CareerExplorer’s step-by-step guide on how to become a respiratory therapist.

Step 1

Is becoming a respiratory therapist right for me?

The first step to choosing a career is to make sure you are actually willing to commit to pursuing the career. You don’t want to waste your time doing something you don’t want to do. If you’re new here, you should read about:

What do respiratory therapists do?
Career Satisfaction
Are respiratory therapists happy with their careers?
What are respiratory therapists like?

Still unsure if becoming a respiratory therapist is the right career path? to find out if this career is right for you. Perhaps you are well-suited to become a respiratory therapist or another similar career!

Described by our users as being “shockingly accurate”, you might discover careers you haven’t thought of before.

Step 2

High School

To lay the foundation for a career in respiratory therapy, students should complete as many courses as possible in biology, health, health occupations, anatomy, physiology, math, chemistry, and physics. Material learned in these classes will make college studies more manageable. A high class rank and grade point average (GPA) will enhance candidacy for degree programs. A first course in cardiopulmonary resuscitation (CPR) is also recommended for high school students considering this occupation.

Step 3

Associate’s Degree or Bachelor’s Degree

While a Bachelor’s degree in respiratory care takes two years longer to earn than an Associate’s degree, completing the four-year program typically gives prospective RTs a competitive edge. Regardless of the education track they choose, aspiring respiratory therapists must be careful to enroll in a program accredited by the Commission of Accreditation for Respiratory Care (CoARC).

Coursework in an Associate’s degree program introduces students to theories and the science of respiratory therapy and teaches clinical techniques for use with adults, children, and infants. The curriculum comprises clinical rotations in various specialty areas, allowing students to practise their skills in real-life situations. In addition to courses specific to the field of respiratory therapy, Associate programs include instruction in college-level algebra, English composition, public speaking, and psychology.

Online Associate’s degree programs targeted at newcomers to the field assist students in arranging local clinical practice, which is a prerequisite to sit for the certification exam.

Bachelor degree programs in respiratory therapy focus on mathematics, anatomy, physiology, chemistry, physics, and pharmacology. Courses specific to the field teach diagnostic testing, clinical respiratory care, cardiopulmonary resuscitation, and the use of respiratory therapy equipment.

Step 4


The National Board for Respiratory Care (NBRC) oversees the Therapist Multiple-Choice (TMC) Examination held at testing centers located throughout the U.S. Candidates who pass the exam earn the Certified Respiratory Therapist (CRT) designation. The NBRC offers a no-charge online practice exam to acquaint candidates with the format of the certification exam.

Step 5


Every state except Alaska regulates licensure for respiratory therapists. The licensing benchmark in nearly all states is the NBRC CRT exam. Some states may require a higher level of certification, such as the NBRC’s Registered Respiratory Therapist (RRT) credential.

In some states, graduates of Associate-level respiratory care programs and students of Bachelor’s programs who have completed requisite coursework may apply for temporary licensure before taking the CRT exam. This allows them to begin working in the field while preparing to sit for the examination.

Step 6

Additional Certifications

Employers may prefer or require that respiratory therapists have additional life support certifications. RTs who wish to work with children or infants should consider earning Pediatric Advanced Life Support (PALS) certification and completing a neonatal resuscitation course. It is recommended that all RTs obtain Basic Life Support and Advanced Cardiac Life Support (ACLS) certifications. These credentials can be kept active through a recertification process.

Step 7

Continuing Medical Education / Certification & Licensure Maintenance

The National Board for Respiratory Care requires Certified Respiratory Therapists to renew their CRT credential every five years through continuing education or testing. CRTs must also maintain their active status annually by submitting a document verifying that they are practising respiratory therapy. Some states require continuing medical education (CME) to retain licensure.

Although approved continuing education providers may vary from one state to the next, it is typical for licensing boards to recognize courses from the following:

 Accreditation Council for Continuing Medical Education
 NBRC Advanced Certification (Adult Critical Care Specialist, Neonatal/Pediatric Respiratory Care Specialist, Registered Pulmonary Function Technologist, Sleep Disorders Testing, Therapeutic Intervention Respiratory Care)
 American Academy of Sleep Medicine
 American Association for Cardiovascular and Pulmonary Rehabilitation
 American College of Cardiology
 American College of Chest Physicians
 American Heart Association
 American Lung Association
 American Medical Association
 American Nurses Association
 American Society of Anesthesiologists
 American Thoracic Society
 National Society for Cardiopulmonary Technologists
 Programs accredited by the American Association for Respiratory Care

Step 8

Advanced Certification

Therapists holding the CRT credential can become Registered Respiratory Therapists. Candidates must pass written and clinical examinations to earn the RRT designation. It is generally possible to earn both the CRT and RRT credentials within three years of graduating from a respiratory therapy program.

The RRT exam consists of two sections. The Written Exam (WRRT) of 115 questions covers a variety of topics, ranging from clinical data review to proper usage of therapeutic procedures. Candidates are given two hours to complete this section. The Clinical Simulation Examination (CSE) presents ten different real life scenarios simulating the different roles of an RT within the respiratory care field. Candidates have four hours to complete these re-enactments and demonstrate their competency in a hands-on environment.

How to become a Respiratory Therapist

An Associate’s degree is the minimum formal education requirement for entry-level respiratory therapist (RT) positions. Many practitioners in the field, however, possess a Bachelor’s degree. RT programs are offered by numerous colleges, universities, vocational and technical schools, as well as the U.S. Armed Forces.

In addition to classroom and laboratory instruction, all respiratory therapy programs include a supervised clinical component that provides students with practical experience treating patients.

When looking for a respiratory therapist program, it is important to select an institution that is accredited by the Commission on Accreditation for Respiratory Care (CoARC). Coursework in all accredited RT degree programs includes:

 Cardiopulmonary anatomy and physiology  Adult, pediatric, and neonatal respiratory care  Provision of healthcare services to patients with transmissible diseases  Clinical application of respiratory care  Pharmacology  Respiratory health promotion / disease prevention / disease management  Legal and ethical aspects of respiratory care practice  Fundamental principles of evaluating current scientific literature

State licensure is mandatory for respiratory therapists practicing in the United States, with the exception of Alaska. While educational prerequisites are similar throughout the country, the application process, continuing education requirements, and renewal regulations may vary from state to state.

Certification in the respiratory therapist profession is administered by the National Board for Respiratory Care (NBRC). The NBRC offers two levels of certification: the Certified Respiratory (CRT) designation and the accepted ‘standard for excellence’ Registered Respiratory Therapist (RRT) designation. Most states requiring licensure recognize these NBRC certifications as acceptable licensing credentials.