Casper, Duet, and Snapshot: 2026/27 Cycle Guide

Medical school admissions go beyond GPA and MCAT scores. Many programs also use behavioral and situational judgment assessments to evaluate how applicants think, communicate, and make decisions in real-world scenarios.

The most common is Casper, a situational judgment test used by many U.S. medical schools. Some schools also use Duet, which measures value alignment between applicants and institutions. Snapshot, a video-response tool once used to assess communication skills, has been discontinued and is no longer part of any admissions process.

This guide explains what these assessments are, how they work, and how to prepare for both test formats effectively during the 2026/27 application cycle.

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What are Casper, Duet & Snapshot?

Casper and Duet are tests from Acuity Insights (formerly known as the Altus assessments) that evaluate different aspects of an applicant’s profile during the medical school admissions process.

Think of these as your digital interview panel, each offering a unique lens into your qualities, values, and approach to medicine. Rather than testing academic knowledge, these assessments focus on personal and professional attributes that are difficult to measure through traditional application metrics.

Here’s a brief overview of each:

Casper is a situational judgment test that presents you with short written or video-based scenarios. Applicants explain how they would respond, helping schools assess how they would reason through ethical, interpersonal, and professional challenges.
Duet is a value-alignment assessment. Instead of testing problem-solving, it compares your preferences and priorities with the culture, mission, and learning environment of participating medical schools.

Snapshot was previously included in the same suite as a short video-response tool. It asked applicants to respond to behavioral prompts on camera to help schools assess skills like communication style and professionalism.

Acuity Insights phased it out after the 2022/23 application cycle, determining that its purpose overlapped with existing interview formats. Some schools may still evaluate things like communication skills through interviews or secondary applications, but Snapshot itself is no longer part of the process.

The AAMC PREview exam is a similar assessment tool used to evaluate competencies such as ethics, collaboration, and decision-making. Some programs accept either PREview or Casper, depending on their admissions requirements, but applicants are typically not required to complete both.

Casper

Casper is an online situational judgment test used to better understand personal qualities that are important in medicine but not captured by GPA or MCAT scores. These include social intelligence, empathy, professionalism, communication, and ethical decision-making.

During the test, you’ll be presented with short written or video-based scenarios that reflect real-world situations you might encounter in healthcare, teamwork, or academic environments.

After each scenario, you’ll answer a series of open-ended questions explaining how you would respond and why. Casper takes approximately 65-85 minutes to complete and is divided into 2 timed sections:

Video response section: This section includes 4 video-based scenarios. For each scenario, you’ll respond to 2 open-ended questions using your webcam. You only have 1 minute to record a response for each question.
Typed response section: This section includes 7 scenarios. For each scenario, you’ll respond to 2 open-ended questions. You’ll have 3.5 minutes total to type responses for both questions before moving on to the next scenario.

The test is fully automated, meaning it moves from one scenario to the next without the ability to pause between questions. There is an optional 10-minute break between the sections, and another 5-minute break (if you want it) halfway through your typed responses.

How to Prepare

Casper test prep is less about memorizing content and more about learning how to structure clear, thoughtful responses under time pressure. Here’s the advice I always share with my students:

Familiarize yourself with the test structure. Understand the flow and timing of both the video and typed response sections to manage your time effectively during the test.
Practice ethical decision-making. Review basic ethical principles and frameworks. Being comfortable with these concepts can help you articulate well-thought-out responses.
Reflect on real-life scenarios. Think about situations where you've handled conflict, worked on a team, demonstrated leadership, or navigated difficult decisions.
Try practice scenarios. Timed practice questions help you become more comfortable organizing your thoughts quickly while improving your written and verbal communication.
Get feedback. Reviewing your practice responses with mentors, advisors, or former admissions committee members can help identify areas for improvement before test day.

Scoring

Casper isn’t scored based on right or wrong answers. Trained raters evaluate your responses using a standardized scoring rubric, and individual question scores are combined into a single overall result reported as a quartile ranking.

Applicants receive a quartile score that reflects how they performed compared with other Casper test takers:

First Quartile: 0-24 percentile (bottom 25%)
Second Quartile: 25-49 percentile
Third Quartile: 50-74 percentile
Fourth Quartile: 75-100 percentile (top 25%)

Higher quartile scores are generally associated with clear communication, strong reasoning, and thoughtful consideration of multiple perspectives, as well as familiarity with the test format. However, Casper is only one component of the medical school admissions process.

Medical schools evaluate applicants holistically, considering factors such as GPA, MCAT scores, clinical exposure, interviews, and other application materials. Understanding how these factors come together can help applicants better assess their chances of getting into medical school.

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Duet

Duet is an untimed, computer-based assessment that typically takes applicants about 15 minutes to complete. Applicants review paired statements and select the option that best reflects their personal preferences.

Responses are then compared with the priorities and characteristics of participating medical schools, helping applicants and programs better understand potential areas of alignment and fit.

Unlike Casper, Duet does not include situational scenarios or video responses. There are no right or wrong answers, so applicants should respond honestly based on their own values, goals, and approach to their medical school journey.

How to Prepare

Like Casper, Duet does not require memorization or extensive studying. The best preparation is self-reflection. Here’s some advice I give my students:

Understand the assessment’s purpose. The goal of Duet is to vet an authentic alignment of your values with those of prospective schools. Shared values matter!
Research school values. Investigate the core values, mission statements, and cultures of the top medical schools you’re interested in. This knowledge can inform your responses and help you select programs that are a genuine match.
Spend time reflecting. Think about your own values, what motivates you in medicine, and what you seek in medical education. Authenticity in your responses is key.
Review sample questions. You won’t find a practice test for this one, but if available, review sample Duet questions to become familiar with potential topics. For example, questions may explore interest in rural medicine, approaches to teamwork, or preferences for different learning environments.
Consult mentors. Discussing your values and educational goals with mentors or advisors can provide clarity and insight and help you take confident ownership of your responses.

Scoring

Duet does not have a traditional score based on correct or incorrect answers, and it does not use a quartile ranking system like Casper. Instead, applicants receive a report showing how their preferences align with participating programs. This information may be used by medical schools as one part of their holistic admissions review, alongside other application materials.

Learn More: Answering “Why This Medical School,” Step-by-Step

Which Schools Require Casper or Duet?

It’s important to know which schools require Casper and Duet as part of the application process. While Duet is not often required, some schools may recommend completing it to help assess alignment with their values and mission. The table below lists MD and DO schools that require either exam for the 2026/27 application cycle.

Institution	MD or DO?	Casper Required?	Duet Required?
Baylor College of Medicine	MD	Y	N
Boston University Aram V. Chobanian & Edward Avedisian School of Medicine	MD	Y	N
Burnett School of Medicine at TCU	MD	Y	N
California University of Science and Medicine	MD	Y	N
Central Michigan University College of Medicine	MD	Y	N
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell	MD	Y	N
Drexel University College of Medicine	MD	Y	N
East Tennessee State University James H. Quillen College of Medicine	MD	Y	N
Louisiana State University New Orleans - School of Medicine	MD	Y	N
Medical College of Wisconsin	MD	Y	N
Meharry Medical College	MD	Y	N
Michigan State University College of Human Medicine	MD	Y	N
Netter School of Medicine Quinnipiac University	MD	Y	N
New York Medical College	MD	Y	N
Renaissance School of Medicine at Stony Brook University	MD	Y	N
Rush University Medical College	MD	Y	N
Rutgers Robert Wood Johnson Medical School	MD	Y	N

Institution	MD or DO?	Casper Required?	Duet Required?
Sam Houston State University College of Osteopathic Medicine	DO	Y	N
Temple University Lewis Katz School of Medicine	MD	Y	N
Texas Tech Health Sciences Center El Paso	MD	Y	N
Touro College of Osteopathic Medicine NY/MT	DO	Y	N
Tulane University School of Medicine	MD	Y	N
University of Colorado Denver Medical School	MD	Y	N
University of Northern Colorado - College of Osteopathic Medicine	DO	Y	N
University of Texas at Tyler School of Medicine	MD	Y	N
University of Texas Health Science Center Houston, McGovern Medical School	MD	Y	N
University of Texas Health Science Center San Antonio, Long School of Medicine	MD	Y	N
University of Texas Medical Branch, John Sealy School of Medicine	MD	Y	N
University of Texas Southwestern	MD	Y	N
University of Vermont Larner College of Medicine	MD	Y	N
Virginia Commonwealth University School of Medicine	MD	Y	N
Wake Forest School of Medicine	MD	Y	N
West Virginia University School of Medicine	MD	Y	N
William Carey University College of Osteopathic Medicine	DO	Y	Y

Note: This table is accurate for the 2026/27 application cycle and will be updated when dates are posted for the 2027/28 cycle.

When You Should Take Casper & Duet

Timing your Casper and Duet assessments is an important part of staying on track during the medical school application process.

For most applicants, the best time to complete Casper and Duet is in the late spring or early summer of the application cycle. This is around the time you submit your primary application through AMCAS, TMDSAS, or AACOMAS. This ensures your results are available as schools begin reviewing primary applications and sending secondary applications.

Traditional applicants: Aim to take Casper and Duet shortly after submitting your primary application, ideally before secondary applications become a priority.
Gap year and nontraditional applicants: If you are applying after time away from school, consider completing these assessments by early summer as well. This also allows you to incorporate new insights from the assessments into your application and interview prep.

Before scheduling your test date, confirm the requirements and deadlines for each school on your list, as distribution deadlines can vary by program.

Costs & Fees

Casper fees vary by admissions cycle and are specific to the current application year. For the 2026/27 medical school application cycle, fees for the Casper assessment (CSP-10111) are:

Casper: The Casper test comes with an $85 fee, which includes distribution to 9 of your choice. Additional distributions are available for $20 per program.
Duet: Duet is included in the $85 Casper fee. This is another reason why we recommend completing it, even if it’s not expressly required by every school on your list.
Rescheduling fee: A fee of $20 applies if you reschedule your test within 30 days of your scheduled test date or after your confirmed test date and time has passed. There is no fee to reschedule 31 days or more before your original exam date.

All fees are final, non-refundable, and valid only for the current admissions cycle. Acuity Insights recognizes certain Fee Assistance Programs (FAPs), which may help eligible applicants reduce their Casper fees. Learn more about accepted programs and how to apply your approval on the Acuity Insights website.

FAQs

To schedule Casper, create an account through Acuity Insights and register for the assessment for your application cycle and location. During registration, you’ll choose your test date and select the schools you want to receive your results. Duet is included with Casper registration and can be completed through the same platform.

Because requirements vary by medical school, confirm which assessments are required before selecting your distribution list.

Casper and Duet cannot be retaken within the same admissions cycle, and results are only available for the cycle in which the test was completed. If you need or want to complete the assessments again, you must wait until the next admissions cycle to retake them.

The Altus Suite is a legacy term used to describe assessments (currently Casper and Duet) developed by Acuity Insights. While the term is still commonly referenced, the assessments are now officially delivered by Acuity Insights, and applicants will typically see them referred to as Casper and Duet in application portals.

Duet doesn’t include a video component. The assessment focuses on value alignment by asking applicants to indicate their preferences and perspectives on different scenarios. Video responses were part of Snapshot, a separate Acuity Insights assessment that has since been discontinued.

Get Expert Casper Preparation Support

Casper and Duet aren’t about knowing the “right” answer. Successful responses demonstrate empathy, communication, and thoughtful decision-making under time pressure. Our experts at MedSchoolCoach provide Casper prep support to help applicants strengthen their situational judgment skills, refine their responses, and feel confident heading into test day.

With personalized guidance and feedback, you’ll gain a better understanding of what admissions committees look for throughout the medical school application process.

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