One of the most common sources of anxiety around CASPer is the scoring process. Unlike the MCAT, which gives you a clear numeric score, CASPer operates on a system of independent raters, a 1 to 9 scale, and quartile-based reporting. Here is a detailed breakdown of how every part of the scoring works.
Every CASPer response is evaluated by a human rater, not an algorithm. Acuity Insights recruits raters from a diverse pool that includes healthcare professionals, community members, educators, and trained volunteers. Each rater undergoes a standardized training program designed to ensure consistency in scoring.
Critically, each of your 14 scenarios is scored by a different rater. This means no single person evaluates your entire test. The multi-rater design is intentional: it reduces the impact of any one rater's personal biases and produces a more reliable overall score. If one rater is slightly harsher or more lenient, their influence is diluted across the full set of independent evaluations.
Raters assign each scenario a score from 1 (weakest) to 9 (strongest). This is a holistic score for the entire scenario, not a per-question score. The rater reads or watches all of your responses within that scenario and then assigns a single number reflecting the overall quality of your reasoning, empathy, and communication.
General scoring benchmarks:
After all 14 of your scenarios are scored, Acuity Insights aggregates and standardizes your scores into a quartile ranking:
Q1
Bottom 25%
Q2
25th - 50th %
Q3
50th - 75th %
Q4
Top 25%
The quartile is determined by comparing your aggregated score to all other test-takers in the same test cycle and program type. Your raw 1 to 9 scores are not shared with schools. Only the quartile is reported. This means you could score 7s across the board and land in Q3 if the overall pool performed exceptionally well, or score 6s and land in Q3 if the pool was less competitive. Your quartile is always relative to your peers.
Schools that require CASPer receive a report from Acuity Insights that includes your quartile ranking (Q1 through Q4). They do not see your raw scores, the specific scenarios you were given, or your individual typed or video responses. The report is designed to give admissions committees a standardized, comparable metric that can be used alongside other application components.
Some programs also receive a z-score (a standardized score showing how far above or below the mean you performed) in addition to the quartile, giving them slightly more granularity. However, the quartile remains the primary metric used for admissions decisions at most schools.
Both sections are scored using the same 1 to 9 scale and the same competency framework, but raters evaluate them through slightly different lenses:
Raters read your written responses and assess the substance of your reasoning. They look at how clearly you identify the dilemma, whether you consider multiple stakeholders, and how practical and thoughtful your proposed approach is. Grammar, spelling, and sentence structure are not formally scored, but responses that are very difficult to understand due to poor writing may receive lower marks simply because the rater cannot fully assess your reasoning.
Raters watch your recorded video responses and evaluate both the content of what you say and how you communicate it. Delivery matters: a confident, natural tone with good eye contact signals professionalism, while a disorganized or overly rehearsed delivery can detract from otherwise strong content. Raters are trained to focus primarily on substance, but communication style is part of the overall impression.
Across both sections, trained raters evaluate your responses against the nine CASPer competencies. While the specific competencies tested vary by scenario, raters generally look for these qualities:
Myth: There is one correct answer for each scenario.
Reality: CASPer has no single right answer. Raters evaluate the quality of your reasoning, not whether you reached a specific conclusion. Two completely different approaches can both receive high scores if they demonstrate strong empathy, ethics, and critical thinking.
Myth: Typing speed determines your score.
Reality: Typing speed helps you get more content down, but a shorter, well-reasoned response will outscore a long, unfocused one. Quality matters more than quantity. That said, extremely short responses (under 30 words per question) may not give the rater enough material to award a high score.
Myth: Raters can see your other scenario scores.
Reality: Each rater only sees the single scenario they are assigned to evaluate. They have no information about your performance on other scenarios, your identity, your school list, or any other part of your application.
Myth: You need medical knowledge to score well.
Reality: CASPer is not a medical knowledge test. Raters do not expect you to know clinical protocols or medical ethics codes. They are looking for human reasoning, empathy, and mature judgment that any thoughtful person could demonstrate.
Myth: The video section is scored more harshly than typed.
Reality: Both sections use the same scale and standards. The video section can feel more intimidating because you cannot edit your response, but raters are trained to evaluate substance over polish. A slightly imperfect delivery with strong content will score well.
CasperCoach uses AI-powered analysis to estimate your quartile on every practice response. Get detailed feedback on what raters would look for and how to improve your score across all nine competencies.
Start Practicing Free