MCAT vs CASPer vs AAMC PREview: What Do You Really Need? (2025 Guide)

As a pre-med student, you’ve probably heard of the MCAT, the CASPer test, and the newer AAMC PREview exam. But what exactly are they, how do they differ, and which ones are actually required for medical school?

This guide breaks down each of these assessments — their purpose, structure, and which schools use them — so you can focus on what really matters for your med school application. We’ll also share tips on how to prepare and when international clinical experience can help strengthen your application across all dimensions.

Why are there so many tests?

Medical schools want more than just high scores. They’re looking for students who demonstrate:

Academic ability (MCAT)
Ethical reasoning and professionalism (CASPer and PREview)
Emotional intelligence, maturity, and judgment under pressure

These assessments aim to provide a more holistic picture of who you are — not just how well you can memorize facts.

MCAT: Your academic foundation

The Medical College Admission Test (MCAT) is the cornerstone of U.S. and Canadian med school applications. It’s required by nearly all allopathic (MD) and osteopathic (DO) programs.

What it tests:

Biological and Biochemical Foundations of Living Systems
Chemical and Physical Foundations of Biological Systems
Psychological, Social, and Biological Foundations of Behavior
Critical Analysis and Reasoning Skills (CARS)

Format:

7.5 hours total (including breaks)
230 multiple-choice questions
Scored 472–528 (average for MD matriculants: ~511.7)

Who requires it:

All U.S. MD and DO schools (except for early assurance or special pathway programs)
Some international medical schools

CASPer: Assessing who you are, not what you know

The CASPer test (part of the Altus Suite by Acuity Insights) is a situational judgment test (SJT) that evaluates your non-cognitive skills and professionalism.

What it tests:

Empathy and compassion
Ethical decision-making
Communication and teamwork
Problem-solving in complex social scenarios

Format:

~90 minutes
12 scenarios (video- or text-based)
Each followed by 3 open-ended questions
Typed or video-recorded responses

Who requires it:

40+ U.S. MD and DO schools
Many PA, nursing, and dental schools
Also used in Canada and for residency programs

Check specific schools on TakeAltus.com

Key tip:

There’s no “right answer.” Practice responding ethically and logically under time constraints. Unlike the MCAT, it’s less about facts and more about your core values.

AAMC PREview: The new kid on the block

The AAMC PREview Professional Readiness Exam is another SJT — this one developed directly by the AAMC (the same organization behind the MCAT and AMCAS).

What it tests:

Eight core competencies: service orientation, social skills, teamwork, reliability, ethical responsibility, resilience, adaptability, and cultural competence

Format:

~75 minutes
30+ hypothetical scenarios
Rate the effectiveness of four possible responses (Likert-style)
Scored 1–9, with percentile rankings

Who requires it:

Increasing number of U.S. MD schools, including:

University of California Davis
Geisinger Commonwealth
University of Minnesota
More schools adopting each year

Key difference from CASPer:

PREview is multiple choice, not free-response. It’s easier to standardize and more familiar in format, but still designed to assess judgment and professionalism.

Do you need to take all three?

Most students will only need the MCAT.

If your school requires CASPer or PREview, you’ll need to take that one in addition.
No school requires both CASPer and PREview — they usually pick one.
Always check individual schools’ admissions websites or the AAMC’s MSAR tool for specific testing requirements.

Which test matters most?

Test	Weight in Admissions	Who Needs It	Purpose
MCAT	High	All MD/DO applicants	Academic readiness
CASPer	Medium	40+ schools	Ethical and interpersonal qualities
PREview	Growing	20+ schools (2025)	Professional judgment & readiness

In short: MCAT is mandatory, CASPer or PREview may be required, and in-person experiences help bring your scores and application to life.

Can global health experience help with these tests?

Yes — particularly with CASPer and PREview. Here’s how an international internship with Go Elective can support your performance:

Scenario-based learning:

Real cases from maternity, surgery, or internal medicine in Kenya or Tanzania build clinical judgment

Cultural competence:

Immersing yourself in a different health system improves your adaptability and understanding of health disparities

Professionalism under pressure:

You’ll encounter ethical dilemmas, resource constraints, and cross-cultural communication challenges

Reflection material:

These experiences provide rich content for secondaries, interviews, and scenario-based assessments

Final thoughts: Focus on what your target schools require

Start with the MCAT — it’s non-negotiable
Check if your schools require CASPer or PREview (but not both)
Use clinical experiences — especially immersive ones like Go Elective — to build soft skills and real-world insight
Don’t treat these as “extra tests” — think of them as tools to showcase who you are beyond the numbers