This is part 1 of our 5-part series on medical school interviews. The goal of these interviews is to give medical schools a holistic sense of who you are by rounding out the quantitative and written elements of your application—including your GPA, MCAT scores, essays, and recommendations —with a more personal sense of your potential to succeed in medical school and as a physician.
This series covers the four types of interviews and assessments for medical school: the assessments of Acuity Insights and AAMC PREview, as well as traditional and MMI interviews. For information on the other posts in this series, see our overview post here.
Background
Almost two decades ago, two professors in the Department of Medicine at McMaster University in Ontario, Canada, confronted what they saw as a significant defect in medical school admissions: the singular reliance on stats and facts to evaluate which candidates should be invited for interviews.
“We were only able to use reference letters, personal essays, CVs. They don’t tease apart the applicants who excel in terms of their communication, ethics, or empathy from those who don’t,” Dr. Kelly Dore explained. “I’d be signing rejection letters for thousands of applicants every year based upon the grade point average and MCAT, but no good reliable measure of their personal professional characteristics,” said Dr. Harold Reiter. “We needed a screen so that one could properly select those to come to interview.”
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Development of Casper
Over the next ten-plus years, Dore and Reiter researched options for screening applicants’ social intelligence traits and other professional characteristics and developed a test called Casper. A Situational Judgment Test (SJT), Casper would enable medical schools to efficiently assess applicants’ soft skills, such as empathy and collaboration, along with the hard skills conveyed by the rest of their application materials, before they selected which applicants to interview. Dore explained that the aim was “to make sure that they will be good fits within their community both within training and in future practice” and for the selection process to include soft skills earlier on. Situational Judgment Tests like Casper and AAMC PREview, which we cover in Part 2, present test-takers with hypothetical dilemmas that are used to evaluate how the individual would react or behave.
McMaster University began requiring that med school applicants take Casper, and other medical schools followed. Now, a substantial number of medical schools request or require that applicants submit their Casper results as part of their applications. As of 2024, 40 schools require or accept Casper scores for the 2024-2025 applicant cycle. MSAR (on the AAMC website) notes whether each medical school requires, recommends, or accepts Casper.
Addition of Duet
Dore and Reiter co-founded Altus Assessments – which now fall under the brand Acuity Insights – in 2014 with the goal of improving decisions and outcomes both for students and academic programs. The organization uses research-backed assessment methodology to strengthen the quality and efficiency of medical school admissions. They later launched two additional assessments, Snapshot and Duet (both required less frequently than Casper) to measure different competencies and attributes, with the aim of providing a comprehensive evaluation of each applicant. The use of Snapshot was discontinued after the 2022-2023 cycle.
In this post, we’ll walk you through the Casper and Duet assessments. These elements are completed virtually, and your results are sent to schools once Casper has been scored. While you have to sign up for Casper in advance, you can take Duet at any point after reserving your Casper test, but “it should be completed within 14 days of taking Casper to ensure your program(s) can consider all your assessments together.” Taking Casper costs $85, which includes the Duet assessment if needed and distribution of your scores to seven med schools; sending your scores to additional programs costs $18 extra per program.
Casper
Overview
As described on the Acuity Insights website, Casper is an “open-response situational judgment test that measures aspects of your social intelligence and professionalism, like ethics, empathy, problem-solving and collaboration.” Candidates are presented with 14 scenarios to respond to via typing (for eight of the responses) and video (for six of the responses). These scenarios will not necessarily be related to medicine. The goal is not to get the “correct” answers, but rather to demonstrate to admissions committees the process by which you arrived at your decisions. As Reiter put it, “For Casper, there is no right or wrong answer. It’s a controversial situation that’s presented, making it much more attuned to why the applicant is choosing to do what they do.”
Structure
In the first section—the one you’ll reply to via a video recording of you speaking—you’ll be presented with two scenarios that are described in writing and four presented in a video you’ll watch. You’ll be asked to answer two open-ended questions by recording video responses for each (one minute max per video response) in which you talk through them. (You’ll get 30 seconds to reflect before recording your responses.)
In the second section—the one you’ll respond to via typing—you’ll be presented with three scenarios that are described in writing, and five that will be enacted in a video you’ll watch. For each, you’ll get thirty seconds to think, then five minutes to respond to three open-ended questions.
Casper takes, in total, 90-110 minutes to complete, with two optional breaks.
Examples
For a sense of the kinds of scenarios to which you’ll be asked to respond, take a look at the examples on this page. In one video scenario, a man whose wife is about to have a baby confides in his coworker that he’s conflicted about whether to take paternity leave or not. At the end of the video, the coworker turns to you—the applicant—and asks, “What do you think he should do?” The questions you’d be asked to respond to in this hypothetical scenario are:
- Would you recommend he take paternity leave? Why or why not?
- What strategies could you offer to help him make a decision that he feels comfortable with?
- Maintaining work life balance can be challenging. Why do you think people struggle to find balance?
Scoring
Each scenario of a given test is scored by a different rater, the purpose of which is to minimize bias. As Acuity Insights puts it, “The group of raters reflects the diversity of the population. All raters are extensively trained, vetted, and invested in the future of the profession.” An important note: spelling errors do not affect your score (raters are trained to ignore them). Your Casper scores will be sent to the med schools you’re applying to that require them, within two to three weeks after your test date.
Programs are provided with applicants’ percentiles, as well as their “z-scores.” The z-score indicates how close your score is to the average of all Casper takers that took the test on the same day and time (if it’s above average, it’s a positive score; if it’s below average, it’s a negative score) .
Our Tips
Prepare. The best way you can prepare for this unique test is to familiarize yourself with the test format so that you can effectively move through its elements on test day. Beyond reading this article, scour the Acuity Insights website and take a practice test. As for studying for Casper, though, you really can’t! It requires thinking calmly and clearly in the moment. So get a good night’s sleep the evening before and use any strategies to relax that you have at your disposal.
During Test Day. On test day, wear a smart casual outfit since you’ll be replying to some of the scenarios on video. And during the test itself, give yourself time to think through each scenario before you respond, then explain your answer clearly and in detail.
Timing. Although Casper is offered at least monthly, we recommend taking it in the spring before you apply to med schools, so that admissions committees receive your scores by the time you submit your primary application. We also recommend taking both components of Acuity Insights’ testing (Casper and Duet) – even if the schools on your list only appear to require Casper, as the schools’ requirements could change or you may decide to apply to another program later on. After you take Casper, try to take Duet within two weeks so that these scores are included when your Casper score is sent to the medical schools that accept it.
Duet
Overview
Duet is designed to assess how well your values and priorities align with those of the medical school program. According to Acuity Insights, Duet is a standardized tool that medical schools use to identify and select “students who are not only academically excellent, but also aligned with their mission and likely to thrive in their unique environment.” Duet is required by only a handful of allopathic (MD) and osteopathic (DO) programs; check each med school’s website to see which of your schools requires this test.
Structure
First, you’ll be given various pairs of characteristics (like “individual assignments” versus “group tasks”) within certain categories and asked to choose which of the two options in each pair you gravitate toward. Next, you’ll be asked to compare the broader categories with each other, and to choose which in a given pair is more important to you. The test, in total, should take no more than 15 minutes to complete. Keep in mind that you complete Duet only once, not separately for each medical school.
Scoring
Scores are generated automatically based on the degree to which your rankings of characteristics match those of the programs you’re applying to, resulting in an alignment score for each applicant to each program. The individual programs complete Duet before you do, so each program already has a profile.
Our Tips
Prepare. You can prepare for Duet by reflecting on the features of medical schools that are the most important to you. We also suggest researching in detail the schools you’re applying to that appeal to you the most. Are there features, goals, or values that these schools have in common, that align with your own preferences?
To find out information about a med school’s values and priorities, check out their mission statement on MSAR (Medical Schools Admissions Requirements) on the AAMC website. See our blog post on “What Mission Statements Reveal about Medical Schools.” In addition, go on the med school’s website and learn as much as you can about their curricular programs, values, and institutional priorities.
Finally, try to go with your gut so that you will be more likely to end up at a program that genuinely suits your personality and needs!
Timing. Duet can be taken any time after you’ve made your Casper reservation until the earliest score distribution deadlines of the programs you’re applying to. Duet scores are available to programs as soon as you’ve completed the assessment. We recommend that you take Duet within two weeks of taking the Casper test.
Applying to medical school is a complicated process, and interviews are no exception. We encourage you to read through the rest of our blog posts on med school interviews, as well as to contact Collegiate Gateway if you would like guidance on any aspect of the application and admissions process. As always, we’re happy to help!
