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Does death tickle your fancy but your “friends” keep asking you to change the topic of conversation? The free Challenge Mode DLC is here to satisfy your frankly bizarre tastes with mortality rates that only a Hardcore Hospital Gamer can subdue! If harrowing difficulty isn’t enough, Challenge Mode also brings shiny, golden trophies for the fraction of Directors who survive succeed.

Mutated Conditions!

Conditions have begun to mutate into deadly new strains, and it’s a race against time to research the cures before your hospital is flooded with death and disaster. Put those nerds in the Research Lab to work before it’s too late!

• Conditions now randomly mutate, massively increasing their mortality rate and infectiousness – meaning a lot of patients who’re much more likely to kick the bucket
  
• To overcome the mutation, you'll need to treat a large number of affected patients, study the mutation in the Research Lab, or make good use of your consultants
  
• Focus your efforts on these new dangers to keep fatalities to a financially-tolerable minimum while you work on the cure

More Patients!

Infection rates have surged and HEAL’s “KPI safeties” were switched off because they were illegal, so keep an eye on the shuttle bays – the goddamned patients are coming in hordes!

• In Challenge Mode, you’ll have to cope with many more patients than usual – and their swarms will steadily increase over time, whether you’re ready or not
  
• Patients are more likely to be disruptive and inconsiderate, requiring rooms you haven’t yet built, or rooms that already have heavy queues
  
• Sandbox events will spawn patients in much greater numbers to swarm your hospital

More Death!

The cost of MEDI’s body-disposal tech was extortionate but, with the state of these patients, it’s about to save us a fortune on body bags.

• Patients in Challenge Mode can arrive with much lower health, requiring swifter treatment
  
• Patient health deteriorates much faster, and you’ll need your full suite of tools in order to prevent their untimely deaths
  
• Treatment difficulty is increased, requiring the use of happy, high-level doctors to keep patients consistently alive

More Poverty!

By 2049, medical debt exceeded 1,800% of global GDP, and the entire economy turned into mashed potatoes. The ghost of that terrible time has returned, and both we and our patients are flat broke.

• Income from treatments is reduced
  
• The travelling merchant is much less generous with their freebies - no more free holo-docs!
  
• Level 3 doctors can no longer be recruited directly – you’ll have to train them up yourself

More!

Every mechanic has been tuned to provide a more challenging experience from the baseline difficulty. With adjustments to spawners, patient needs, economic balance, patient health, and more, you’ll need to utilise every tool to succeed.

• New loss condition – too many deaths! If the patient survival rate falls too low, your hospital will be yoinked by the “Space Cops”
  
• The Research Lab, Training Room, Recovery Ward and Craftech upgrades are all available from Chapter 1 - rest assured, you’ll need them
  
• Disasters are more frequent and intense
  
• Patients are… less patient, and much harder to keep happy, requiring keen administration to fulfil their needs and desires

If you manage to thrive under these harrowing conditions, you’ll be rewarded with a fancy set of golden trophies to help you remember all the patients who died for your success!

Challenge Mode is our response to your masochistic requests for more difficulty, suffering, and general misery. Built to be unforgiving and push players to utilise their full toolset, it’s intended for those who want their Galacticare experience to have a little more bite to it.