I was going for a pistol start UV recently, and some levels are really hard, especially if you don't know where secrets are. On some levels it's hard to get that shotgun to get things going and the ammo is often scarce.
Yeah, there’s a fair few levels where you’ve got to plan your route very carefully, use particular weapons for particular fights, be strategic about power-ups.
Suburbs is a pretty nasty level to begin with, but IIRC the only way to deal with the two archviles efficiently is double shotgun at close range, which involves popping the invulnerability or it’s not going to work.
Against Thee Wickedly (E4M6 from Doom 1) was my all-time fav doom level for this reason. Boy, it was difficult with pistol start, but so, so, so much fun. Huge replay value. Incidentally, pistol starts in the duke nukem games (I was on N64 version) were also incredibly fun and challenging.