Nursing School Prerequisites: What You Need to Apply

Nursing school prerequisites typically include a set of science courses, a minimum GPA, standardized test scores, and several non-academic components that vary by program type and institution. The specifics shift depending on whether you’re applying to an associate degree (ADN), a traditional bachelor’s (BSN), or an accelerated second-degree program, but the core ingredients are remarkably consistent across the field. What catches many applicants off guard is not the course list itself but the way programs weigh those ingredients against one another and the growing role that non-academic factors play in admissions decisions.

The Core Science Courses

Almost every nursing program in the United States requires the same foundational science prerequisites before you can start clinical coursework. The usual lineup includes human anatomy, human physiology (sometimes combined into a single two-semester sequence), microbiology, and at least one chemistry course. Many BSN programs also require a statistics course and an introductory psychology or developmental psychology class. Nutrition rounds out the list at a large number of schools, though some fold it into the curriculum itself rather than requiring it upfront.

Anatomy and physiology tend to be the heaviest lift. These courses cover everything from cellular biology to organ-system function, and they serve as the foundation for pharmacology and pathophysiology once you’re in the nursing program. Microbiology matters because infection control, immunology, and communicable disease management are central to nursing practice. Chemistry, usually at the introductory or general level, provides the background for understanding drug interactions, electrolyte balance, and lab values you’ll interpret daily as a nurse.

Most programs require these science prerequisites to have been completed within the last five to ten years. The reasoning is straightforward: science knowledge becomes outdated, and programs want students entering clinical courses with relatively fresh understanding. If you took anatomy fifteen years ago during a previous degree, you may need to retake it. Check the specific recency policy at each school you’re considering, because the cutoff varies.

General Education Requirements

Beyond the sciences, nursing programs expect a slate of general education courses. English composition is nearly universal, typically two semesters covering academic writing and argumentation. Many BSN programs also require a speech or interpersonal communication course, a social science elective, and sometimes a humanities course. The reasoning is practical: nurses write care plans, communicate with patients and families, and work across cultural contexts. Programs want evidence that you can do all of that effectively before you arrive.

For students entering an ADN program at a community college, the general education load is lighter. You’ll still need English composition and likely a psychology course, but the broader humanities and social science requirements typical of a four-year degree may not apply. Accelerated BSN programs designed for students who already hold a bachelor’s degree in another field usually accept your existing general education credits wholesale and focus their prerequisite list almost entirely on the science courses.

GPA Thresholds and Why They Matter

A minimum cumulative GPA of 2.5 to 3.0 is the standard threshold at most nursing programs, though competitive programs often have effective cutoffs well above the published minimum. Many schools also calculate a separate science GPA from your prerequisite courses and weight it heavily. Research supports this emphasis: a study of baccalaureate nursing students found that preadmission cumulative GPA was a strong predictor of success in first-semester courses like pathopharmacology, health assessment, and foundations of nursing, with higher GPAs linked to better performance across the board.¹ Prerequisite science GPA specifically predicted success in pathopharmacology, the course that trips up the most first-semester students.

That said, the predictive power of GPA is not absolute. A correlational study of practical nursing students across five cohorts found that composite GPA was not significantly associated with on-time program completion or first-time licensing exam pass rates.² The takeaway isn’t that GPA doesn’t matter, but rather that it works better as a predictor in some program contexts than others. A 3.8 gives you a strong application nearly everywhere, but a 3.0 doesn’t necessarily mean you’ll struggle once admitted.

Standardized Entrance Exams

Most nursing programs require either the TEAS (Test of Essential Academic Skills) or the HESI A2 (Health Education Systems Incorporated Admission Assessment). Both exams test reading comprehension, math, science, and English language proficiency. The TEAS is published by ATI and is probably the more widely required of the two, though regional preferences exist. Some programs accept either exam, and a few have dropped the requirement entirely in recent years.

The TEAS composite score showed predictive value for success in health assessment and foundations courses in one baccalaureate program study, alongside cumulative GPA.¹ But the picture is complicated. The same practical nursing study that found GPA non-significant also found that the overall TEAS composite score was not significantly associated with any of its three success outcomes. Only the TEAS Reading subscale score reached significance for first-semester completion, and even that finding came from a model that was not statistically significant overall.²

What this means practically: the entrance exam is a real gatekeeper at many programs, with minimum score requirements you must meet to be considered. But a mediocre TEAS score does not necessarily doom your performance once you’re in. Programs set cutoff scores (often around 60-70% composite, with competitive programs expecting higher) because the exam provides a standardized comparison point across applicants with GPAs from very different institutions. Prepare for it, aim for the highest score you can manage, and retake it if your first attempt falls short. Most programs allow at least two attempts.

Personal Statements, Interviews, and Non-Academic Criteria

Your transcript and test scores get you past the first filter. What happens next depends on the program. A growing number of nursing schools evaluate non-academic characteristics as part of admissions, assessing qualities like communication skills, moral reasoning, psychological resilience, and motivation for the profession. A scoping review of admission criteria across nursing education found that programs use a wide range of methods to evaluate these traits, including panel interviews, multiple mini interviews, reference letters, personal statements, and personality assessment tools.³

Interviews, when used, tend to assess applicants on dimensions like motivation, problem-solving ability, capacity to relate to others, self-appraisal skills, and clarity of career goals. One study of a BSN program’s interview process described three-member teams rating applicants across six such dimensions on a seven-point scale.⁴ If your target program uses interviews, practice articulating why you want to be a nurse in concrete terms, not vague platitudes about “helping people.”

Personal statements are common but their value as a selection tool is debated within nursing education. One study comparing personal statements to standardized psychological assessments found that personal statements have substantial limitations as a measure of suitability and do not compare well with international standards for psychometric tests.⁵ Programs still require them because they offer a low-cost way to screen for red flags and gauge writing ability, even if they’re imperfect measures of who will thrive in the profession. Write yours honestly, keep it specific to your experience, and don’t treat it as the make-or-break element of your application.

The Shift Toward Holistic Admissions

Nursing education is gradually moving away from a purely numbers-driven admissions model. Holistic admissions review, which considers life experiences, personal qualities, and potential contributions to the profession alongside GPA and test scores, has gained traction in other health professions over the past decade. Research in other disciplines shows that holistic review can increase student diversity without decreasing academic success or workforce readiness.⁶ Nursing, however, has been slower to adopt the approach compared to fields like medicine and dentistry.

That is starting to change. A recent scoping review of holistic admission implementations across nursing programs found that schools using the approach evaluate characteristics beyond academic metrics, including relevant experiences, personal attributes, and the potential to contribute to a more diverse nursing workforce.⁷ The push is partly driven by a recognition that the nursing workforce does not reflect the demographics of the patients it serves. Holistic admissions review is one strategy programs are using to increase the number of underrepresented students entering nursing education.⁸

For you as an applicant, this trend means that your healthcare volunteer hours, prior caregiving experience, community involvement, or personal background overcoming adversity may carry real weight at certain programs, even if your GPA is slightly below the median admitted student. It also means that application components you might consider afterthoughts, like your personal statement or supplemental essays about your background, could matter more than you expect. Not every school has adopted holistic review, but enough have that it’s worth researching whether your target programs use it.

Can You Take Prerequisites Online?

This question comes up constantly, and the answer has shifted in recent years. Historically, many nursing programs required that science prerequisites, particularly those with lab components, be completed in person. The concern was that online labs couldn’t replicate the hands-on learning needed for courses like anatomy and microbiology. But evidence has challenged that assumption. A study comparing online and traditional wet-lab experiences in a human anatomy and physiology prerequisite found that students in the online laboratory section demonstrated mastery of basic science concepts equal to or better than students in the traditional hands-on lab.⁹ The researchers concluded that online lab experiences may represent an accessible and cost-effective alternative for pre-licensure coursework.

In practice, acceptance of online prerequisites varies by program. Some schools have updated their policies to accept online science courses with virtual labs, especially after the pandemic forced a large-scale natural experiment with remote instruction. Others still require in-person labs or specify that they only accept online coursework from regionally accredited institutions. A few draw a distinction between lecture components (which can be online) and lab components (which must be in person). Before enrolling in an online prerequisite, confirm directly with every program you plan to apply to that they’ll accept it. Getting this wrong can cost you a semester or more.

English Proficiency for International and Non-Native Speakers

If English is not your first language, you’ll face an additional layer of requirements. Most nursing programs require international applicants to demonstrate English proficiency through standardized tests like the TOEFL or IELTS. Minimum scores vary, but a TOEFL iBT of 80 or an IELTS band score of 6.5 are common thresholds.

Meeting the minimum, though, may not be enough to keep pace with the demands of a nursing curriculum. Research on non-native English-speaking students in Canadian health professions programs found that discipline-specific academic literacy is a major challenge, requiring proficiency across a wide variety of specialized written genres from reflective writing to theoretical analysis.¹⁰ Nursing in particular involves dense reading, rapid note-taking during clinical experiences, and patient communication that demands fluency beyond what standardized tests measure. If you’re close to the minimum proficiency threshold, investing extra time in academic English preparation before starting prerequisites will pay dividends once you’re in the program.

How Long Prerequisites Take and How to Sequence Them

If you’re starting from scratch with no college credits, expect prerequisite completion to take roughly one to two years of full-time study. The science courses typically need to be taken in a specific order: general chemistry before or alongside anatomy, anatomy before physiology (at schools that separate them), and microbiology after at least one semester of biology or anatomy. Stacking too many lab sciences in a single semester is a common mistake that leads to burnout or poor grades in the courses that matter most for your application.

A manageable approach for most people is two lab sciences per semester alongside one or two general education courses. That pace gets you through the prerequisite list in three to four semesters. If you’re working full-time, extending to five or six semesters is realistic and doesn’t hurt your application as long as your grades stay strong. Accelerated timelines exist at some institutions, with shortened terms of five to eight weeks that let you complete courses faster, but the compressed format is demanding and not suited to everyone’s learning style.

Students who already hold a bachelor’s degree in another field will often find that their general education requirements are already satisfied, leaving only the science courses. In that case, you might finish prerequisites in two to three semesters, positioning you for an accelerated BSN program that compresses the nursing curriculum into 12 to 18 months. The prerequisite timeline is one of the most customizable parts of the process, so map it out early and build in a buffer for any courses that need to be retaken.

Common Prerequisite Mistakes That Delay Applications

A few errors come up often enough to be worth calling out. The first is assuming all community college credits transfer cleanly. While community colleges are a perfectly valid and often more affordable place to take prerequisites, not every nursing program accepts every community college’s courses. Some universities require that a minimum number of credits come from a four-year institution. Others have articulation agreements with specific community colleges but not others. Check transfer policies before you enroll, not after you’ve completed the course.

The second common mistake is neglecting the science GPA. Programs that calculate a separate prerequisite science GPA typically weigh it as heavily as or more heavily than your cumulative GPA. A student with a 3.7 cumulative GPA but a 2.9 in their science courses is in a weaker position than someone with a 3.3 overall and a 3.5 in the sciences. If your first attempt at anatomy or chemistry didn’t go well, retaking the course and earning a strong grade is usually worth the time investment.

The third is missing the application timeline. Nursing program admissions are often cyclical, with applications due months before the start date. Many competitive BSN programs have a single annual application window. Missing it means waiting an entire year. Start tracking deadlines the moment you begin prerequisites, and plan your course sequence so that all requirements are met before the application closes, not just before the program starts.

Healthcare Experience and Certifications

While not universally required, healthcare experience strengthens your application at many programs, especially those using holistic review. Some schools list a certified nursing assistant (CNA) certification as a prerequisite or strong recommendation. Earning a CNA credential typically takes four to twelve weeks and gives you direct patient care experience that both informs your personal statement and demonstrates commitment to the field.

Other forms of experience that programs value include volunteer hours in hospitals or clinics, work as an emergency medical technician (EMT), medical assistant experience, or caregiving roles. Programs that evaluate experiences as part of holistic admissions are looking for evidence that you understand what nursing involves beyond the idealized version. Direct exposure to patient care, even in a limited capacity, signals that you’ve made an informed career choice. If your program doesn’t explicitly require healthcare experience, getting some anyway is one of the few things you can do to differentiate yourself from applicants with similar academic profiles.

Background Checks and Immunization Records

These aren’t academic prerequisites, but they can derail an otherwise complete application if you overlook them. Nearly all nursing programs require a criminal background check before starting clinical rotations, and some require one at the time of admission. Certain criminal convictions can disqualify you from clinical placements and, by extension, from completing the program. State boards of nursing also conduct background checks before issuing a license, so it is worth understanding your state’s policies early if you have any history of concern.

Immunization requirements are similarly non-negotiable. You’ll typically need documentation of vaccination against hepatitis B, measles, mumps, rubella, varicella, and often influenza and COVID-19. A current tuberculosis screening (either a skin test or blood test) is standard. Many programs also require a physical exam and evidence of current CPR certification, usually at the Basic Life Support (BLS) for Healthcare Providers level through the American Heart Association. Gathering these documents takes time, so start early rather than scrambling at the last minute.