Becoming a respiratory therapist takes two to four years of education, a national certification exam, and a state license. The career pays a median salary of $80,450 per year, and job growth is projected at 12 percent through 2034, which is much faster than average. Here’s what each step looks like.
What Respiratory Therapists Do
Respiratory therapists treat people who have trouble breathing, from premature newborns with underdeveloped lungs to adults with chronic conditions like COPD or asthma. On a typical day, that means evaluating patients, running diagnostic tests, managing ventilators, administering medications directly to the lungs, and analyzing blood samples in the lab. You work closely with physicians to determine treatment plans, and you’re often the one adjusting equipment and monitoring patients in real time.
Most respiratory therapists work in hospitals, but the field extends into home health care, sleep disorder clinics, pulmonary rehab centers, and diagnostic laboratories. The work can involve 12-hour shifts, overnight rotations, and weekends, since patients need respiratory support around the clock.
Step 1: Complete an Accredited Program
You need a degree from a program accredited by the Commission on Accreditation for Respiratory Care (CoARC). Programs are available at the associate, bachelor’s, and master’s degree levels. An associate degree is the minimum for entry-level practice and typically takes about two years. A bachelor’s takes four years and can open doors to leadership roles, research, or education positions later in your career.
Coursework covers anatomy and physiology, chemistry, microbiology, mathematics, pharmacology, and cardiopulmonary science. You’ll also spend significant time in hands-on clinical rotations. Programs commonly require over 1,000 hours of supervised clinical experience in hospitals and other care settings, where you practice ventilator management, airway care, and patient assessment on real patients.
CoARC maintains a searchable directory of accredited programs on its website, which is the simplest way to confirm a school meets the standard. Graduating from a non-accredited program can disqualify you from sitting for the national exam, so verify accreditation before enrolling.
Step 2: Pass the National Board Exam
After graduating, you need to earn a credential through the National Board for Respiratory Care (NBRC). The credentialing process works through a tiered exam system with two possible outcomes.
The Therapist Multiple-Choice (TMC) Examination uses two cut scores. If you meet the lower threshold, you earn the Certified Respiratory Therapist (CRT) credential. If you hit the higher threshold, you earn the CRT and become eligible to continue toward the Registered Respiratory Therapist (RRT) credential, which requires passing a Clinical Simulation Examination as well. The RRT is the more advanced credential and the one most employers prefer.
To be eligible, you need at least 62 semester hours of college credit that include anatomy and physiology, chemistry, microbiology, and mathematics. In practice, completing any CoARC-accredited program satisfies these requirements.
Step 3: Get Your State License
Nearly every state requires a license to practice. Alaska is the only state with no licensure law. The general process involves submitting an application to your state’s respiratory care licensing board with proof of your NBRC credential and your degree from an accredited program.
Many states offer temporary permits for recent graduates who are waiting on exam results. These are typically valid for six months to one year and require you to work under supervision. Once you pass your exam and submit the results, you receive your full license.
Requirements vary by state, so check your state board’s website for specifics. Some states, like New Jersey and Pennsylvania, require continuing education in particular topics such as infection control, patient safety, and medical ethics. Others, like Colorado and Michigan, have no continuing education requirements at all for renewal.
Keeping Your License Current
Most states require you to renew your license every one to two years, and the majority mandate continuing education credits as part of that renewal. The number varies widely. Arkansas and Idaho require 12 credits annually. California and Georgia require 30 credits every two years. Connecticut requires just 10 per year. A handful of states, including Colorado and Hawaii, do not require any continuing education for renewal.
Continuing education can include conferences, online courses, workshops, and employer-sponsored training. Some states specify that a portion of your credits must come from live, in-person sessions.
Specialty Credentials
Once you hold the RRT credential, you can pursue specialty certifications to advance your career and earning potential. The NBRC offers several:
- Adult Critical Care Specialty (RRT-ACCS): Validates expertise in caring for critically ill adults, including managing advanced devices like ECMO circuits and pulmonary vasodilators.
- Neonatal/Pediatric Specialty (NPS): Covers the unique skills needed to treat infants and children, whose respiratory needs differ significantly from adults.
- Sleep Disorders Specialty (RRT-SDS): Focuses on diagnosing and treating sleep disorders, including conducting and interpreting sleep studies.
- Pulmonary Function Technologist (RPFT): Certifies advanced competency in pulmonary function testing, which measures lung capacity and airflow.
- Asthma Educator Specialist (AE-C): Covers asthma management, patient education strategies, and the impact of chronic illness across different populations.
These credentials aren’t required to work as a respiratory therapist, but they signal specialized knowledge to employers and can qualify you for higher-paying or more focused roles in ICUs, NICUs, sleep labs, or pulmonary function labs.
Salary and Job Outlook
The median annual wage for respiratory therapists was $80,450 as of May 2024, according to the Bureau of Labor Statistics. Pay varies by location, employer type, and experience. Specialty credentials and a bachelor’s degree can push compensation higher, particularly in critical care or supervisory roles.
Employment is projected to grow 12 percent from 2024 to 2034, driven by an aging population and the growing prevalence of chronic respiratory conditions. That growth rate is well above the average for all occupations, which means strong job security and consistent demand for new graduates entering the field.