*Note that for the 2026-2027 residency application cycle, no programs are listed as Casper participants. This could change later in the year.
While much of your residency application is based on your grades, Step scores, and other hard skills, it says little about your soft skills, such as empathy, professionalism, ethical decision-making, and bedside manner. This is why more and more residency programs are now requiring applicants to take the Casper test, a key component of Acuity Insights. So, which residency programs require Casper?
Read on to learn what the Casper test is, which residency programs require Casper, and how to succeed if you need to take the test.
Save our complete Casper Test Guide to prepare for Casper, including detailed study strategies, Casper dos and don’ts, and how test-takers are assessed.
Last updated February 2026.
The Computer-Based Assessment for Sampling Personal Characteristics (Casper) is the major component of Acuity Insights, a multi-part assessment designed to assess a premed or medical student’s empathy and communication skills.
You may have encountered Casper when you applied to medical school four years ago, but the test and the corresponding components from Acuity Insights continue to evolve year after year. For example, in 2022, a video component was added to Casper, splitting the test into two: a video response section followed by a typed response section. In 2025, the number of scenarios changed from 14 to 11, and you are asked one fewer question in the typed response section, shortening the test from 90-110 minutes to 65-85 minutes.
Find more details about how Casper is formatted in the FAQ section below.
Note that Casper is only one part of Acuity Insights. Some programs may also require a Duet assessment. Check the requirements of each program you are applying to to determine what aspects of Acuity Insights, if any, are needed.
In the past, some US residency programs required Casper.
As of the 2026-2027 application cycle, no programs are listed as participating, although this could change later in the year. For the 2025-2026 cycle, only two anesthesiology programs and one OB/GYN used Casper. (Updated February 2026.)
Casper is a computer-based situational judgment test developed in 2010 in Canada to measure who you are beyond your hard skills and grades. Casper evaluates your interpersonal communication skills, ethics and ethical decision-making, empathy, and fairness.
While excellent grades and a high Step 2 score are definitely key to any residency application, there’s a lot more to being a doctor than excelling in academia. Doctors must also be able to earn their patients’ trust and communicate effectively with them. They need to listen closely to their patients’ information, determine the problem, and deliver a wide range of challenging or, at times, earth-shattering information.
Doctors require patience, tact, and emotional intelligence—and stellar grades are not a reliable measure of these qualities.
Casper tests people based on the following nine competencies:
Casper is composed of 11 scenarios, some word-based and some video-based, and two open-ended questions follow each scenario.
The scenarios are a mix of SJTs (Situational Judgment Tests) and behavioral descriptor questions. The scenarios aren’t usually based in a clinical setting. For example, you could be in a grocery store or at a job interview.
The test is divided into a video response section and a typed response section.
In the video response section, you will record a video of yourself verbally replying to four scenarios, some word-based and some video-based. After each scenario is presented, you will be asked two questions and given 1 minute to record a video response to each.
Your response will be automatically uploaded once your one minute is up. You will not be able to play back your recording or change your answer.
In the typed response section, you will type your responses to seven scenarios. Two corresponding questions will follow each scenario, and you have 3.5 minutes to type your responses to both questions before you are automatically advanced to the next scenario.
If your timer runs out, your responses will be automatically saved and uploaded. You can also choose to submit your answers before the timer runs out. In either case, you cannot change your answers.
Each of your Casper responses is scored relative to other responses to the same scenario. Therefore, your score represents how strong your response is compared to the other test takers. Your responses are evaluated on a Likert scale from 1 to 9 (1 = poor, 9 = excellent).
Your Casper scores reflect your ability to use critical reasoning and social interpretation to effectively and ethically respond to professional and interpersonal dilemmas. Casper scores are Z-scores—standardized scores of applicants’ raw mean Casper scores. Acuity Insights also calculates an applicant’s percentile rank and quartile rank.
You will not receive your specific score. You will only receive a quartile rank indicating how well you performed relative to your peers. Programs will receive both your Casper score and your percentile rank.
Scores are divided into four equal parts.
Scoring in the fourth quartile means your responses were thought superior to everyone who landed in the third, second, and first quartiles, meaning you did better than 75% of other Casper test takers. Scoring in the first quartile doesn’t mean you failed; however, it does mean you performed worse than 75% of other Casper test takers.
This Is How the Casper Test Is Scored.
While you can’t necessarily study for Casper, you can prepare for it with regular practice. You can answer sample test questions, take practice tests, improve your reading comprehension, and record and review video responses to get used to the test format.
Practicing within the Casper test format is critical to your success on the big day.
The Med School Insiders Casper AI Course leverages cutting-edge AI and in-depth video tutorials. It’s the most comprehensive prep resource for Casper out there.
Get instant feedback on both the typed and video response sections of the Casper test, including immediate personalized evaluation and emotion detection analysis. For the typed section, our platform will help you improve your typing speed as you simultaneously master essential Casper vocabulary.
The course includes unlimited practice problems, which means you’ll have endless opportunities to refine your skills, adapt to various scenarios, and truly understand the nuances of the Casper exam.
Plus, it comes with a 3-day money-back guarantee, so you can try it at no risk.
Tactfully and thoughtfully approaching your residency application is essential to your success. Med School Insiders can help you prepare a stand-out residency application. Our team of doctors has years of experience helping medical students match with their ideal program.
We offer several Residency Admissions Consulting Services tailored to your needs, including personal statement editing, USMLE tutoring, interview prep and mock interviews, and overall application editing.
If you’re drawn to the heart, you eventually have to answer one question. Do you want to manage it or operate on it? We’re putting cardiologists and cardiothoracic surgeons head-to-head.
Medical school secondary application FAQs: costs, deadlines, essay prompts, pre-writing strategies, and what admissions committees are actually looking for.
