TMC Exam: How Hard Is It Really

Is The TMC Exam Hard?

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The TMC (Therapist Multiple-Choice) exam is a critical milestone for anyone pursuing a career in respiratory therapy. As the first step towards becoming a registered respiratory therapist or a certified respiratory therapist, the TMC exam measures the knowledge and skills of aspiring respiratory therapists. 

However, as a potential exam-taker, you may wonder: is the TMC exam hard? According to recent statistics, the pass rate for the TMC exam varies from year to year. Generally, it hovers around 70-80%. But for repeated attempts, the percentage drops to about 45%. This means that nearly one-third of test-takers do not pass the exam on their subsequent attempt. 

The TMC exam is known for being comprehensive, and while the TMC exam is undoubtedly challenging, passing is possible. In this article, we will explore the difficulty level of the TMC exam, what factors contribute to exam difficulty, and strategies to help you prepare for the exam.

Overview of the TMC exam

The TMC exam is a standardized exam administered by the National Board for Respiratory Care (NBRC) to measure the competency of aspiring respiratory therapists. The exam has 160 multiple-choice questions: 140 primary and 20 pretest questions. It is also administered in a computer-based format and covers a wide range of topics related to respiratory therapy, including;

  1. Patient assessment
  2. Oxygen therapy
  3. Mechanical ventilation
  4. Disease management.

It is also offered year-round at various testing centers throughout the United States. The exam must be completed within three hours, and candidates must achieve a minimum passing score to earn their credentials.

The TMC exam is highly-rated because it is a critical step in becoming a registered respiratory therapist (RRT) or a certified respiratory therapist (CRT). The RRT credential requires passing the TMC and Clinical Simulation Examination (CSE). In contrast, the CRT credential requires passing the TMC exam only.

Factors that contribute to the exam’s difficulty

The TMC (Therapist Multiple-Choice) exam is a challenging exam measuring respiratory therapy students’ and graduates’ knowledge and skills. The exam can be tough for several reasons.

For one, the exam covers a lot of ground. There’s a ton of material to cover, including patient assessment, oxygen therapy, mechanical ventilation, and disease management. Preparing for the exam can be overwhelming, and studying and memorizing all the relevant material requires much time and effort.

Another factor that contributes to the exam’s difficulty is the time limit. Candidates have only three hours to complete 160 multiple-choice questions. That means they must read each question carefully, think critically, and select the best answer quickly. It is also harder on candidates that are not used to computer-based examinations. 

Moreover, the exam questions are designed to be practical. They often require candidates to apply their knowledge to real-world scenarios. For example, the exam may present a complex case study or patient scenario that requires candidates to use their problem-solving skills to identify the best course of action.

Lastly, the TMC exam is regularly updated to reflect changes in the field of respiratory therapy. Keeping up with the latest developments and updates to the exam content can be challenging, requiring candidates to invest significant time and effort.

Is the TMC harder than other respiratory therapy exams?

While there is no definitive answer as to whether the TMC is harder than other respiratory therapy exams, each exam has unique characteristics. The TMC exam is not the only exam administered by the NBRC. While the TMC exam is the most well-known, other exams, such as the Clinical Simulation Exam (CSE) and specialty exams, can be equally challenging or even more difficult.

The CSE, for example, assesses a candidate’s ability to apply their knowledge and skills in a clinical setting, including patient assessment, problem-solving, and critical thinking. This exam is more challenging than the TMC because it requires candidates to demonstrate their ability to think on their feet and apply their knowledge to real-life scenarios.

Specialty exams, such as the Neonatal/Pediatric Respiratory Care Specialty Exam, are also challenging because they require knowledge of specific areas within respiratory therapy. These exams typically focus on a particular patient population or respiratory condition and require candidates to demonstrate their knowledge and skills.

Strategies to make the TMC easy for you

Preparing for the Therapist Multiple-Choice (TMC) exam can be challenging. Still, there are several strategies that candidates can use to make the exam easier and increase their chances of success. Here are some of the most effective strategies:

  • Develop a study plan: A study plan helps you stay organized and focused while preparing for the exam. Create a schedule that includes study time, practice exams, and breaks.
  • Use study materials: There are many study materials available, including textbooks, study guides, online courses, and practice exams. Ensure you use various materials to reinforce their understanding of the exam content. A high-yield material is the study content from NRBC. Access it here. You should also get a personalized study plan to help you prepare better. Find the best study plan here
  • Take practice exams: Practice exams help candidates understand the exam format, identify areas of weakness, and build confidence. You should take as many practice exams as possible to become familiar with the types of questions asked and the time constraints. Take the practice TMC exam here.
  • Focus on high-yield topics: Strategy helps you win. Ensure you focus on the most critical topics, such as pulmonary function testing, mechanical ventilation, and oxygen therapy. These topics are typically heavily weighted on the exam.
  • Utilize study groups: Studying with peers can help reinforce concepts and fill knowledge gaps. You can join study groups or create your own with classmates or colleagues.
  • Get enough rest and exercise: Lastly, adequate rest and exercise are essential for staying focused and alert while studying. Aim for at least 7-8 hours of sleep each night and incorporate regular exercise into their routine.


Regardless of which exam you take, each one is designed to assess the candidate’s knowledge, skills, and ability to perform essential tasks in the field of respiratory therapy. Preparing for these exams requires dedication, hard work, and a thorough understanding of the format and content. With proper preparation, you can increase their chances of success and become registered or certified respiratory therapists. Remember to stay focused, stay motivated, and trust in your abilities.