q4
Top 25%

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.

1

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.

2

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.

3

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.

4

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.

5

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.

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 schools requiring CASPer

Every requirement, curated from official admissions pages and re-verified each cycle.

23 of 163

MD programs require CASPer

5 of 64

DO programs require CASPer

2 of 78

Dental programs require CASPer

Search the full requirements database

All 305 US MD, DO and dental programs — sortable by school, state and requirement, with AAMC PREview status alongside. Participation changes annually; each record links to the school’s admissions guide.

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.

CASPer (Computer-based Assessment for Sampling Personal characteristics) is an online situational judgment test (SJT) developed and administered by Altus Assessments (now operating as Acuity Insights). It presents applicants with video and text-based scenarios depicting professional, ethical, or interpersonal situations. Applicants type open-ended responses within a 5-minute window per section. Scores are reported to schools as quartiles relative to the applicant cohort, not as raw or scaled scores.

Step 5 of 5Interview simulator

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.

Reviewed by NextGenMedPrep Admissions Team, admissions editorial team at the NextGenMedPrep. Last reviewed: July 26, 2026