Rumors abound about the horrors of CRNA school. Can they be true? How hard is CRNA School, anyways?
Since “hard” is such a subjective word, let me tell you what you can expect from a nurse anesthesia curriculum, and you can decide for yourself if it’s worth the effort.
Your experience will be subjective as well, depending on a host of factors that vary from student to student and from school to school.

In fact, the crna school you attend will have a huge impact on how “easy” or “hard” CRNA school is for you.
But before I get to those differences, let me tell you what makes CRNA school so tough.
3 reasons why CRNA school is harder than nursing school.
First, you are expected to have a higher level of understanding of each concept in an anesthesia program.
Whereas in nursing school, you could pass the test if you could only remember the right answer, in an anesthesia program, you will need to know WHY and HOW each component interacts with the next. You will be required to maintain a more in-depth knowledge and understanding of your profession at all times. You will be in situations where you’ll need to make split second decisions, and you won’t have time to look up the answer. As a CRNA, you won’t have coworkers to depend on, so you’ll need to be the expert.
The second thing that makes CRNA school harder than nursing school is the sheer VOLUME of information you are required to learn in a short period of time.
They say it’s like drinking out of a fire hose. Only you’ll need to remember everything that came out of that hose. You’ll need a solid method of studying that allows you to retain what you learn with less effort. The study methods you used to get by in nursing school may or may not be enough. (I’ll write a page on this later, but in the meantime, if you’re looking for the absolute most efficient way to study, search any of the following keywords in YouTube and you’ll thank me later: spaced repetition, active recall, anki or quizlet).
The third component of CRNA school that makes it more challenging than nursing school is the # of hours each week you are committing yourself to.
The schedule can get crazy. Some semesters will allow you to maintain a sense of normalcy (especially towards the beginning of the program), but during other semesters, you’ll need to kiss Netflix (and time with your family) goodbye.
Those were three aspects of nurse anesthesia schooling that are universally hard, no matter who you are, or which school you go to. The following are factors that can vary more, depending on the choices you make.
Factors that can make or break you during your CRNA School experience:
There are a few factors to consider when selecting CRNA schools to apply to. The choices you make here will make an impact on how hard CRNA School is for you.
They are: Front-loaded vs. integrated, board pass rates & attrition rates, and passing test scores.
Front loaded vs. Integrated programs:
Since 70% of programs are front-loaded, you are more likely to end up in a front-loaded CRNA program. Especially with programs transitioning to the DNP, it is likely that more and more programs will adopt a fully front-loaded or hybrid front-loaded curriculum.
Definitions:
In a front-loaded CRNA program, your didactics (course work) comes first, meaning you’ll spend the first year of the program doing coursework and studying for tests. You’ll begin clinicals later in the program (usually after the first year).
In an integrated CRNA program, you will usually start clinicals somewhere around month 3 (often in a sim lab), and then usually one day a week at first, balanced by a heavier course load. Over time, clinical days are added and course work diminishes.
Since the purpose of this article is to answer the question “how hard is CRNA school”, I will highlight only aspects of each program type that may add challenges to your load. I will fully discuss the pros and cons of front-loaded vs. integrated in a separate article (not yet posted).
Whether you choose a Front-loaded or integrated CRNA program, here are ways that either choice may make CRNA school hard.
Front-loaded CRNA programs
There are two major challenges with front-loaded programs. First, the time that passes from when you learn the information to when you USE the information can feel a long time to many. Unless you have methods for keeping the information in your head, it’s easy to lose it by the time you need it.
The second major challenge with front-loaded programs is that for some people, it’s hard to retain the information when it’s so far removed from its application. In other words, it’s all a bunch of theory until you know what to do with it.
Having said all that, most CRNA students (and program directors) agree that the advantages of a front-loaded set up outweigh the disadvantages.
Integrated CRNA programs
In theory, integrated crna schools are a beautiful thing. They accommodate your need for immediate hands-on experience to reinforce the book knowledge. It gives context to discovery. In practice, however, you need to be careful when considering integrated programs. There’s a lot of ways they can go wrong.
While some of them are carefully planned around your success, others can unintentionally put you in a position of failure. To be in a clinical setting after only 3 months of training can feel too-soon for many. Some programs are very thoughtful about the order of information and clinical rotations. So in these programs, what you learn in class will be the same thing you’re practicing in the clinical setting. In other programs, the sequence may feel more hap-hazzard, and you may find yourself feeling ill-prepared to perform in the clinical setting with the little training you’ve been given.
Another major challenge of an integrated program is that it limits the number of clinical sites you can go to for experience, as you need to stay within driving distance to lectures. In a large city or a large hospital system like Keiser, that won’t be a problem, but in smaller states/ cities, you may find yourself getting a smaller range of experience than you hoped for.
The last challenge with fully integrated programs comes from having to juggle didactic and clinical responsibilities at the same time, often on the same day. While some programs make sure these are never on the same day, other programs don’t. So you may end up spending 12 hours in the OR and then come home to study all night for an exam the following day, or worse, have to come back for an evening class at the end of an exhausting day in the hospital.
Integrated vs Front-loaded was ONE factor that can make or break your CRNA School experience. Let’s talk about the next one: Board pass rates and attrition rates.
NBCNRA Board Pass Rates & Attrition Rates

Comparing CRNA programs has always been tricky; there are so many factors to consider. But there are two statistics that I feel reflect the quality of a program more than all the rest: NBCRNA first time pass rates and attrition rates.
The first, NBCRNA pass rates, is a clear reflection of how prepared graduating students are to answer relevant questions about anesthesia. A school with a 100% first time pass rate is clearly doing more to prepare their students than a school with a 60% pass rate (average pass rate is 88%).
The other important statistic to look at is a program’s attrition rate. This measures the number of students who don’t complete the program, for any reason. A small attrition rate is acceptable, and is hardly avoidable, but anything over 15% is something I would think twice about.
For context, the average attrition rate for CRNA school is 5%, and there are only 8 schools with an attrition rate over 15%, and nearly 100 with a rate lower than 15%. When you’re trusting a school with 2-3 years of your life and over $100,000 of your cash, you need to know you can trust them to get you to the end. This statistic will tell you what you need to know about their track record.
Passing Test Scores
The last thing you need to know to answer the question, “how hard is CRNA school?”, is the score that will be considered passing at your school. This comes as a surprise to many, but is not an issue for others.
In nursing school, a passing grade might be 72-77% (out of a total score of 100), depending on the school, passing scores in CRNA school are much higher.
You may need anywhere from an 85-92% score in every class and every clinical (minimum score depends on the program you attend). Most programs will allow you ONE class with a grade below the passing score. After that, you will be asked to leave the program.
If your grades are borderline, or you have struggled in heavy science courses before, this will be an important detail to take note of.
Finally, to complete the discussion of “How Hard is CRNA School?”, I will go over some CRNA school horror stories. These are true stories of CRNA hopefuls who’ve contacted me within the last 10 years. I’ve arranged their stories by most common.
5 most common reasons CRNA hopefuls drop out or are kicked out of CRNA School
Academics – Most students who fail out do so because of academics. Most of the time, it’s after they get their second “B” that they are asked to leave. When Sarah contacted me, she was in tears over scoring a 91.4 on her last exam. A passing score for her would’ve been a 92, and at that point, there was nothing more she could do.
If academics have bested you in the past, what will be different this time? How can you be sure you can pass such a challenging program?
Parents or loved one passed away during the program. For Greg, the grieving process was too much to go through during the rigors of school. He had been given a 6 week extension to submit his capstone project after the unexpected death of his father, but it wasn’t enough time. His grief was so heavy he could not bring himself to finish the project. He had already accepted a job and had even passed his NBCRNA exam, but all of that was revoked when he failed to turn in his project on time. He wasn’t given a second extension. He lost everything and was not allowed to become a CRNA.
Have you ever experienced a loss of this magnitude? How would you handle it? If this is a concern for you, consider asking the admissions committee how student loss is handled. Are allowances made for extenuating circumstances? With the COVID pandemic surging across the US, this is no small consideration.
Divorce – Paul’s relationship with his spouse was not strong enough to weather the storm of intense workload. His marriage erupted in the midst of an 80 hour work-week; it was too much to juggle and it all came crashing down.
If you are married, what will you do to protect your marriage during this time of high demands?
Finances – Cheryl wasn’t prepared to pay for the program and had to leave in order to work again full time. The loans she had been approved for weren’t enough and her credit was maxed out. With no other options, she dropped out of the program to continue working.
How will you prepare to go 2-3 years without an income?
Lack of Support – Rebecca went to a school out of state – away from the support of her family which she was quite close to. She wasn’t able to complete the program without her family close by. She was overwhelmed with loneliness and felt homesick.
After reading through this, if you were kicked out of a program, or left half-way through, which reason would it likely be?
What can you do ahead of time to better prepare for this challenge?
Conclusion
With so much riding on this decision, can you afford to get it wrong? We’ve prepared a tool for you that allows you to compare all CRNA Schools with each other to determine which are worthy of your application, and which will give you your strongest chance of acceptance.
It is our #1 resource on All-CRNA-Schools.com and has been since 2013.
In the end, instead of asking “how hard is CRNA school”, you might be better off asking “is CRNA School worth the effort for me?” It’s an entirely different question, but it might get you closer to the answer you’re looking for.
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