History ThatOneLevel / SimulationGame

* ''VideoGame/WarThunder: From 2020, large maps used for enduring confrontation have been added to regular battles with jets. Which is great if you are using supersonic jets that can quickly cover the distance, the problem is that you can get them even if you are using early subsonic jets (even post-war prop planes due to battle rating!), and the travel time si really tedious. In certain cases you won't even have enough fuel to reach midmap, such as with rocket propelled aircraft like the Me-163.

* ''[[VideoGame/WarThunder]] has city maps, which force tanks to close quarter brawlings. Not all players dislike them, but those who do are very vocal.
** From 2020, large maps used for enduring confrontation have been added to regular battles with jets. Which is great if you are using supersonic jets that can quickly cover the distance, the problem is that you can get them even if you are using early subsonic jets (even post-war prop planes due to battle rating!), and the travel time si really tedious. In certain cases you won't even have enough fuel to reach midmap, such as with rocket propelled aircraft like the Me-163.

*** ''VideoGame/{{Ace Combat Zero|TheBelkanWar}}'' has "Valley of Kings" which combines the gimmick with the typical series gimmick of making the air above a canyon instant death, making you brave a gauntlet of AA guns, [=SAMs=] and pillboxes just to ''get to'' the tunnel. Flying above 2000 feet leads to a missile warning: if you don't get below that in time, [[TheComputerIsACheatingBastard you'll have a missile launched at you from out of nowhere and automatically hit you]]. Did I mention the bridges in the way? Finally, if you're not using the FAE Bomb or the MPBM[[note]]While taking them seems to be a no-brainer, remember that due to plot reasons you're stuck with the same plane and weapon for the last three missions. This means that, if you do take those bombs, you're stuck with just the regular missiles for the mission before Valley of Kings, which contains what might be the most difficult dogfight in the entire game.[[/note]] you'll need to make multiple tunnel runs since you have to destroy all of the joint locks for each V2 controller before the controller itself can be hit. At least if you enter the tunnel through the south, the named ace in the tunnel who appears after you destroy the first two controllers is flying away from you and thus makes possibly the game's easiest non-bomber kill.

** The first game (''VideoGame/AirCombat'' outside Japan) has possibly the worst canyon mission of any, and a lot of that is FakeDifficulty due to terrible graphics. It's an incredibly narrow canyon, and it is very very difficult to tell the two walls apart without flying close enough to the ground that you can see where the walls are, so every turn is an opportunity to crash due to very poor ability to judge distance.

** ''VideoGame/AceCombat7SkiesUnknown'' has '''FOUR''' examples in the base game ''alone'' - A lesser one in the form of ''Rescue,'' which features the same radar minefield gimmick from ''5'' and ''X'', but later opens up into a much more forgiving air-to-ground and later anti-air/escort mission [[spoiler:Which fails regardless as Harling's Osprey is shot down, serving as the catalyst to the rest of the game]], to greater examples in ''Long Day,'' ''Stonehenge Defensive,'' and ''Fleet Destruction.''
*** ''Long Day'' is a drawn out air-to-ground assault mission, a series staple, which could already be a turn-off if the person playing already doesn't like that style of gameplay, as it's just a ''slog'' to get through, especially in the early game. ''Stonehenge Defensive's'' mission objective is simple on paper - Defend [[SuperWeapon Stonehenge]] from the Erusean military, [[spoiler:An inverse of ''VideoGame/{{Ace Combat 04|ShatteredSkies}}[='=]s '' twelfth mission, which is about ''destroying'' Stonehenge.]] while Osean engineers get it operational for an attack on one of the Arsenal Birds. Naturally, things do not go according to plan, and you have to slow the Arsenal Bird down by directly attacking it. ''Fleet Destruction'' is the second of two "Destroy everything" missions in the base game, and like ''Long Day,'' is a slog for new players who probably don't have the more advanced aircraft or special weapons unlocked. Fortunately, the time limit is generous and the points required aren't too high to be completely insurmountable for newbies, and it has good background music, to boot.

*** Even Fiasco Forest is easier than Harmonic Hills, which is pretty much Rainbow Valley [[UpToEleven turned up a few more notches]]. You still can't change the landscape at all, but now there is the added difficulty of not being able to build above the height of the trees. Oh, and just to make things ''extra'' fun, this park has the smallest number of starting rides in the game. How many do you get? '''Three'''. ''Three'' measly rides and ''two'' measly shops and stalls, ensuring that you'll have to do a sizable amount of research to get an even half-decent selection. ''[[ThisIsGonnaSuck Good freaking luck]]'' with this one. It doesn't even show up that late in the scenario list (being the 18th of 30), and it's far more difficult and frustrating than pretty well all of the ones following it.

*** ''Long Day'' is a drawn out air-to-ground assault mission, a series staple, which could already be a turn-off if the person playing already doesn't like that style of gameplay, as it's just a ''slog'' to get through, especially in the early game. ''Stonehenge Defensive's'' mission objective is simple on paper - Defend [[SuperWeapon Stonehenge]] from the Erusean military, [[spoiler:An inverse of [[VideoGame/AceCombat04ShatteredSkies]] Ace Combat 4's twelfth mission, which is about ''destroying'' Stonehenge.]] while Osean engineers get it operational for an attack on one of the Arsenal Birds. Naturally, things do not go according to plan, and you have to slow the Arsenal Bird down by directly attacking it. ''Fleet Destruction'' is the second of two "Destroy everything" missions in the base game, and like ''Long Day,'' is a slog for new players who probably don't have the more advanced aircraft or special weapons unlocked. Fortunately, the time limit is generous and the points required aren't too high to be completely insurmountable for newbies, and it has good background music, to boot.

** ''VideoGame/AceCombat7SkiesUnknown'' has '''four''' examples in the base game ''alone'' - A lesser one in the form of ''Rescue,'' which features the same radar minefield gimmick from ''5'' and ''X'', but later opens up into a much more forgiving air-to-ground and later anti-air/escort mission [[spoiler:Which fails regardless as Harling's Osprey is shot down, serving as the catalyst to the rest of the game]], to greater examples in ''Long Day,'' ''Stonehenge Defensive,'' and ''Homeward.''
*** ''Long Day'' is a drawn out air-to-ground assault mission, a series staple, which could already be a turn-off if the person playing already doesn't like that style of gameplay, as it's just a ''slog'' to get through, especially in the early game. ''Stonehenge Defensive's'' mission objective is simple on paper - Defend [[SuperWeapon Stonehenge]] from the Erusean military [[spoiler:An inverse of [[VideoGame/AceCombat04ShatteredSkies Ace Combat 4's twelfth mission, which is about ''destroying'' Stonehenge.]] while Osean engineers get it operational for an attack on one of the Arsenal Birds. Naturally, things do not go according to plan. ''Homeward

* The ''VideoGame/TraumaCenter'' series has two versions of this trope. The first is due to levels being very difficult to clear on their own. The second version applies to levels that can be cleared reasonably, but have incredibly stringent conditions for the XS rank. The former tends to show up more in ''New Blood'' due to some levels being balanced for co-op play, while the latter is seen more in ''Trauma Team'' with its tough Specialist difficulty.
** "Awakening" (mission 2-4 of ''Under the Knife'') is almost evil in its difficulty, especially since it's still in the game's early chapters. Basically, a patient has a whole bunch of aneurysms in his intestines, five of which all decided to try and burst at the same time. You're meant to burn a Healing Touch and try to fix him up, but if you're after rank, you have to take all five of them out without it. Unless you balance them just right, at least one ''will'' burst, taking the S with it. This one is so notorious that ''Second Opinion'' for the Wii simplifies it. On Normal difficulty, only four appear at the end. If the patient's vitals are near-max, he'll survive all of them exploding, leaving you to clean up and head out. Your rank will take a hit, but you'll pass.
** Level 5-2 is called "[[TitleDrop Under The Knife]]", which implies an epic climax. Your enemy is the aggressive but straightforward Kyriaki. This time, however, you have to treat ''five'' patients in a single mission, with only ten minutes on the timer. Making matters worse is the fact that getting through a Kyriaki mission requires nothing so much as skill with suturing. The stylus motion for suturing is not only undetected by the game half the time, but it's the first thing you start screwing up when your hands start to get tired. The final insult? That ticking ten minute timer hanging over your head ''isn't an automatic GameOver'' like with all previous operations. The game does throw you a bone by letting you advance if you've finished at least 2 patients but run out of time, with the only cost being the player's rank and score. Problem is, by then you're too focused on the bottom screen and the timer to notice when Angie tells you backup has arrived, and may just restart in a fit of rage when you notice you're short on time.
** Missions 5-9 and 6-8 of ''Under the Knife'' (and ''Second Opinion'') are literally impossible to beat if the player uses the Healing Touch at any other time than at the VERY end of the level. Worse still is the fact that if you did use the Healing Touch when you shouldn't have, the game tells you nothing. You just hit that point in the level, and if you don't know about this beforehand, the level becomes UnwinnableByDesign until you fail the mission.
** While not unfairly difficult, the last chapter of ''Under the Knife'' is simply uncreative. Having defeated (or, actually, [[spoiler: redeemed through a version of [[WarriorTherapist Combat Therapy]]]]) the BigBad, you have to fight through a BossRush to get to TheManBehindTheMan- the same seven strains of GUILT you've been fighting for half the game, just requiring faster action. A shameless retread which is made more aggravating by losing what forgiveness these missions had previously. ''Second Opinion'' truncates the whole chapter into a one-episode flashback, and replaces it with more variations on GUILT revisits.
** "Fallen Heroes", the penultimate story operation of ''Second Opinion'', can be surprisingly brutal. It's a [[MarathonLevel multi-stage GUILT operation]], and because you alternate between two doctors, you have two Healing Touches at your disposal for different parts of the level. You'll probably need both of them. Here's why:
*** The first part of the mission is '''Triti''', which is ThatOneBoss among the initial GUILT strains. If you didn't already know how to efficiently treat it, you might end up wasting Derek's Healing Touch to entirely trivialize this part, giving up an asset that could help for the next portion of the level.
*** The second part is Kyriaki, which is trivial by this point in the game, but third patient has Deftera. What makes this GUILT more annoying is that blood regularly pools over the field, forcing you to drain it so you can treat what's underneath. If Deftera is going berserk and blood pools over it, you'll waste a bit of time getting it out of the way -- enough time for more tumors to appear and for vitals to plummet.
*** The final part is Paraskevi on the heart. ''One entire Paraskevi''. You cannot afford to let a single one escape, or it's an immediate GameOver.
** There are four challenge missions in ''New Blood'' that involve treating a series of patients in a simulation. The final one involves one patient with that is infected with Kyriaki, Cheir, and infant Savato, and the one before that involves a simultaneous Deftera and Soma infection.
** ''New Blood'' chimes in with "Lost in the Flames", an operation to treat a burn victim. The mission isn't particularly hard in theory, and there's nothing that will lower the patient's vitals apart from gradual attrition and player mistakes. The greatest threat here is the time limit. What makes it tough is that the player has to cover a burn with four pieces of donor skin to treat each one, when a) the skin is time-consuming to produce, b) if the burn starts bleeding (at random) any skin already there will fall off, and c) it's painfully easy to put a piece of skin on the wrong burn, virtually guaranteeing the target burn will start to bleed before the player can get more ready. It's virtually impossible to let the patient die here, but even a perfect run will run down the clock horrifyingly fast.

** "Strike Force" (chapter 7-2 of ''New Blood'') is a mission that involves three patients. The first one is a Brachion infection, which is the PuzzleBoss of ''New Blood''. It's not particularly hard, but it eats up a large amount of time and can get nasty if the heads regenerate. The second operation is a simultaneous Cheir and Soma infection, a nasty combination, but one that can be overcome with the right strategy and a little luck. The final operation, though, is on a patient infected with both Soma and Onyx. Onyx is not mentioned until you either ready the magnifier and spot its shadow, or it first attacks while you're treating Soma. Treating Onyx invariably means taking your eye off Soma to find the hidden Onyx, and a red tumor is almost guaranteed to harden while doing so. The kicker for these multiple patient operations is that when you lose, you have to start from the beginning, making it all the more annoying considering the Onyx/Soma combination is intricate enough to be its own mission.
** In ''VideoGame/TraumaTeam'', Tomoe's final mission is [[spoiler:searching through a collapsed mall for people trapped in the rubble.]] The way the stage is set up, it's very hard to keep track of what you're looking for, and every time you find one, you get sent back to the start - at which point the level changes shape. It's essentially a 3D maze from hell.
** While ''Trauma Team'' is notably easier than the past games, getting an XS rank is now ''much'' more difficult. Nowhere does this become more apparent than "Blade of Resolve" and "Love in the Ground", which require the player to get all COOL miniranks and to finish absurdly fast.
** The X-Missions are a set of {{Brutal Bonus Level}}s unlocked after completing the main story, pitting you against extra difficult versions of the pathogens you've been fighting. The game classifies them as '''[[HarderThanHard Extreme]]''' difficulty, so you know they're not for the faint of heart. Still, certain X-Missions stand out above the rest, sometimes requiring ''muscle memory'' to act fast enough to beat them.
*** X-1 of ''Under the Knife'' is perhaps one of the biggest {{Difficulty Spike}}s, as the Kyriaki bodies are incredibly aggressive with lacerations and each bleeding laceration causes vitals to plummet like a rock. It's so infamous that one of the safest strategies to beat it involves exploiting the game's upper limit on the number of wounds it can accommodate on-screen. It's only made slightly more tolerable in ''Second Opinion''.
*** X-6 of ''Second Opinion'' caps your patient's vitals at 50 for an unexplained reason. Since slicing apart a Paraskevi body is guaranteed to inflict about 30 vital damage, you have to stop to inject the stabilizer after each step. You have much less room for error, and risk losing time for each cut.
*** X-3 of ''Under the Knife 2'' pits the player against Pempti, but with the unmentioned twist being that one of the two cores is tougher than the other, just to throw off experienced players who have been evenly dividing laser exposure between both cores.

* ''VideoGame/AceCombat'' primarily has these in levels where the mission/parameters have nothing to do with the difficulty setting; the "game stopper" is ''VideoGame/AceCombat5TheUnsungWar''[='=]s "Four Horsemen," mission 12b. It's only one of the two paths, but [[GuideDangIt you're given no clue that your answer to a wingman's question in mission 10 will have any consequence]]. Things aren't so bad on the other path (defending a civilian airport from invasion and then bombing enemy bunkers in the jungle while anti-air defenses you can't target fire missiles at you), or even in the other mission on this path (simply dropping special bombs to neutralize a gas attack then trailing a civilian vehicle), while this mission requires you to perform four consecutive timed destructions of radar sites, which means that you have to take into account your weapon's travel time ''and'' your own travel time -- go past the radar site and you fail, while if you get in position too early you'll have to break/slow down, which can cause a stall or wasted time (especially if you have to turn around to reposition yourself for another attack run), and you have less time between each radar site. Did we mention that your wingmen may mess up ''their'' approaches against their own targets which you don't see and cause everyone to have to abort their attack run and try again? Making things worse, if you want the Flanker line of aircraft or the FALKEN, you ''have'' to play this mission at least once.

* ''VideoGame/NotTonight'': January 10, 2018 has the job shift at the King's Head, where one simple mistake can ruin your chances of getting an S Rank that you're trying to get (two mistakes can get you a fine, and three mistakes can make you fail the shift). The key word here is "patience" (i.e., not being too hasty), as letting a customer in with a mistake on an ID card (underage, expired [=IDs=], etc.) can throw you off-balance, with the face mismatches (mostly) being the worst offender.

* ''VideoGame/NotTonight'': January 10, 2018 has the job shift at the King's Head, where one simple mistake can ruin your chances of getting an S Rank that you're trying to get (two mistakes can get you a fine, and three mistakes can make you fail the shift). The key word here is "patience" (i.e., not being too hasty), as letting a customer in with a mistake on an ID card (underage, expired IDs, etc.) can throw you off-balance, with the face mismatches (mostly) being the worst offender.

** Day 296: The Heatwave. During the first half of the level, the valves will constantly overheat, which means you need to take your eyes of the screen and adjust the table fan to cool down the correct valve. However, the valves will constantly keep changing and the table fan will randomly shut down, forcing you to switch it back on ASAP, or else the valve will overheat and the trip switch would've blown, shutting down all your controls. If you're unlucky enough, you may have to deal with the valve as well as the interference while also trying to make the broadcast perfect forcing you to prioritize one thing over the other. [[spoiler: The rest however becomes a BreatherLevel, with no interference or valve overheating occurring, and Jeremy holding the newsroom hostage quickly kicks your viewers joining in to the max even if you did very terribly before. The only hard thing is the censoring Jeremy's swears and following the three camera rules. The rest is simply what your moral choices are and who you are supporting.]]

* ''VideoGame/AceCombat'' primarily has these in levels where the mission/parameters have nothing to do with the difficulty setting; the "game stopper" is ''VideoGame/AceCombat5TheUnsungWar''[='=]s "Four Horsemen," mission 12b. It's only one of the two paths, but [[GuideDangIt you're given no clue that your answer to a wingman's question in mission 10 will have any consequence]]. Things aren't so bad on the other path (defending a civilian airport from invasion and then bombing enemy bunkers in the jungle), or even in the other mission on this path (simply dropping special bombs to neutralize a gas attack), while this mission requires you to perform four consecutive timed destructions of radar sites, which means that you have to take into account your weapon's travel time ''and'' your own travel time -- go past the radar site and you fail, while if you get in position too early you'll have to break/slow down, which can cause a stall or wasted time (especially if you have to turn around to reposition yourself for another attack run), and you have less time between each radar site. Did we mention that your wingmen may mess up ''their'' approaches against their own targets which you don't see and cause everyone to have to abort their attack run and try again? Making things worse, if you want the Flanker line of aircraft or the FALKEN, you ''have'' to play this mission at least once.
** There are a few other standouts in ''The Unsung War'', particularly "Lit Fuse", which is problematic thanks to its gimmick. You're sent to support a marine force as they move in to take over various enemy bunkers, gradually rendezvousing with each other until they're fully grouped up to take on the final part of the mission. The problem is twofold: one, the dialogue notes that those bunkers cannot be destroyed by your weapons - they ''have'' to be knocked out temporarily by your weapons, then stormed and captured by the ground forces. Two, the dialogue ''is completely lying to you'' - the bunkers simply respawn a set number of times no matter what you do and you have to kill them repeatedly before the ground forces can pass by, which is never actually explained in-game. "Fortress" is a lesser offender simply because there are far too many targets for you to take out with just missiles with the amount of ammo the planes available to you at that point in time have; at the very least, its gimmick is being a TimedMission where you tell the allied forces to stop or go at specific points, which is less prone to randomly failing through no fault of your own.

*** ''5'' introduces the twisty-turvy tunnel later used in ''Zero'', but with multiple altitude changes along the way (not just at the entrance and exit of the tunnel), has enemy fighters in the tunnel in front of you headed in your direction, and whereas you can just slow down in all other tunnel missions and use autopilot to stabilize your flight path, here you have an enemy fighter hot on your tail the whole time and so have to go at essentially full speed the whole way. Fortunately, it's generally the widest of these tunnels, so crashing isn't the real issue.

*** In "Chandelier" in ''6'' you have to travel a ''long'' way to the action with nothing going on before then having a ton of heavy anti-aircraft fire tossed into your face on top of some ships (including ''missile'' boats!) ''and'' the last of Strigon Team, ace pilots one and all; after you destroy all of the targets (which will take quite some time since some require multiple hits and from particular angles) your wingman goes down and even heavier AAA appears in the form of a double-stacked line of gun towers; only after you destroy those can you go after the remaining targets. The very end has you flying into the tunnel which itself can attack you by ''[[ThereIsNoKillLikeOverkill firing a cruise missile into your face]]''. And this is assuming that you got this far, as unlike "Valley of Kings" which gives a definite time limit, you have to complete the mission before too many cruise missiles are fired and can hit [[spoiler:Gracemeria]], so you'll have to guesstimate how much time/cruise missile launches you have left based on the dialogue. Fortunately, if you manage to survive the AAA on the way in, there's a conveyor belt underneath Chandelier that carries the cruise missiles to its rear; destroying the cruise missiles before they can be loaded will buy you some time depending on how you're balancing it with destroying the targets.

*** The 'don't fly above (insert low altitude here)' missions are annoying, but in some games in the series the missiles don't spawn so close to you. This enables you to outrun them (or at least keep them from hitting you till they detonate) while flying the overpowered [=MiG=]-25/31. Unfortunately, this creates an {{Unwinnable}} situation, since they respawn one after another--so after descending back to an altitude that will let you complete the mission, the speed that's required to outrun the one that inevitably spawns above you prevents you from maneuvering through the narrow confines of the level. That the dragster-like [=MiGs=] were built for intercepting (which requires simply going faster than your target) versus dogfighting (which involves a lot of quick turning) doesn't help.

** "Awakening" (mission 2-4) is almost evil in its difficulty, especially since it's still in the game's early chapters. Basically, a patient has a whole bunch of aneurysms in his intestines, five of which all decided to try and burst at the same time. You're meant to burn a Healing Touch and try to fix him up, but if you're after rank, you have to take all five of them out without it. Unless you balance them just right, at least one ''will'' burst, taking the S with it. This one is so notorious that ''Second Opinion'' for the Wii simplifies it. On Normal difficulty, only four appear at the end. If the patient's vitals are near-max, he'll survive all of them exploding, leaving you to clean up and head out. Your rank will take a hit, but you'll pass.
** Level 5-2. You know it's going to be a pain since it's called "[[TitleDrop Under The Knife]]", which implies a certain epic climax. Your enemy is the parasite Kyriaki, who is annoying, but usually pretty straightforward. This time, however, you have to treat ''five'' patients in a single mission, with only ten minutes on the timer. Making matters worse is the fact that getting through a Kyriaki mission requires nothing so much as skill with suturing. The stylus motion for suturing is not only undetected by the game half the time, but it's the first thing you start screwing up when your hands start to get tired. The final insult? That ticking ten minute timer hanging over your head ''isn't an automatic GameOver'' like with all previous operations. The game does throw you a bone by letting you advance if you've finished at least 2 patients but run out of time, with the only cost being the player's rank and score. Problem is, by then you're too focused on the bottom screen and the timer to notice when Angie tells you backup has arrived, and may just restart in a fit of rage when you notice you're short on time.
** Missions 5-9 and 6-8 of ''Under the Knife'' (and ''Second Opinion'') are literally impossible to beat if the player uses the Healing Touch at any other time than at the VERY end of the level. Worse still is the fact that if you did use the Healing Touch when you shouldn't have, the game tells you nothing. You just hit that point in the level, and if you don't know about this beforehand, the game will just "hang" until you fail the mission.

** While technically [[BrutalBonusLevel Bonus Levels,]] the X Missions also deserve mention. Though they're not named for difficulty in ''Under The Knife'', they are in every succeeding sequel... under '''[[NintendoHard Extreme]]''' difficulty. While all of the X Missions are indeed beatable, they all border on FakeDifficulty given that you have to have memorized the pattern for defeating the offending disease down to freaking ''muscle memory''.

* Collecting all the paintings in ''VideoGame/AnimalCrossing''. Other rare sets can take literally a year or more to complete, but at least you can't forge a bug or fossil. Damn you, Crazy Redd! In ''New Leaf'' you can actually look for the mistakes in the forgeries yourself, making it a little more justifiable, but how many gamers (not to mention the percentage of little kids playing) are masters of art?

** While not unfairly difficult, the last chapter of ''Under the Knife'' is simply uncreative. Having defeated (or, actually, [[spoiler: redeemed through a version of [[WarriorTherapist Combat Therapy]]]]) the BigBad, you have to fight through a BossRush to get to TheManBehindTheMan- the same seven strains of GUILT you've been fighting for half the game, just requiring faster action. A shameless retread which is made more aggravating by losing what forgiveness these missions had previously.

** "Awakening" (mission 2-4) is almost evil in its difficulty, especially since it's still in the game's early chapters. Basically, a patient has a whole bunch of aneurysms in his intestines, five of which all decided to try and burst at the same time. You're meant to burn a Healing Touch and try to fix him up, but if you're after rank, you have to take all five of them out without it. Unless you balance them just right, at least one ''will'' burst, taking the S with it. This one is so notorious that ''Second Opinion'' for the Wii simplifies it. On Normal difficulty, only four appear at the end. If the patient's vitals are near-max, he'll survive all of them exploding, leaving you to clean up and head out. Your rank will take a hit, but you'll pass.

** ''New Blood'' chimes in with "Lost in the Flames", an operation to treat a burn victim. The mission isn't particularly hard in theory, and there's nothing that will lower the patient's vitals apart from gradual attrition and player mistakes. The greatest threat here is the time limit. What makes it tough is that the player has to cover a burn with four piece of donor skin to treat each one, when a) the skin is time-consuming to produce, b) if the burn starts bleeding (at random) any skin already there will fall off, and c) it's painfully easy to put a piece of skin on the wrong burn, virtually guaranteeing the target burn will start to bleed before the player can get more ready. It's virtually impossible to let the patient die here, but even a perfect run will run down the clock horrifyingly fast.
*** ''Under the Knife 2'' one-ups this with "Hall of Shadows" in its final chapter. The burn treatment process is similar with all the accompanying problems. Only this time, you've got three patients... and ''five minutes'' to treat them all.

** While ''Trauma Team'' is notably easier than the past games, getting an XS rank is now ''much'' more difficult. Nowhere does this become more apparent than "Blade of Resolve" and "Love in the Ground", which require the player to get all COOL miniranks and to finish absurdly fast.** While technically [[BrutalBonusLevel Bonus Levels,]] the X Missions also deserve mention. Though they're not named for difficulty in ''Under The Knife'', they are in every succeeding sequel... under '''[[NintendoHard Extreme]]''' difficulty. While all of the X Missions are indeed beatable, they all border on FakeDifficulty given that you have to have memorized the pattern for defeating the offending disease down to freaking ''muscle memory''.

* ''[[VideoGame/TraumaCenter Trauma Center: Under The Knife]]'', as an Atlus game, is ''hard'' -- so much so that literally ''every mission'' could be ThatOneLevel to some players. However, most fall into the "tough but fair" category, with several exceptions:
** Deftera. While most missions are ultimately tests of skill primarily, Deftera is nearly 90% luck. If two pairs of Deftera hit like colors at the beginning of the second stage, you might as well just quit and start over. Either the tumors will kill the patient outright, or you'll finish with the tumors just in time to fight MORE tumors when like colors meet AGAIN- never having the opportunity to attack Deftera itself. Deftera can be blocked off by antibiotic gel spread in its path like a wall. This is hinted at in one sentence in the manual that doesn't even directly reference Deftera -- only that the gel can repel parasites. ''Good luck making that connection when [[WebAnimation/AwesomeSeries Zombie Cancer]] is eating your patient.''

** Also, while not unfairly difficult, the last chapter of the game is simply uncreative. Having defeated (or, actually, [[spoiler: redeemed through a version of [[WarriorTherapist Combat Therapy]]]]) the BigBad, you have to fight through a BossRush to get to TheManBehindTheMan- the same seven strains of GUILT you've been fighting for half the game, just requiring faster action. A shameless retread which is made more aggravating by losing what forgiveness these missions had previously.
*** Most annoyingly are the missions 5-9 and 6-8, which are literally impossible to beat if the player uses the Healing Touch at any other time than at the VERY end of the level. Worse still is the fact that if you did use the Healing Touch when you shouldn't have, the game tells you nothing. You just hit that point in the level, and if you don't know about this beforehand, the game will just "hang" until you fail the mission.
** While technically [[BonusLevelOfHell Bonus Levels,]] the X Missions also deserve mention. Though they're not named for difficulty in ''Under The Knife'', they are in every succeeding sequel... under '''[[NintendoHard Extreme]]''' difficulty. While all of the X Missions are indeed beatable, they all border on FakeDifficulty given that you have to have memorized the pattern for defeating the offending disease down to freaking ''muscle memory''.
%% *** Especially Kyriaki in ''Under The Knife.'' ''(Shudder)''
** "Awakening" is almost evil in its difficulty, especially since it's still in the game's early chapters. Basically, a patient has a whole bunch of aneurysms in his intestines, five of which all decided to try and burst at the same time. You're meant to burn a Healing Touch and try to fix him up, but if you're after rank, you have to take all five of them out without it. Unless you balance them just right, at least one ''will'' burst, taking the S with it. This one is so notorious that ''Second Opinion'' for the Wii simplifies it. On Normal difficulty, only four appear at the end. If the patient's vitals are near-max, he'll survive all of them exploding, leaving you to clean up and head out. Your rank will take a hit, but you'll pass.

*** The second part is Kyriaki, which is trivial by this point in the game, but third patient has Deftera. What makes this GUILT more annoying is that blood regularly pools over the field, forcing you to drain it so you can treat what's underneath. If Deftera is going berserk and blood pools over it, you'll waste a bit of time getting it out of the way - enough time for more tumors to appear and for vitals to plummet.

** In the main storyline of ''New Blood'', there is an even harder mission, "Strike Force", that involves three patients. The first one is a Brachion infection, which is the PuzzleBoss of ''New Blood''. It's not particularly hard, but it eats up a large amount of time and can get nasty if the heads regenerate. The second operation is a simultaneous Cheir and Soma infection, a nasty combination, but one that can be overcome with the right strategy and a little luck. The final operation, though, is on a patient infected with both Soma and Onyx. Onyx is not mentioned until you either ready the magnifier and spot its shadow, or it first attacks while you're treating Soma. Treating Onyx invariably means taking your eye off Soma to find the hidden Onyx, and a red tumor is almost guaranteed to harden while doing so. The kicker for these multiple patient operations is that when you lose, you have to start from the beginning, making it all the more annoying considering the Onyx/Soma combination is intricate enough to be its own mission.

* In ''VideoGame/{{Catherine}}'', getting the true freedom ending is hell--not only because keeping your karma meter in the direct center is difficult, but also because you have to answer the final three questions based not on the actual answers, but based on the side of the rope you're required to pull. Not mention the damn hard puzzles.

* ''VideoGame/AceCombat'' primarily has these in levels where the mission/parameters have nothing to do with the difficulty setting; the "game stopper" is ''VideoGame/AceCombat5TheUnsungWar''[='=]s "Four Horsemen," mission 12b. It's only one of the two paths, but [[GuideDangIt you're given no clue that your answer to a wingman's question in mission 10 will have any consequence]]. Things aren't so bad on the other path, or even in the other mission on this path, while this mission requires you to perform four consecutive timed destructions of radar sites, which means that you have to take into account your weapon's travel time ''and'' your own travel time -- go past the radar site and you fail, while if you get in position too early you'll have to break/slow down, which can cause a stall or wasted time (especially if you have to turn around to reposition yourself for another attack run), and you have less time between each radar site. Did we mention that your wingmen may mess up ''their'' approaches against their own targets which you don't see and cause everyone to have to abort their attack run and try again? Making things worse, if you want the Flanker line of aircraft or the FALKEN, you ''have'' to play this mission at least once.
** There are a few other standouts in ''The Unsung War'', particularly "Lit Fuse", which is problematic thanks to its gimmick. You're sent to support a marine force as they move in to take over various enemy bunkers, gradually rendezvousing with each other until they're fully grouped up to take on the final part of the mission. The problem is those bunkers cannot be destroyed by your weapons - they ''have'' to be knocked out temporarily by your weapons, then stormed and captured by the ground forces. What makes this a problem is that the game doesn't adequately explain ''exactly'' when you need to fire so that the ground forces have enough time to get in and capture it before it starts firing on them again and they're forced to retreat - sometimes you'll shoot the target the instant it pops up, but that won't be good enough. "Fortress" is a lesser offender simply because there are far too many targets for you to take out with just missiles with the amount of ammo the planes available to you at that point in time have; at the very least, its gimmick is being a TimedMission where you tell the allied forces to stop or go at specific points, which is less prone to randomly failing through no fault of your own.

*** ''VideoGame/{{Ace Combat Zero|TheBelkanWar}}'' has "Valley of Kings" which makes you brave a gauntlet of Anti-Aircraft Artillery, Surface-to-Air Missiles and Pillboxes just to ''get to'' the tunnel. Flying above 2000 feet leads to a missile warning: if you don't get below that in time, [[TheComputerIsACheatingBastard you'll have a missile launched at you from out of nowhere and automatically hit you]]. Did I mention the bridges in the way? Finally, if you're not using the FAE Bomb or the MPBM [[note]]While taking them seems to be a no-brainer, remember that due to plot reasons you're stuck with the same plane and weapon for the last three missions. This means that, if you do take those bombs, you're stuck with just the regular missiles for the mission before Valley of Kings, which contains what might be the most difficult dogfight in the entire game.[[/note]] you'll need to make multiple tunnel runs since you have to destroy all of the joint locks for each V2 controller before the controller itself can be hit. At least if you enter the tunnel through the south, the named ace in the tunnel who appears after you destroy the first two controllers is flying away from you and thus makes possibly the game's easiest non-bomber kill.
*** ''5'' introduces the twisty-turvy tunnel later used in ''Zero'', but with multiple altitude changes along the way (not just at the entrance and exit of the tunnel), has enemy fighters in the tunnel in front of you headed in your direction, and whereas you can just slow down in all other tunnel missions and use autopilot to stabilize your flight path, here you have an enemy fighter hot on your tail the whole time! Fortunately, it's generally the widest of these tunnels, so crashing isn't the real issue.
*** These go back to ''VideoGame/AceCombat2'', which has a similar final mission to ''04''. ''VideoGame/AceCombat3Electrosphere'' has a similar mission, with altitude changes and closing doors which serve to make it a "twisty" tunnel, with the added "bonuses" that, like ''Zero'', you have to fly all of the last set of missions with whatever craft you picked for the first mission in that set, ''and'' that sequence comes right after you unlock an aircraft that looks useful (the XFA-36A) but turns out to be barely maneuverable in comparison to what you already have.
*** In "Chandelier" in ''6'' you have to travel a ''long'' way to the action with nothing going on before then having a ton of heavy anti-aircraft fire tossed into your face on top of some ships (including ''missile'' boats!) ''and'' the last of Strigon Team, ace pilots one and all; after you destroy all of the targets (which will take quite some time since some require multiple hits and from particular angles) your wingman goes down and even heavier AAA appears in the form of a double-stacked line of gun towers; only after you destroy those can you go after the remaining targets. The very end has you flying into the tunnel which itself can attack you by ''[[ThereIsNoKillLikeOverkill firing a cruise missile into your face]]''. And this is assuming that you got this far, as unlike "Valley of Kings" which gives a definite time limit, you have to complete the mission before too many cruise missiles are fired and can hit [[spoiler:Gracemeria]], so you'll have to guesstimate how much time/cruise missile launches you have left based on the dialogue. (Fortunately if you manage to survive the AAA on the way in, there's a conveyor belt underneath Chandelier that carries the cruise missiles to its rear; destroying the cruise missiles before they can be loaded will buy you some time depending on how you're balancing it with destroying the targets.)

*** The 'don't fly above (insert low altitude here)' missions are annoying, but in some games in the series the missiles don't spawn so close to you. This enables you to outrun them (or at least keep them from hitting you till they detonate) while flying the overpowered [=MiG=]-25/31. Unfortunately, this creates an {{Unwinnable}} situation, since they respawn one after another--so after descending back to an altitude that will let you complete the mission, the speed that's required to outrun the one that inevitably spawns above you prevents you from maneuvering through the narrow confines of the level. That the dragster-like [=MiGs=] were built for intercepting versus dogfighting doesn't help.
** The first game (''VideoGame/AirCombat'' outside Japan) has possibly the worst canyon mission of any, and a lot of that is FakeDifficulty due to terrible graphics. It's an incredibly narrow canyon, and it is very very difficult to tell the two walls apart, so every turn is an opportunity to crash due to inability to judge distance.

** Area 06-D in ''Ace Combat 5''[='=]s arcade mode (Operation Katina). The mission is to destroy 24 air targets (most of them fighters, with one large transport plane that takes a ''lot'' of hits to destroy - thankfully this is optional). Sounds easy enough, right? But you are only given 20 regular missiles and 4 [=XMAAs=] (with longer range). It takes 2 missiles (or 1 XMAA) to destroy a fighter. Usually in arcade mode, there are special targets that you can destroy to replenish your missile supply. In this area, there are none of those targets, so you will eventually run out of missiles before you can destroy every target, which means that you will have to manually aim your machine gun (which has infinite ammo) to shoot down a target. ''All while several other fighters are on your tail, firing missiles at you''. All of which are also highly-skilled and highly maneuverable. On top of that, you start off with a 30-second time limit, which can be extended by killing targets as in every other area in arcade mode.

* ''VideoGame/AceCombat'' primarily has these in levels where the mission/parameters have nothing to do with the difficulty setting; the "game stopper" is ''VideoGame/AceCombat5TheUnsungWar''[='=]s "Four Horsemen," mission 12b. It's only one of the two paths, but [[GuideDangIt you're given no clue that your answer to a wingman's question in mission 10 will have any consequence]]. Things aren't so bad on the other path, or even in the other mission on this path, while this mission requires you to perform four consecutive timed destructions of radar sites, which means that you have to take into account your weapon's travel time ''and'' your own travel time -- go past the radar site and you fail, while if you get in position too early you'll have to break/slow down, which can cause a stall or wasted time (especially if you have to turn around to reposition yourself for another attack run), and you have less time between each radar site. Did I mention that your wingmen may mess up ''their'' approaches against their own targets which you don't see and cause everyone to have to abort their attack run and try again? Making things worse, if you want the Flanker line of aircraft or the FALKEN, you ''have'' to play this mission at least once.

* ''Franchise/TheSims'':