2-4 years of training, $390-$800 in board exam fees, state licensure, then $56-60k as a new grad RRT. Here is every step.
2 years
Associate path
4 years
Bachelor's path
$390-$800
Board exam fees
$56-60k
Starting salary
Most CoARC programmes require anatomy and physiology (often 2 semesters), microbiology, algebra or statistics, English composition, and introductory chemistry. If you have these from a prior degree, you may skip directly to programme application.
Search the CoARC programme directory (coarc.com) for accredited associate or bachelor's programmes. Competitive admission: GPA 2.5-3.5+, letters of recommendation, personal statement, sometimes TEAS or HESI exam. Acceptance rates vary; some community college programmes are highly selective.
Core coursework includes ventilator management, respiratory pharmacology, cardiopulmonary pathophysiology, arterial blood gas interpretation, pulmonary function testing, neonatal respiratory care, and sleep medicine fundamentals.
Rotations span multiple settings: adult ICU, neonatal ICU, emergency department, medical-surgical floors, sleep lab, and pulmonary function lab. Strong clinical sites at teaching hospitals significantly improve NBRC pass rates and job placement.
The TMC covers all clinical domains. A high-cut score is required to proceed to the CSE. Most graduates prepare with NBRC study guides, Kettering Seminars materials, and practice exams. First-time pass rates at strong CoARC programmes exceed 85%.
The CSE presents branching clinical scenarios testing decision-making. Passing both TMC (high-cut) and CSE earns the Registered Respiratory Therapist (RRT) credential, which most hospitals require at hire or within the first year.
Most states require a separate state licence in addition to NBRC credentials. Fees range from $50 (some states) to $200. License renewal is typically every 2 years with continuing education (20 CRCE credits). A few states do not have RT-specific licensure laws, though this is changing.
New grad RTs typically start in general hospital floor and ICU rotation. After 1-2 years of experience, pursue specialty credentials: ACCS for critical care, NPS for NICU and pediatrics, SDS for sleep lab. Each adds $2,500-$5,500/yr and opens dedicated specialty positions.
Where
Community colleges, some universities
Outcome
Eligible for CRT/RRT exams. Sufficient for most staff RT positions.
Most cost-effective entry point. Strong community college programmes often match university pass rates.
Where
Universities with CoARC BS/BSRC programme
Outcome
Eligible for CRT/RRT exams. Required for most supervisor/manager roles.
Growing preference from hospital systems. CoARC moving toward BS-only new programme standard.
Where
Online (clinical component local)
Outcome
Upgrades existing RRT credential holders to bachelor's. No new board exams.
Best option for working RRTs wanting management eligibility without returning full-time to school.
The community college associate path is one of the most cost-efficient routes into a $80k+ healthcare career.
| Cost Item | Community College | Public University | Private University |
|---|---|---|---|
| Tuition (2 yr / 4 yr) | $8,000-$18,000 | $20,000-$35,000 | $40,000-$80,000 |
| Textbooks and equipment | $1,000-$2,500 | $1,500-$3,000 | $2,000-$3,500 |
| Clinical fees and uniforms | $500-$1,000 | $500-$1,500 | $1,000-$2,000 |
| NBRC TMC exam | $190 | $190 | $190 |
| NBRC CSE exam | $200 | $200 | $200 |
| State licence | $50-$200 | $50-$200 | $50-$200 |
| Total estimate | $10,000-$22,000 | $22,000-$40,000 | $43,000-$86,000 |
Tuition figures are estimates based on NCES average 2024-2025 data. Does not include living expenses or opportunity cost during training.
Not all CoARC programmes are equal. These are the most reliable public indicators of programme quality.
The Annual Report of Current Status measures student outcomes including NBRC first-attempt pass rates, graduation rates, and employment rates within 12 months. Available publicly on the CoARC website. Look for scores above 75%.
Strong programmes post 80%+ first-attempt TMC high-cut pass rates. The national average hovers around 70-75%. Ask the admissions office for their programme's most recent 3-year rate.
Rotations at Level I or Level II trauma centres, teaching hospitals, and dedicated NICUs expose students to more complex patients and better prepare them for the NBRC CSE and early-career competitiveness.
Programmes with strong hospital affiliations often have informal or formal pipeline hiring. Ask whether clinical rotation sites frequently hire their own students. A 90%+ placement rate within 6 months is strong.
New-grad respiratory therapists enter the workforce in one of two primary paths: direct hospital hire into a general pool or a formal new-graduate residency programme.
Most common path. New grads rotate through multiple units (floor, ICU, ED) during a 6-12 week orientation, then settle into a primary unit based on need and preference. Expect 3-6 months to full competency.
Offered by larger health systems (HCA, Ascension, CommonSpirit). Structured 12-month programme with dedicated preceptors, classroom sessions, and progressive clinical responsibility. Growing in prevalence.
Specialty plan: After 1-2 years as a generalist staff RT, pursue the ACCS credential to open ICU-dedicated positions (+$3,500-$5,500/yr) or NPS to move into NICU (+$3,000-$5,000/yr). See the full credential ROI page for timing and study requirements.
Sources: CoARC (coarc.com) programme accreditation standards. NBRC exam fees 2026 (nbrc.org). NCES tuition data 2024-2025. BLS OES May 2024 salary figures (SOC 29-1126). State licensure requirements vary; check your state respiratory care board.