CASPer vs PREview 2026: Key Differences, Which Schools Require Each, and How to Prepare
Apply to enough US medical schools and you'll likely run into one — or both — of two situational judgment tests with confusingly similar purposes: CASPer and PREview. Both claim to measure the same things — empathy, ethical reasoning, communication under pressure. Both report quartile scores. And both are now fixtures on a growing number of MD program checklists. But they're built by different organizations, structured completely differently, and demand different preparation strategies entirely.
Which schools require which? Is one objectively harder? And if your list includes programs requiring both, how do you avoid doubling your prep workload? This guide untangles all of it.
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What Is the Difference Between CASPer and PREview?
The short version: CASPer asks you to build an answer; PREview asks you to judge one. CASPer is open response — you type or record your own reaction to a scenario under a hard time limit. PREview presents 186 multiple choice questions, each scored on a 4-point scale, asking how effective or ineffective a given response would be. Acuity Insights runs CASPer; the AAMC runs PREview.
| Feature | CASPer | PREview |
|---|---|---|
| Full name | Computer Based Assessment for Sampling Personal Characteristics | Professional Readiness Evaluation |
| Administrator | Acuity Insights | AAMC |
| Format | Open response — typed and video | Multiple choice |
| Number of scenarios / questions | 11 (7 typed, 4 video) | 186 questions |
| Time | 65-85 mins | 75 mins |
| Response type | Write or record your own answer | 4-point scale |
| Time per scenario | 3.5 minutes typed / 1 minute video | No time limit per question; overall limit applies |
| Scoring | Quartile ranking (Q1 to Q4) | Quartile ranking |
| Programs requiring it (US) | Approximately 50 MD and DO programs | Approximately 12 MD programs |
| Preparation approach | Framework based, timed writing and speaking | Scenario analysis, option evaluation strategy |
| Registration platform | (Acuity Insights](https://acuityinsights.app/casper/) | AAMC |
That format gap drives everything else. With CASPer, there's no scaffolding, you're identifying the ethical dimensions of a scenario and constructing a response from a blank page in 3.5 minutes. With PREview, you're working through 186 questions rating how effective a given response would be on a 4-point scale, the dimensions are already on the page; your job is judging them. Same underlying competencies, almost opposite cognitive task.
Which US Medical Schools Require CASPer?
Roughly 50 US MD and DO programs require CASPer for the 2026 cycle — names like Tulane, Drexel, Texas A&M, Hackensack Meridian, and Boston University, with concentrations across Texas, Illinois, New Jersey, Louisiana, Missouri, and Virginia.
The Acuity Insights program directory is the place to check the current, complete list, it shifts slightly each cycle.
Which US Medical Schools Require PREview?
A much smaller group — around 12 US MD programs — currently require the AAMC's PREview exam.
| Medical School | State |
|---|---|
| University of Cincinnati College of Medicine | Ohio |
| University of Colorado School of Medicine | Colorado |
| Medical College of Wisconsin | Wisconsin |
| Virginia Commonwealth University School of Medicine | Virginia |
| University of Kansas School of Medicine | Kansas |
| Additional AAMC PREview programs | Various |
The AAMC maintains the authoritative, current list — confirm directly rather than relying on this snapshot for your specific cycle.
Do Any Programs Require Both CASPer and PREview?
A handful of programs have flirted with requiring both, but in practice most schools commit to one or the other, not both. If your application list happens to straddle both groups, there's no shortcut: you sit two separate assessments, register separately for each, and a CASPer score won't satisfy a PREview requirement (or vice versa). The two systems don't talk to each other.
Is CASPer Harder Than PREview?
Depends what "harder" means to you — they're difficult in different ways.
CASPer is harder because:
- You're building a complete response from nothing, with no options to react against
- The video section adds a performance layer — tone, pacing, eye contact all factor in
- Each scenario is scored independently and irreversibly; there's no recovering a weak answer later in the test
PREview is harder because:
- The 4-point scale format can create false confidence — it feels more approachable even when the judgment call is genuinely hard
- Rating 186 questions on how effective a response would be requires sustained, consistent judgment across a much longer test
- That sheer volume — nearly 17 times more items than CASPer's 11 scenarios — demands a different kind of stamina
Most applicants find CASPer the more intimidating of the two going in, simply because there's nothing to lean on. With preparation, both become systematic, but CASPer preparation tends to be the bigger lift.
How to Prepare If Your Programs Require Both
Do CASPer first. The ethical reasoning frameworks and stakeholder-awareness habits you build for CASPer transfer almost directly into how you'll judge PREview's 4-point scale items — the nine CASPer competencies map closely onto what PREview is actually evaluating. Applicants who've done thorough CASPer prep tend to find PREview's judgment calls noticeably more intuitive than those who go in cold.
For PREview specifically, the shift is from generating a response to rating one — practice reading scenarios through a professional-competency lens rather than a personal-preference one, and get comfortable with the 4-point effectiveness scale across a high volume of items. The AAMC's own PREview materials are worth reviewing for format familiarity.
A practical sequence:
- Confirm which assessments each target program actually requires
- Register for CASPer at Acuity Insights, ideally for a March to May slot
- Run four weeks of structured CASPer preparation
- Sit CASPer and confirm score distribution
- If PREview is also required, register at aamc.org
- Spend one to two weeks on PREview-specific practice with the 186-question, 4-point scale format
The combined timeline — roughly four to six weeks for CASPer, then one to two for PREview — is shorter than preparing for each in isolation, precisely because of how much the competency work overlaps.
CASPer vs PREview: Answers to the Questions Applicants Ask Most
Who needs to take CASPer vs PREview?
If your program is one of the ~50 requiring CASPer (via Acuity Insights), you sit CASPer. If it's one of the ~12 requiring PREview (via AAMC), you sit PREview. If your list includes both types, you sit both. Always confirm on each program's own admissions page. These lists move.
What is the main difference between CASPer and PREview?
Format, fundamentally. CASPer: 11 scenarios, you write or record your own answer, strict timing. PREview: 186 questions, you rate how effective or ineffective a response would be on a 4-point scale, no per-question timer. Both target the same underlying 9 competencies — empathy, ethics, communication — but the cognitive task is almost opposite.
When should I take CASPer and PREview?
CASPer: March to May, so scores land before most programs start reviewing primary applications in late June or July. PREview follows AAMC's own application cycle timing — check their site directly. If you need both, CASPer goes first.
Where do I register for CASPer vs PREview?
CASPer: Acuity Insights. PREview: AAMC. Two completely separate registrations, two separate fees, no shared account or bundled pricing.
Which is harder: CASPer or PREview?
Most people find CASPer harder going in, open response under time pressure with nothing to react against tends to feel more exposed than rating provided options. But PREview's 4-point scale across 186 questions hides its own difficulty: maintaining consistent, nuanced judgment across that many items is a genuinely demanding form of concentration. Both respond well to structured prep.
Can I use my CASPer preparation for PREview?
To a meaningful degree, yes. The ethical reasoning and competency frameworks from CASPer prep carry over almost directly — the nine CASPer competencies and PREview's professional readiness dimensions overlap heavily. What CASPer prep doesn't give you is practice with PREview's specific 186-question, 4-point scale format, which is worth a dedicated week or two on its own.
How MYLS Interview Helps Applicants Prepare for CASPer
MYLS Interview provides mock CASPer test to covers all nine official CASPer competencies with AI scored feedback on every practice response, built for MD applicants specifically.
About MYLS Interview
190+ interview programs and 24,000 practice questions, with feedback scored against the official nine-competency framework on every response.
Our Features
- 190+ interview programs covering CASPer for US MD and DO applicants
- 24,000+ practice questions across all nine competencies and three question types
- AI powered response feedback identifying competency gaps after every attempt
- Timed mock tests replicating Medical CASPer conditions, typed and video
- Video response practice with structured delivery feedback
- A foundation that transfers — the same competency framework underpins PREview preparation too
How We Can Help
If your list includes PREview requirements alongside CASPer, the MYLS Interview CASPer Mock Test gives you the ethical reasoning foundation that makes the transition to PREview-specific practice noticeably faster, you're not starting from zero twice.
Start Your CASPer Preparation Today
For CASPer-requiring programs, the gap between Q2 and Q4 is almost entirely a function of preparation. The open response format rewards practiced response habits more than raw intuition. If both CASPer and PREview are on your list, starting with CASPer isn't just the recommended order; it's the more efficient one, since the competency work doesn't need to be redone for PREview.
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Frequently Asked Questions
Do I need to take both CASPer and PREview for medical school?
Only if your school list spans both categories, most individual programs require one or the other, not both. Check each program's admissions page; don't assume based on what a similar program requires.
How many medical schools require PREview?
Around 12, as of 2026, a much smaller footprint than CASPer's roughly 50. The AAMC keeps the current list, and it does shift between cycles.
Is PREview easier than CASPer?
It feels less intimidating upfront because there's no blank page to fill, but rating 186 questions on a 4-point effectiveness scale, consistently, is its own genuinely demanding skill. "Easier" and "less exposed at first glance" aren't quite the same thing here.
What score do I need on CASPer and PREview for medical school?
Same target for both: Q3 as the floor, Q4 as the goal, Q4 meaning the top 25% of that test type's takers for the cycle. Competitive programs generally expect Q3 or above on whichever assessment they require.