top of page
  • Writer's pictureRajani Katta MD and Samir Desai MD

Altus Suite and the CASPer Exam for the Residency Match: What You Need to Know

Updated: Sep 8, 2023

Common Questions About the Casper Exam and Strategies to Help you Prepare

The Casper exam is a relatively new exam. Although it has been used more frequently in the medical school admissions process, more residency programs are starting to require it for their applicants. In this post, we’ll provide important background on the Casper exam, why it is used by some residency programs, how it is being used by these residency programs, and an overview of some of the programs that are requiring it.

If you’d like to learn how to do well on the Casper exam, please check out our 6-part blog post series, linked below. Posts 5 and 6 in the series are especially high-yield if you are preparing to take the Casper exam.

For more on how to prepare for the Casper test, please see our blog post series.

Additional Resources

If you'd like additional resources to help you prepare for interviews, our course The Residency Interview 101 can help you quickly and confidently learn what to say during your interview. It's important to learn how to stand out and not sound like other applicants, which is a key focus of the course.

What is Altus Suite?

Altus Suite is the developer of three different types of assessments. These tools have been used in the medical school admissions process for a number of years. As of 2022, they are also now being used in the residency match by some residency programs.

  • In the 2021-2022 application cycle, these assessments were piloted for use in the residency admissions process by 11 different residency programs.

  • In the 2022-2023 application cycle, many more residency programs are expected to require applicants to take one or more of these assessments.

  • The Ophthalmology residency match has already announced that it is requiring the CASPer exam for all students applying this cycle.

What are the three assessments offered by Altus Suite?

  • The CASPer exam is a situational judgment test

  • Snapshot is a one-way video interview

  • Duet is a type of assessment that aims to match programs with applicants who share their values, priorities, mission, and learning opportunities

For more information on these assessments, see the Altus Suite Website. We have more information on the CASPer exam below and in our 6-part blog post series.

What is the CASPer exam?

The CASPer exam (also referred to as the Casper exam in this blog post) is a type of situational judgment test. Basically, applicants are presented with different scenarios and then asked to create an “open” response. In other words, instead of choosing a multiple choice response, applicants are asked to either type out or videotape their own response, in their own words, to challenging situations.

The CASPer was designed to test an applicant on 10 different qualities. These qualities are:

  • Collaboration

  • Communication

  • Empathy

  • Equity

  • Ethics

  • Motivation

  • Problem Solving

  • Professionalism

  • Resilience

  • Self-Awareness

Image of residency applicant taking the CASPer test for the residency match
The CASPer test is a situational judgement test designed to assess applicants on 10 different qualities

Why is the CASPer exam required for the ophthalmology match and other residency programs?

The ophthalmology match is piloting use of the CASPer exam for this cycle, likely in order to add an extra "data point" for programs. This is helpful for programs who are seeking other methods of assessing an applicant prior to the interview stage.

  • Cognitive skills are evaluated by an applicant's USMLE Step scores and medical school grades.

  • Non-cognitive skills, although partially assessed through clerkship evaluations and letters of recommendation, are mainly assessed via interviews.

  • It's felt that the CASPer exam may provide an additional assessment of these non-cognitive skills.

  • Therefore, these exam scores may be helpful for residency programs in deciding which applicants to invite for interviews.

What is the CASPer exam like?

  • On the CASPer exam, there are 15 scenarios

  • For each scenario, you will be asked three questions

  • You are asked to respond to these questions by creating your own answers

  • The CASPer is NOT a multiple choice exam

  • There are no “right“ answers

  • The scenarios may be presented to you in the form of either a video or text

  • The open response is required to either be typed or recorded as a video

  • In an attempt to capture your “authentic“ responses, this is a timed test, and there is significant time pressure

  • For a typed response, you will have about 90 seconds

  • For a video response, you will have 60 seconds

Do I need to study for the CASPer exam?

The makers of the test state that you do not need to study. They recommend that applicants take the free practice exam that is offered and make sure that they know how the test works, but that's about it.

I disagree and strongly feel that a few hours of preparation can significantly reduce your anxiety and improve your performance.

Please see the end of this blog post for a full list of links to other posts in my series on how to prepare for the CASPer exam.

Why do some residency programs require the Altus Suite assessments and the CASPer exam?

As the Step 1 exam has gone to pass/fail scoring, there is a concern that residency programs are losing a metric that they had previously relied on to screen applicants.

It is well recognized that programs are receiving an increasing number of applications. It is challenging for programs to screen these large numbers of applications and then invite a much smaller number to interview.

The CASPer, Snapshot, and Duet assessments represent three additional ways in which residency programs can try to narrow down applicants to invite for interviews.

When did programs start requiring the Altus Suite assessments?

Which residency programs participated in the pilot program for Altus Suite and the CASPer exam?

These assessments were piloted by residency programs in the 2021–2022 application cycle. Per the website for Altus Suite, they partnered with 11 residency programs:

Internal Medicine

  • Parkview Medical Center

  • Hamilton Medical Center

  • UConn Health

General Surgery

  • Boston University Medical Center

  • UConn Health

  • Florida Atlantic University

Family Medicine

  • Hamilton Medical Center

OB-Gyn programs

  • NYU Langone Health

  • University of Texas Rio Grande Valley

  • University of Michigan


  • Temple University

Will other residency programs be using the CASPer exam and Altus Suite assessments in the 2022-2023 application cycle?

Altus has reported that the CASPer exam and other assessments will be available to all residency programs for the 2022 - 2023 match cycle. They reported that feedback from applicants and students was positive.

A number of residency programs have already reported that they will require these assessments for the 2022-2023 cycle.

Which residency programs will require the CASPer exam and Altus Suite in the 2022-2023 residency match application cycle?

*We will continue to update this blog post as more programs make clear their requirements.

  • Please see the list above for programs that utilized these assessments in 2021-2022

  • Applicants applying for the ophthalmology match are now asked to take the CASPer exam:

  • Here is the statement per the website for the ophthalmology match:

  • "July 21 - Sept 8: This year ophthalmology is piloting use of the Altus suite in residency applications. Applicants for residency may schedule the Altus Casper test on any of the following offered dates: July 21, August 16, August 30, and a backup date is also scheduled for September 8 for those who cannot make one of the earlier (preferred) dates."

  • For more information see 2022-23 Ophthalmology Residency Match FAQs document.

  • For other residency programs, please see the list below.


  • Albany Medical College

  • Beth Israel Deaconess Medical Center

  • Boston Medical Center

  • Emory University

  • Henry Ford Hospital

  • Mayo Clinic Florida

  • Rush University

  • Tufts Medical Center

  • University of Arizona

  • University of Connecticut

  • University of Florida, Gainesville

  • University of Florida Jacksonville

  • University of Kansas Medical Center

  • University of Miami

  • University of Utah

  • University of Vermont

  • University of Washington

Internal Medicine:

  • St. Mary Mercy Hospital


  • Ascension Providence Hospital

  • Cleveland Clinic Akron General

  • Creighton University Arizona

  • Dartmouth Hitchcock Medical Center

  • Hofstra University Northwell Health

  • Louisiana State University Shreveport

  • Loyola University Medical Center

  • Mountain Area Health Education Center (MAHEC)

  • New York University Langone

  • OhioHealth Riverside

  • Oregon Health & Science University – Casey Eye Institute

  • Penn State Health Milton S. Hershey Medical Center

  • Philadelphia College of Osteopathic Medicine

  • Stamford Health

  • The Brooklyn Hospital

  • University of California, Irvine

  • University of California San Diego

  • University of California San Francisco

  • University of Chicago

  • University of Cincinnati Medical Center

  • University of Colorado

  • University of Iowa

  • University of Michigan

  • University of Minnesota

  • University of Nebraska

  • University of Washington

  • University of Wisconsin-Madison

  • UTRGV – OB/GYN(Consortium Program)

  • Virtua Health

  • Wellstar Kennestone

  • Western Michigan University

  • Wright State University


  • See above for details on ophthalmology match


  • Beth Israel Deaconess Medical Center

  • Boston Medical Center

  • Northeast Georgia Medical Center

Will scores on the CASPer exam or Altus Suite assessments be used to “weed out“ any residency applications?

That’s a great question, and of course it will depend on the individual programs.

There were definitely indications from the pilot phase that some programs may use the CASPer exam or other assessments to exclude some applicants from consideration.

Dr. Thomas Genuit, the Program Director at the surgery residency program at Florida Atlantic University had this to say about reviewing Snapshot responses. “… It was interesting to see that there were quite a few candidates who look good on paper, but when looking at their CASPer scores and Snapshot rating some potential red flags were revealed. When we’re trying to find well-rounded applicants, those personal and professional attributes really matter.“

He also noted that performance in Snapshot closely mirrored performance in the real interviews. Therefore, Snapshot may be helpful to decide who gets the last few spots for interviews if candidates are otherwise very similar.

Can high scores on the CASPer exam or other assessments help residency applicants obtain an interview?

It’s very early in the process of rolling out these new assessments, and we have very limited data.

However, it’s possible that these new assessments may help some applicants obtain interviews.

Dr. Donald Hess, Program Director of the general surgery residency at Boston University School of Medicine, was quoted as saying that their team was able to use Duet to find additional candidates to interview. “These candidates had lower step scores so we would have missed them otherwise, but with Duet we were able to interview 18 candidates that were fabulous!“

Here’s another quote indicating that a high CASPer score may help applicants.

Per Dr. Salcedo “with our very limited interview spots, we did end up inviting several applicants to interview in large part due to the CASPer scores. They really blew it out of the water with their scores, placing in the 90th percentile or higher – and these were individuals who otherwise would’ve been on the waitlist.“

Dr. Salcedo reported that in future rank meetings, they expect the CASPer and Duet scores, along with board scores, “will be pretty popular points of discussion and inform decisions on who to move up or down that list.“

Which assessments will residency programs use?

Do programs prefer the CASPer exam, Snapshot, or Duet?

Again, every residency program will approach this differently.

The OB/GYN residency program at the University of Texas Rio Grande Valley used all three assessments. They used them to decide both who to interview, as well as how to rank applicants on their waitlist.

They state that they weighted CASPer scores higher than Snapshot or Duet scores when it came to interview selections, because of the strong psychometrics of the CASPer exam.

How do residency applicants feel about CASPer and Altus Suite?

We have very little data on the thoughts of residency applicants. Altus Suite has published limited information on their website. They did provide a few quotes from applicants from an exit survey.

  • “I think it is a well-rounded form of testing the candidate on a personal level“

  • “if this brings programs to focus more holistically on applicants beyond just grades, then it is worth it.“

Altus Suites reports that applicants in their exit surveys noted that different assessments provided multiple opportunities to showcase unique personal and professional qualities beyond their standard application.

The bottom line: The CASPer exam and Altus Suite assessments may be an important consideration for some residency programs, and you should spend sufficient time preparing

The conclusion for me is that if a residency program is requiring that applicants take the CASPer exam, then it’s worth it for applicants to spend the time necessary to prepare. There are no “right” answers on the exam, but there are definitely a number of strategies that can help you prepare.

How can I do well on the CASPer exam?

Are there tips to score well on the CASPer test?

We wrote a book for medical school applicants on how to prepare for the CASPer exam, along with an associated 6-part blog series. I strongly recommend that you learn the strategies outlined in these resources.

I classify these as strategies to help you organize your thoughts and then strategies to help you get it all down on paper. Many of these strategies focus on efficiency, since a key feature of the test is that it introduces significant time pressure.

Even just a few hours invested in learning these strategies can significantly help you in terms of reducing anxiety and improving performance.

Additional Resources

If you'd like additional resources to help you prepare for interviews, our course The Residency Interview 101 can help you quickly and confidently learn what to say during your interview. It's important to learn how to stand out and not sound like other applicants, which is a key focus of the course.

For more on how to prepare for the Casper test, please see our blog post series.


Dr. Rajani Katta is the creator of The Residency Interview 101, the online course that helps applicants quickly and confidently prepare for their residency interviews. She is also the co-author of The Successful Match: Rules to Succeed in the Residency Match and served as Professor of Dermatology at the Baylor College of Medicine for over 17 years.

Dr. Samir Desai is the author of The Successful Match: Rules to Succeed in the Residency Match and is co-founder of MD2B Connect, the most trusted and highest-rated provider of hands-on clinical experiences for IMGs in the U.S.


bottom of page