Casper vs. AAMC PREview: What Every Premed Should Know

Depending on which medical schools you’re applying to, you may need to take one or both situational judgment tests now required by a growing number of programs: Casper, administered by Acuity Insights, and the AAMC PREview exam. Some schools require Casper, some require PREview, and a handful require both. Many require neither.

Casper and PREview test similar soft skills, but they’re meaningfully different in format, cost, scoring, and which schools require them. This guide breaks down every key difference so you know exactly what you’re dealing with before you register.

If you’re applying to residency, Casper may also be a factor, though, as of the 2026-2027 cycle, no US residency programs are currently listed as participating.

Casper vs. AAMC PREview: Main Differences

Casper is a computer-based situational judgment test that measures who you are beyond your hard skills and grades. The test was developed in 2010 in Canada to assess a student’s interpersonal communication skills, ethical decision-making, empathy, and problem-solving.

PREview is also a situational judgment test developed over the past few years by the AAMC. PREview has a multiple-choice format, and currently, only a handful of medical schools require it.

Difference #1: How the Tests Are Formatted

Both Casper and PREview require similar preparation, but their test formats are quite different. For Casper, you’re required to answer questions in a live video submission as well as a typed section. PREview is a multiple-choice test.

Casper Test Format

Casper is split into two sections.

First, there is a video response section that asks participants to verbally respond to four scenarios, some video-based and some word-based. Each scenario is followed by two questions. You have one minute to answer each question in a video recording. Once the one minute is up, your answer is automatically submitted. You cannot edit, go back, or change your answer.

Second is a typed response section that asks you to type your responses to seven scenarios, some word-based and some video-based. Each scenario is followed by two corresponding questions. You have 3.5 minutes to type your responses to both questions. After 3.5 minutes, you are automatically advanced to the next scenario.

You cannot go back and change your answers. If your timer runs out or you submit your answers before your allotted 3.5 minutes are up, your responses are automatically saved and uploaded.

In total, including an introduction and two breaks, the Casper test takes 65-85 minutes to complete.

This is How the Casper Test Is Scored.

PREview Test Format

The PREview exam consists of 30 hypothetical scenarios that students may encounter in medical school. The scenarios are based on real-life situations in healthcare, education, and other settings. The questions are developed for premeds, so no healthcare or clinical experience is required to score well on the test.

Students are asked to evaluate the effectiveness of behavioral responses to each of these scenarios in a multiple-choice format.

Each scenario is a short paragraph that outlines a potential problem students may face. The scenario is followed by a list of potential items (responses) that describe the actions you could take in response to the dilemma. Students must rate the effectiveness of each response using a 4-point scale:

1 = very ineffective, 2 = ineffective, 3 = effective, and 4 = very effective.

While the number of items (responses) that follow each scenario will vary, the test contains a total of 186 questions.

Difference #2: Competencies

Casper test questions are based on nine competencies that test a student’s soft skills.

The nine Casper competencies are:

• Collaboration
• Communication
• Empathy
• Fairness
• Ethics
• Motivation
• Problem solving
• Resilience
• Self-awareness

The AAMC’s PREview exam is based on their new and improved premed competency model. It includes professional, science, and thinking and reasoning competencies.

Professional Competencies:

• Cultural Awareness
• Cultural Humility
• Commitment to Learning and Growth
• Teamwork and Collaboration
• Empathy and Compassion
• Resilience and Adaptability
• Ethical Responsibility to Self and Others
• Reliability and Dependability
• Interpersonal Skills

The Science Competencies:

• Human Behavior
• Living Systems

Thinking and Reasoning Competencies:

• Critical Thinking
• Quantitative Reasoning
• Scientific Inquiry
• Written Communication

AAMC’s PREview exam covers a broader range of personality traits and skills, including commitment to growth, human behavior, quantitative reasoning, and scientific inquiry. The scenarios you encounter on the test will have a broader range of circumstances and will require test-takers to apply interdisciplinary thinking.

Difference #3: The Number of Participating Schools

Although PREview expects many more schools to adopt its new situational judgment test, so far, only a handful have required it. As of May 2026, 14 schools require a PREview test, and another 16 recommend it.

View the full list of required and recommended PREview schools in 2026.

In comparison, Casper is currently required by 33 medical schools.

View a full list of schools participating in Casper in 2026.

Difference #4: How Test Results Are Issued

Your Casper score is automatically submitted to the medical schools you’re applying to about two to three weeks after you take the test, but you are not able to see your results. Instead, about a month after you take the test, you will receive a “quartile,” which indicates how you performed in relation to the other applicants who took Casper.

The quartiles break down like this:

• 25% of applicants score in the first quartile (0-24 percentile)
• 25% of applicants score in the second quartile (25-49 percentile)
• 25% of applicants score in the third quartile (50-74 percentile)
• 25% of applicants score in the fourth quartile (75-100 percentile)

Landing in the first quartile means the raters (the people evaluating your exam) felt that 75% of your peers provided answers that were more empathetic and complete than yours. Landing in the fourth quartile means the raters regarded your answers as better than 75% of your peers.

PREview works a bit differently. About a month after completing the test, you and the participating schools you selected will receive a single score ranging from 1 (lowest) to 9 (highest). This score is based on how closely your effectiveness ratings align with those of the medical educators who helped develop the PREview’s scoring key.

Your total score is accompanied by a “confidence band,” which shows the range in which your total score lies. Since some questions will naturally be more ethically complex than others, confidence bands were designed to help signal “the lack of precision of test scores.” They are meant to discourage distinctions between test-takers with similar scores.

Along with your total score and confidence band, a percentile rank will also be reported. Similar to Casper’s quartiles, percentile ranks of scores represent the percentages of examinees who earned the same or lower scores than you did.

Difference #5: How Much the Tests Cost

Casper costs $85 USD and includes the distribution of your results to 7 schools of your choosing. An additional $18 USD is charged for each additional program to which you want your results sent.

PREview costs a 1-time fee of $105 USD, which includes the distribution of your results to an unlimited number of participating programs.

If you only need to submit your Casper score to 7 or fewer schools, Casper is the cheaper option. For 8 or more schools, PREview becomes cheaper, but expect both of them to run you around $100.

Prepare for Either Test with Confidence

Knowing which test you need is step one. Preparing for it is another matter entirely. 

If you need to take Casper, the Med School Insiders Casper AI Course gives you instant feedback on both your typed and video responses, emotion detection analysis, unlimited practice problems, and a 3-day money-back guarantee. 

If PREview is on your list, the Med School Insiders PREview AI Course combines AI-powered feedback with in-depth video tutorials and unlimited practice questions. Both come with a 3-day money-back guarantee, so you can try either at no risk.

Casper vs. PREview FAQ

Do I need to take both Casper and PREview?

Not necessarily. Whether you need one, both, or neither depends entirely on the schools you’re applying to. Check each school’s requirements on your list individually. Some schools require Casper. Some require PREview. Some recommend PREview without requiring it. And many require neither. If you’re applying to a broad list of schools, there’s a reasonable chance you’ll need at least one of them.

When should I take Casper and PREview relative to my application?

As early as possible. Both tests can affect when your application is considered complete by participating schools, and medical school admissions operate on a rolling basis. For PREview, aim to take it in one of the first four testing windows, which run from mid-April through late June. For Casper, test dates are available monthly from March through February, but check the deadline set by each school you’re applying to, as they vary. Don’t let either test hold up your application.

Which test do more schools require?

Casper currently has broader adoption, with 33 medical schools requiring it. PREview is required by 14 schools, recommended by 16, and a growing number are listed as exploring it for future use. That number is likely to increase as the AAMC continues to expand the program.

What happens if a school only recommends PREview instead of requiring it?

You can technically skip it, but that’s probably not the right call. If you’re up against an equally qualified candidate who completed the recommended exam and you didn’t, they have an edge. Admissions committees notice when applicants go above and beyond, and when they don’t.

Can I void either test?

PREview, yes. Casper, no. At the end of your PREview test, you’ll be asked whether you want your exam scored or voided. Voiding counts toward your annual and lifetime attempt limits, but it prevents the score from being sent to schools. Casper has no void option. Once you complete it, your results are automatically sent to your selected schools, with no option to withhold them.

Do I need to take Casper for residency?

As of the 2026-2027 application cycle, no US residency programs are listed as requiring Casper. In the 2025-2026 cycle, only three programs used it: two anesthesiology programs and one OB/GYN. PREview is only used for medical school admissions and has no residency component. This could change in future cycles, so it’s worth checking the Acuity Insights website when you’re applying.