How to Prepare for the Casper Test for Medical School | MedSchoolCoach

How to Prepare for the Casper Test for Medical School


Posted in: Applying to Medical School

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The Casper test is a distributed by Acuity Insights (formerly Altus assessments). Medical schools use it to evaluate how an applicant aligns with their program and to develop a holistic understanding of each student. The test allows medical students to demonstrate their communication and other non-cognitive skills. Typically, the Casper is administered prior to an in-person or virtual interview at a medical school, and is considered part of the secondary application process. At some medical schools, you may take the test later.

Keep reading to find out more about Casper exams and how to prepare.

What is the Casper exam?

Casper stands for Computer-based Assessment for Sampling Personal Characteristics. Prior to 2023, Casper was 1 of 3 exams that comprise the Altus Suite, a multi-part assessment used in medical school admissions cycles. Casper is an open-response, situational judgment test (SJT) that evaluates professionalism and non-cognitive skills, such as collaboration, problem-solving, ethics, and empathy.

In 2023, Altus Assessments and One45 merged to become Acuity Insights. After much research, Acuity Insights made slight changes to the Casper test, including the decision to combine the scores for typed and video responses to make admissions more equitable.

Do you have to take the Casper test to go to medical school? You only have to take the Casper test to go to medical school if you are applying to a medical school that requires it.  

First used in Canada, more than 60 United States-based medical schools and roughly a dozen residency programs have now adopted its use. Casper helps schools screen applicants as part of the admissions process.  

Medical schools and residency programs use the Casper exam in lieu of, or in addition to, the traditional medical school interview.

Casper Test Format

At the beginning of 2023  the Casper test changed after Altus and One45 merged.  It still incorporates video responses via webcam, but this section comes first, before the typed sections, to prevent any typed answers being lost due to video uploading issues. Casper includes 14 dilemmas or scenarios, followed by 2 questions, each with 5 minutes to respond. Think of Casper as an automated set of multiple mini interviews.

What is the Casper exam format? The Casper exam format includes:

  • 9 video-based scenarios and 5 word-based scenarios
  • 8 scenarios require typed responses; 2 are word-based and 6 are video-based
  • 6 scenarios require video responses; 2 are word-based and 4 are video-based

How long is the Casper exam? The Casper exam takes 90-110 minutes to complete. 

What kinds of questions are on the Casper test? Casper questions tend to include a range of medical, ethics, and behavioral scenarios. Not all questions are medically related, in fact most are behavioral questions.

Example Scenario

Consider this statement: “From time to time, we deal with conflict in some form.”

Open-ended questions to the applicant:

  • Describe a time when you had to deal with conflict and how you coped with it.
  • How might you handle a similar situation differently should it arise again?
  • What would be your strategy if you were faced with a conflict that was extremely difficult to resolve? 

Casper Test Prep

The Casper exam is not necessarily a test you need to study for with a practice test, like the MCAT. In fact, it’s designed not to be studied for. It’s a test of your ability to think and handle situations. However, we do recommend you go through a few Casper scenarios or sample Casper cases to get an idea of what to expect.

For that, the MedSchoolCoach Casper Prep program is perfect.  It will take you through every aspect of the exam you need to understand and includes coaching by a physician.

Other recommendations we’ve included below come from Je Suis Banane on Student Doctor Network:

Read “Doing Right” by Philip C. Hébert: This is an excellent crash course in medical ethics. The book contains a lot of different scenarios that if you have time to read will give you great insight.

Look up the background/FAQs of Casper: Get a great understanding of the format of the test, take the, and use the MedSchoolCoach Casper Prep Program to your advantage. Learn the history, and acknowledge that the test is designed so that it is difficult to improve your score by studying.

Find sample test questions from different websites and use those to your advantage: You’ll find lots of resources on YouTube if you do a quick search for ‘Casper sample questions,’ ‘medical ethics questions,’ or ‘medical interview questions.’

Practice taking notes for videos & sample questions to accurately grasp scenario: On test day, you can’t go back and re-watch the video — it’s a 1-time deal. Make it count. Hone your note-taking skills beforehand.

When to Take the Casper Test

When should you take the Casper exam? You should take the Casper exam while preparing your AMCAS application, since schools have begun requiring the Casper score along with the primary application. We recommend registering for the exam in April or May of the year you apply.

While you’re gathering information for you medical school application — pre-med GPA, MCAT, LOR, post-bacc, etc. — go ahead and schedule a test date. Be sure to give yourself enough time to prepare for the exam.

Note: it will take 2-3 weeks for scores to be distributed to schools, so plan early.

How much does the Casper test cost? It generally costs $10 to take the Casper test, plus an additional $10 per school that receives your scores.

Casper Scores

Each of the 15 scenarios are scored by a different independently contracted test rater. Raters are instructed to ignore spelling and grammar mistakes and to focus on content alone.

For testers with a slower typing speed, take note: If you don’t finish answering within the allotted 5 minutes, raters will try to understand your train of thought. Any bullet points or unfinished sentences will contribute to your score.

Test takers should be sure to always explain why they’ve taken a certain stance on a topic, as raters are instructed to evaluate your intent and not your specific stance.

Prior to the 2022-2023 test update, Altus shared that each scenario was scored with a rating between 1 and 9. With the updated test, Altus has not disclosed how test scores are determined. During the first application cycle with this new test, only schools selected to participate in the early adopter program will receive test results from the video response section.

What medical schools use the Casper test?

The medical schools that use the Casper test change every year. Medical schools that currently require Casper include:

Allopathic Medical Schools

  • American University of The Caribbean School of Medicine
  • August University Medical College of Georgia
  • Baylor College of Medicine
  • Boston University School of Medicine
  • Central Michigan University College of Medicine
  • Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
  • Drexel University College of Medicine
  • East Tennessee State University Quillen College of Medicine
  • Florida Atlantic University Charles E. Schmidt College of Medicine
  • Howard University College of Medicine
  • Indiana University School of Medicine
  • Marshall University Joan C. Edwards School of Medicine
  • Medical College of Georgia at Augusta University
  • Medical College of Wisconsin
  • Meharry Medical College
  • Mercer University School of Medicine
  • Michigan State University College of Human Medicine
  • New York Medical College
  • Northeast Ohio Medical University 
  • Oregon Health & Sciences University School of Medicine
  • Penn State College of Medicine
  • Rutgers Robert Wood Johnson Medical School
  • San Juan Bautista School of Medicine
  • Stony Brook University Renaissance School of Medicine
  • SUNY Upstate Medical University
  • Temple University Lewis Katz School of Medicine
  • Texas A&M University College of Medicine
  • Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine
  • Texas Tech University Health Sciences Center School of Medicine at Lubbock
  • Tulane University School of Medicine
  • University of Colorado School of Medicine
  • University of Illinois College of Medicine
  • University of Miami Miller School of Medicine
  • University of Nevada, Reno School of Medicine
  • University of Texas at Tyler Health Science Center School of Medicine
  • University of Texas Health Science Center at Houston, McGovern Medical School
  • University of Texas Health Science Center at San Antonio, Long School of Medicine
  • University of Texas Medical Branch at Galveston School of Medicine
  • University of Texas Southwestern Medical School
  • University of Vermont Larner College of Medicine
  • University of Washington School of Medicine
  • Virginia Commonwealth University School of Medicine
  • Wake Forest School of Medicine
  • West Virginia University School of Medicine

Osteopathic Medical Schools

  • Alabama College of Osteopathic Medicine
  • Arkansas College of Osteopathic Medicine
  • California Health Sciences University College of Osteopathic Medicine
  • Idaho College of Osteopathic Medicine
  • Kansas Health Science Center – Kansas College of Osteopathic Medicine
  • Michigan State University College of Osteopathic Medicine
  • Sam Houston State University College of Osteopathic Medicine
  • Touro University Nevada College of Medicine
  • Touro College of Osteopathic Medicine, New York
  • Western University of Health Sciences College of Osteopathic Medicine of the Pacific
  • William Carey University College of Osteopathic Medicine

Medical Schools in Canada

  • Dalhousie University
  • McGill University
  • McMaster University
  • Memorial University Faculty of Medicine
  • Queen’s University
  • University of Ottawa
  • Université de Montréal
  • Université de Sherbrooke 
  • Université Laval
  • University of Alberta
  • University of Manitoba
  • University of Saskatchewan

Find out more about the medical schools using the Casper/Altus Suite in our Ultimate Guide to Virtual Assessments

What residency programs use Casper?

The following residency programs use Casper:

Family Medicine:

  • Hamilton Medical Center

General Surgery:

  • Boston University Medical Center
  • UConn Health (optional, but encouraged)
  • Florida Atlantic University

Internal Medicine:

  • Parkview Medical Center
  • Hamilton Medical Center
  • UConn Health (optional, but encouraged)


  • NYU Langone Health
  • University of Texas Rio Grande Valley
  • University of Michigan


  • Temple University (optional, but encouraged)

The Altus Suite

Along with the Casper exam, there are two other portions of the Altus Suite assessments.


Snapshot is a one-way video response tool designed to give students an opportunity to demonstrate their personal attributes, particularly during this time where in-person communications are difficult. It is about 10-15 minutes in length, with unlimited time for practice questions. The format is such that there are 3 one-way questions with 2 minutes to record a video response to each.


Duet is a value alignment assessment designed to compare the alignment of the values that matter most to a student in a residency program with those of the program(s) that they are applying to. It is about 15-20 minutes in length. The format has 30 program characteristics that are compared in pairs across 3 categories, with no time limits.

We recommend verifying with each school you’re applying to about which parts of the Altus Suite are required for their applications process. 

Prepare for the Casper Exam with Help from the Experts

If you need help preparing for the Casper exam, check out this resource: Medical School Casper Preparation

We’ll pair you with a Physician Advisor that’s interviewed thousands of medical school candidates and served on admissions committees. They provide a realistic experience, so you know exactly what to expect when it’s time to take the Casper exam. We’re here to help you maximize your chances of getting accepted — the first time.

Picture of Renee Marinelli, MD

Renee Marinelli, MD

Dr. Marinelli has practiced family medicine, served on the University of California Admissions Committee, and has helped hundreds of students get into medical school. She spearheads a team of physician advisors who guide MedSchoolCoach students.

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