Altus Suite overview

Altus Duet, Explained: The Values Assessment That Isn't Scored Like Casper

Duet is Altus's short, untimed values-alignment assessment. It asks you to compare what you want in a program against what programs offer, then measures how well the two line up. It is not a graded test like Casper, there are no right answers, there is no practice version, and it only appears in your Acuity account if one of your chosen programs requires it. In short: answer it honestly, and spend your real prep time on Casper.

What is the Altus Duet assessment?

Duet is a values-alignment assessment built by Acuity Insights, the same company that runs Casper. Its job is not to judge how well you reason through an ethical scenario. Instead, it captures what you value in a training program and compares that to what participating programs say they offer, so an admissions team can see where a candidate's priorities and the program's strengths overlap.

Duet is part of the Altus Suite. That suite used to include a third component, Snapshot, a one-way video interview, but Acuity retired Snapshot after the 2022/23 application cycle. Today the suite is Casper and Duet. If you are reading an older guide that still lists Snapshot as a current step, it is out of date. Our Altus Suite breakdown explains how the pieces fit together now.

How does Duet work?

You work through a set of head-to-head comparisons. Acuity says Duet is untimed, takes roughly 15 minutes, and presents 21 pairs of items. Each pair asks you to choose which of two program characteristics matters more to you, across themes like research opportunities, teaching style, community focus, and how you interact with faculty. After the individual comparisons, you also weigh the broader categories against each other.

Because it is untimed, there is no clock pressure of the kind that makes Casper stressful. The catch is that you complete Duet only once per admissions cycle, so it is a real submission, not a rough draft you can redo. Set aside a quiet 15 to 20 minutes and answer deliberately.

How is Duet scored?

Duet is not scored like Casper, and this is the point most applicants get wrong. There is no quartile, no percentile, and no correct sequence of answers. Your ranked preferences are compared against each participating program's own profile to produce a measure of fit. Because it reflects your values rather than a skill, you cannot pass or fail it and there is nothing to get objectively right.

Contrast that with Casper, which returns a quartile from 1 to 4 based on how trained raters score your responses relative to your cohort. If you want to understand that side of the Altus Suite, our Casper scoring guide covers how quartiles are produced and what they do and do not tell a school.

Do you actually need to take Duet?

Probably only if a specific program tells you to, and only a small set of programs currently use it. The most reliable way to know is your Acuity account: Duet appears there automatically after you reserve Casper, but only if at least one program on your distribution list requires it. If it never shows up, none of your selected schools asked for it.

A handful of mostly US medical programs have used Duet in recent cycles, and the exact list shifts from year to year, with some schools requiring Casper only, some adding Duet, and some using it as a limited pilot. Because of that churn, do not rely on any third-party list, including this one, as the final word. Confirm on each school's own admissions page and watch your Acuity dashboard. If Casper is your main concern, our guide to medical schools that require Casper explains how to verify a requirement without carrying an old list forward.

When do you complete Duet?

After Casper, and soon after. Acuity recommends completing Duet within 14 days of your Casper test, and it must be submitted before the earliest distribution deadline of any program on your list that requires it. Once you finish, results are sent to the relevant programs about 24 hours later.

The practical takeaway is simple: do not let Duet slip. It is quick, but it is tied to the same deadlines that govern your Casper distribution, and a missed Duet can hold up an otherwise complete application to a program that requires it. For how Casper distribution and deadlines work in general, see our guide to sending Casper scores.

Can you prepare for Duet?

Not in any meaningful study sense, and you should not try to game it. There is no practice version of Duet, and because it measures your genuine preferences, the honest answer is the right answer. Trying to guess what a program “wants” to hear defeats the purpose of an alignment tool and can produce a worse fit, not a better one.

So here is where your energy should actually go. Duet is a 15-minute, answer-honestly step. Casper is the timed, high-stakes assessment where preparation clearly changes how organized and complete your responses are under pressure. Reading about Casper will not move that; reps will. Work through our two-week Casper study plan and drill timed scenarios, and treat Duet as the quick, sincere formality it is designed to be.

Common Duet myths

• “Duet is scored like Casper.” No. There is no quartile and no right answer, only an alignment measure.
• “Everyone applying with Casper has to take Duet.” No. It appears only when a selected program requires it.
• “I should answer what programs want.” No. Answer honestly; misrepresenting your values undermines the point and the fit.
• “Duet includes Snapshot.” No. Snapshot was retired after 2022/23; the suite is Casper and Duet.
• “I can retake Duet if I dislike my answers.” No. It is once per cycle, so complete it deliberately.