Medical school is a difficult and rigorous endeavor, but what exactly makes it so tough?  Each course and rotation presents its own unique challenges, but some are notoriously more difficult.


The first two years of med school are almost like a continuation of college. You go to class, study, and sit for exams. At American University of Antigua (AUA) College of Medicine, students take classes in a number of specialties, including:

  • Medical Cell Biology
  • Foundation of Medicine
  • Human Structure & Function
  • Biochemistry & Genetics
  • Behavioral Sciences & Medicine
  • Introduction to Clinical Medicine
  • Microbiology
  • Immunology
  • Pathology
  • Pharmacology

These courses are part of the U.S. medical school curriculum and provide students with the knowledge they will need for their rotations.


In their third year, students begin clinical rotations, which comprise the final two years of medical school and consist of core and elective clerkships. Core rotations are required to graduate but students can choose a certain number of elective rotations to see what specialty may be right for them. These are the typical core rotations:

  • Internal Medicine
  • Pediatrics
  • Surgery
  • Family Medicine
  • Psychiatry
  • Neurology

Elective rotations include, but are not limited to, cardiology, emergency medicine, or immunology. During rotations, students will practice medicine as apprentices and will be evaluated on their performance and knowledge.

What’s the Hardest Course?

Most students consider their first semester of Biochemistry to be the hardest class they’ve ever taken. Students with a limited knowledge of biology will find this one especially challenging. Memorizing biochemical pathways using something as simple as flashcards can help, but for the most part, you’re just going to have to study in overdrive. Read each day’s lesson in advance so you can get a grasp of what is being discussed in class instead of trying to figure it out afterwards.

The second generally agreed upon hardest course is Gross Anatomy (aka Human Structure & Function). In this class, you’ll learn all the minute details pertaining to the human body like cranial nerves and the orbicularis oculi muscles in your eye. There’s a lot of memorization involved here in addition to learning from human cadavers, which some students believe is more helpful than learning from a book. Remember, where biochemistry is all about concepts and pathways, anatomy is spatial and based on where everything in the body is located in relation to everything else.

Both of these courses are taken in the first year of medical school. To prepare, many future med students adjust their study habits during their senior year of undergrad and that’s a great idea. Getting in the habit of studying a few hours every night as opposed to 24 hours straight before an exam will definitely help you get in shape for the intensity to come.

What medical school courses were the hardest for you and how did you survive them?