Determining the single hardest subject in nursing school is subjective and frequently depends on the student’s aptitude and the instructor’s teaching style. However, based on collective research, certain core classes consistently stand out as the most challenging.

The most frequently cited difficult subject is Pharmacology, the study of medication. This course is notably dense, requiring students to master hundreds of drug classifications, mechanisms of action, side effects, and complex dosage calculations. Some sources suggest this subject is the most failed class due to the sheer volume of memorization and critical application required.

Following closely are Medical-Surgical Nursing and Pathophysiology. Med-Surg is often a major hurdle because it requires students to synthesize and apply all prior knowledge from foundational courses including Anatomy and Physiology (A&P) and Pathophysiology to real-world, complex patient care scenarios. Pathophysiology is demanding in its own right, as it focuses on understanding how diseases alter normal bodily functions.

Other challenging courses include advanced pre-requisites like A&P, as well as specialty subjects such as Pediatric Nursing and Obstetrics (OB).