Key Takeaways
- Becoming a respiratory therapist takes about 2 to 4 years: complete a CoARC-accredited associate or bachelor’s degree in respiratory care, pass the NBRC credentialing exams, and obtain a state license.
- Every US state except Alaska requires a license to practice as a respiratory therapist, and most states base licensure on holding the CRT or RRT credential.
- An associate degree is the minimum, but a bachelor’s degree is increasingly preferred by employers and opens more career paths, including leadership, education, and research roles.
To become a respiratory therapist, you complete a CoARC-accredited degree in respiratory care, pass the NBRC credentialing exams, and obtain a state license. Most entry-level programs take about two years for an associate degree, while a bachelor’s degree usually takes about four years.
Respiratory therapy is not a physician’s path. It is a licensed, bedside clinical career for people who want direct patient care, often helping patients breathe during emergencies, ICU care, recovery after surgery, and long-term lung disease treatment.
How to Become a Respiratory Therapist
Becoming a respiratory therapist requires formal respiratory care training, national credentialing exams, and state licensure where required. The steps below show the typical path from education to clinical practice.
Step 1: Earn a CoARC-accredited degree
The foundation is a respiratory care program accredited by the Commission on Accreditation of Respiratory Care (CoARC). Program accreditation is non-negotiable: you cannot sit for the NBRC credentialing exams without graduating from a CoARC-accredited program.
An associate’s degree is the minimum requirement to become a respiratory therapist. This is a two-year program that covers the core science and clinical skills to enter the field.
A bachelor’s degree in respiratory care builds on the same clinical foundation as an associate degree, but adds more training in research, leadership, healthcare systems, and advanced patient care. It may also help respiratory therapists qualify for supervisory, educational, research, or administrative roles, especially in hospitals and academic settings.
Prerequisite coursework for most programs includes anatomy and physiology, chemistry, microbiology, and college-level mathematics. Some programs accept students directly from high school; others require completion of prerequisites before admission.
Step 2: Complete clinical training
Every CoARC-accredited program includes supervised clinical rotations as a required component of the degree, not an optional add-on. Rotations take place across hospital departments, including intensive care units, emergency departments, pulmonary care floors, and neonatal ICUs.
During clinical training, students develop the hands-on skills that define the profession: ventilator setup and management, airway suctioning and intubation assistance, arterial blood gas interpretation, pulmonary function testing, oxygen therapy delivery, and patient and family education. Clinical hours are where respiratory therapists are actually made.
Step 3: Pass the NBRC credentialing exams
After graduating from an accredited program, the next step is credentialing through the National Board for Respiratory Care (NBRC).
- Therapist Multiple-Choice (TMC) Exam: This is the entry-level licensing exam. A passing score at the low cut score earns the Certified Respiratory Therapist (CRT) credential. A passing score at the high cut score makes you eligible to proceed to the CSE.
- Clinical Simulation Exam (CSE): Passing the CSE, after achieving a high TMC score, earns the Registered Respiratory Therapist (RRT) credential. The RRT is the profession’s advanced standard and is increasingly required for hospital positions, critical care roles, and travel assignments.
The NBRC is transitioning to a combined RT Examination in January 2027. This will replace the current two-step TMC/CSE structure. If you’re planning your timeline around the new system, check the NBRC website for the most current transition information, since exam rules and eligibility requirements may shift.
Step 4: Obtain your state license
All states except Alaska require a license to practice as a respiratory therapist. Most state boards require proof of CRT or RRT certification, a completed application, a fee, and sometimes a state-specific law or ethics course. A few states have additional requirements around clinical hours or background checks.
Because requirements vary, check directly with your state’s respiratory care board or licensing authority before applying. The American Association for Respiratory Care (AARC) maintains a list of state affiliate organizations that can point you to the right credentialing body.
Step 5: Consider specialty credentials and continuing education
Once licensed and working, optional NBRC specialty credentials let respiratory therapists deepen their expertise and increase earning potential:
- Neonatal/Pediatric Specialist (NPS/RRT-NPS): For RTs working in NICUs and pediatric units.
- Adult Critical Care Specialist (ACCS/RRT-ACCS): For those specializing in adult ICU and ventilator management.
- Sleep Disorders Specialist (SDS): For RTs working in sleep labs and diagnostics.
- Pulmonary Function Technology (CPFT/RPFT): For those focused on diagnostic testing.
Maintaining any NBRC credential also requires continuing education to stay current. Bachelor ‘s-to-master’s programs exist for RTs interested in advanced practice, leadership, or clinical education roles.
How Long Does It Take to Become a Respiratory Therapist?
Becoming a respiratory therapist takes relatively less time compared to most other healthcare careers. An associate-degree graduate who passes their NBRC exams and obtains state licensure can be working within months of starting the program.
| Route | Duration |
| Associate degree (CoARC-accredited) | ~2 years |
| Bachelor’s degree (CoARC-accredited) | ~4 years |
| NBRC TMC and CSE exams | A few weeks to 2 months after graduation |
| State license application | A few weeks after credentialing |
| Total (associate route) | ~2 to 2.5 years |
| Total (bachelor’s route) | ~4 to 4.5 years |
Skills and Qualities of a Respiratory Therapist
Training helps you become a credentialed respiratory therapist. The qualities below help you succeed in the role and handle the demands of patient care.
- Technical precision: Ventilators, arterial blood gas analyzers, bronchoscopes, and pulmonary function equipment require accurate setup and careful interpretation. Small errors in critical care have direct patient consequences.
- Calm decision-making under pressure: Respiratory emergencies, codes, and deteriorating ICU patients don’t allow for extended deliberation. RTs need to act quickly and correctly under stress.
- Communication and patient education: Teaching a newly diagnosed COPD (chronic obstructive pulmonary disease) patient how to use an inhaler, or explaining a family member’s ventilator settings to worried relatives, requires patience, clarity, and empathy.
- Physical stamina: Hospital RTs typically work 12-hour shifts that involve moving between multiple units, positioning patients, and managing heavy equipment.
- Attention to detail: Medication dosing, ventilator settings, and alarm thresholds require exact execution. Checklists and protocols are your ally.
Respiratory Therapist Salary and Job Outlook
Respiratory therapists earn solid pay for a healthcare career that can start with an associate degree. The Bureau of Labor Statistics (BLS) reports a median annual wage of around $80,000, with the highest 10% earning more than $100,000.
The job outlook is strong. The BLS projects respiratory therapist employment to grow 12% from 2024 to 2034, much faster than the average for all occupations. About 8,800 openings are expected each year over the decade.
Demand is mainly driven by an aging population and higher rates of respiratory conditions such as COPD, pneumonia, and other lung disorders. The BLS also notes that efforts to reduce hospital readmissions and move some care into outpatient settings may increase demand for respiratory therapists in clinics and doctors’ offices.
Where respiratory therapists work
The majority of respiratory therapists work in hospital settings, where the largest concentration of ventilator-dependent patients, code emergencies, and complex respiratory cases is found. Other practice settings include:
- Intensive care units and emergency departments: highest acuity, highest demand for advanced credentials
- Neonatal and pediatric intensive care units: specialized population requiring the NPS credential
- Pulmonary rehabilitation programs: chronic disease management in outpatient settings
- Sleep labs: diagnostic testing and CPAP setup for sleep-disordered breathing
- Home health and durable medical equipment companies: setting up and managing home oxygen and home ventilators
- Skilled nursing facilities: ongoing respiratory care for long-term care patients
A Fast Path Into Clinical Healthcare
Becoming a respiratory therapist is one of the most efficient ways to enter clinical healthcare with meaningful patient responsibility. A 2-year associate degree, the NBRC exams, and a state license put you at the bedside in intensive care, emergency medicine, and neonatal units within roughly two years of starting school.
The path also has room to grow. Specialty credentials, bachelor’s completion programs, and leadership tracks allow experienced RTs to move into higher-paying and higher-responsibility roles over time.
If this guide has you thinking about where your healthcare career could ultimately go, some respiratory therapists go on to pursue medical school and become pulmonologists, anesthesiologists, or critical care physicians. If that’s a path you want to explore, Caribbean Medical University is an accredited option worth looking at early. Use the Find Your Med School form to compare programs and see where a longer career in medicine could take you.
Frequently Asked Questions (FAQs)
Can you become a respiratory therapist without a degree?
No. A CoARC-accredited associate degree is the minimum requirement to sit for the NBRC credentialing exams, and the exams are required for licensure in virtually every state. There is no degree-free path into licensed respiratory therapy practice in the United States.
Is the respiratory therapist exam hard?
The NBRC TMC and CSE exams are considered among the more rigorous healthcare credentialing exams. The CSE in particular uses branching clinical simulations that require applied decision-making under time pressure. Most programs build NBRC exam preparation into their curriculum, and structured review courses significantly improve pass rates. The NBRC publishes detailed content outlines and practice tools on its website.
What is the difference between a respiratory therapist and a nurse?
Respiratory therapists specialize in pulmonary and cardiopulmonary care: ventilators, airway management, inhaled medications, oxygen therapy, and diagnostic testing like pulmonary function studies. Registered nurses provide broader patient care across all body systems. RTs typically hold a two or four-year degree and NBRC credentials; RNs hold at minimum an associate degree in nursing and pass the NCLEX. Both roles are essential in critical care, where they work closely together.
Can internationally educated respiratory therapists practice in the US?
Foreign respiratory therapy education does not qualify graduates for the NBRC exams. Internationally trained candidates must complete a CoARC-accredited program in the United States before being eligible to sit for credentialing exams and apply for a state license. There is no equivalency pathway that bypasses the US program requirement.
Is respiratory therapy a good career choice?
Respiratory therapy can be a strong choice for people who want to enter healthcare faster, work directly with patients, and earn a solid salary without spending 8 to 12 years in training.
The job can be demanding. Many respiratory therapists work 12-hour shifts, weekends, holidays, and high-stress emergencies. But the field has strong demand, steady job security, and meaningful patient care, especially for people who want to work at the bedside.
