Becoming a respiratory therapist typically requires completing an accredited respiratory therapy program, earning at least an associate degree, completing clinical training, passing the required credentialing examination, and meeting your state’s licensing requirements.
For many students, the process takes about two to four years, depending on whether they pursue an associate or bachelor’s degree and how long they need to complete prerequisite courses.
Respiratory therapists work with patients who have breathing or cardiopulmonary problems. They may care for premature infants, children with asthma, adults with pneumonia or COPD, trauma patients, and critically ill people who need mechanical ventilation.
According to the U.S. Bureau of Labor Statistics, respiratory therapists earned a median annual wage of $82,280 in May 2025, and employment is projected to grow 9% between 2025 and 2035.
Quick Answer
The typical path to becoming a respiratory therapist in the United States is:
- Complete high school or earn a GED.
- Complete prerequisite science and math courses.
- Enroll in an accredited respiratory therapy program.
- Earn at least an associate degree in respiratory therapy.
- Complete required clinical training.
- Graduate from a program accredited or supported by the Commission on Accreditation for Respiratory Care (CoARC).
- Pass the appropriate National Board for Respiratory Care examination.
- Apply for state licensure where required.
- Begin working as a respiratory therapist.
- Maintain credentials and complete continuing education as required.
Most states require respiratory therapists to hold a license. Alaska is currently the exception.
What Is a Respiratory Therapist?
A respiratory therapist, often abbreviated RT, is a healthcare professional who evaluates and treats people with breathing and cardiopulmonary problems.
Respiratory therapists work with patients ranging from premature newborns to older adults.
Their responsibilities may include:
- Assessing breathing problems
- Performing pulmonary function tests
- Administering oxygen
- Delivering aerosolized medications
- Managing mechanical ventilators
- Assisting during medical emergencies
- Monitoring blood oxygen levels
- Performing arterial blood gas testing
- Providing airway-management treatments
- Helping patients manage chronic respiratory conditions
- Educating patients and families
For a deeper look at the occupation itself, read our guide on what a respiratory therapist does.
Step 1: Complete High School or Earn a GED
The first step is completing high school or earning an equivalent credential.
Students interested in respiratory therapy should build a strong foundation in science and mathematics.
The Bureau of Labor Statistics recommends high-school coursework such as:
- Biology
- Chemistry
- Physics
- Algebra
These subjects prepare students for college-level respiratory therapy coursework.
Courses in anatomy, health sciences, and medical terminology may also be useful if available.
Step 2: Complete College Prerequisites
Respiratory therapy programs may require prerequisite courses before students enter the professional phase of the program.
Requirements vary by college.
Common prerequisites may include:
- Anatomy and physiology
- Biology
- Chemistry
- Microbiology
- College algebra
- English composition
- Psychology
Some programs admit students directly after high school, while others require completion of prerequisite courses first.
Always check the admission requirements of the specific programs you are considering.
Step 3: Choose an Accredited Respiratory Therapy Program
Accreditation is one of the most important things to verify before enrolling.
The Commission on Accreditation for Respiratory Care (CoARC) accredits respiratory therapy education programs in the United States.
You can search for programs directly through the CoARC accredited-program directory.
Programs are available at different degree levels, including:
- Associate degree
- Bachelor of Science degree
- Bachelor of Applied Science degree
- Other qualifying entry-to-practice programs
Before enrolling, verify that the program is currently accredited or otherwise meets current NBRC eligibility requirements.
Why CoARC Accreditation Matters
Graduating from the appropriate respiratory therapy education program is important because eligibility for professional credentialing depends on educational requirements established by the National Board for Respiratory Care.
As of the current NBRC requirements, candidates entering through the standard pathway generally need to graduate from an entry-to-practice respiratory therapy program supported or accredited by CoARC and hold at least an associate degree.
Choosing a program without checking accreditation can create serious problems when you later apply for credentialing or licensure.
Step 4: Earn an Associate or Bachelor’s Degree
Respiratory therapists typically need at least an associate degree in respiratory therapy.
The Bureau of Labor Statistics states that an associate degree is the typical entry-level education for the profession, although some employers prefer candidates with bachelor’s degrees.
Associate Degree
An associate respiratory therapy program commonly takes about two years after prerequisites, although the total time can vary.
This is often the fastest traditional route into the profession.
Bachelor’s Degree
A bachelor’s program typically takes around four years for a full-time student beginning after high school.
A bachelor’s degree may provide additional coursework in areas such as:
- Leadership
- Research
- Advanced clinical practice
- Healthcare management
- Education
- Public health
A bachelor’s degree is not universally required for entry-level respiratory therapist positions, but some employers prefer it.
Associate Degree vs. Bachelor’s Degree
| Factor | Associate Degree | Bachelor’s Degree |
|---|---|---|
| Typical length | About 2 years after prerequisites | About 4 years |
| Entry into profession | Yes | Yes |
| Lower education cost | Often | Usually not |
| Advanced coursework | Less | More |
| Employer preference | Accepted widely | Preferred by some employers |
| Leadership preparation | Limited | Usually greater |
| Graduate-school preparation | Possible but may require additional coursework | Typically stronger |
The best choice depends on:
- Your career goals
- Local program availability
- Tuition
- Time
- Employer expectations in your region
Step 5: Complete Respiratory Therapy Coursework
Respiratory therapy programs combine classroom instruction, laboratory training, and clinical experience.
Students may study subjects such as:
- Anatomy and physiology
- Cardiopulmonary anatomy
- Respiratory physiology
- Pharmacology
- Mechanical ventilation
- Airway management
- Oxygen therapy
- Pulmonary function testing
- Patient assessment
- Neonatal and pediatric respiratory care
- Critical care
- Cardiopulmonary disease
- Medical ethics
Because respiratory therapists frequently work with critically ill patients, programs emphasize both technical skills and clinical judgment.
Step 6: Complete Clinical Training
Clinical education is a major part of respiratory therapy training.
Students work in supervised healthcare environments where they apply classroom knowledge to real patients.
Clinical rotations may occur in:
- Hospitals
- Intensive care units
- Emergency departments
- Neonatal intensive care units
- Pulmonary laboratories
- Outpatient clinics
- Sleep laboratories
- Rehabilitation settings
Students may learn to:
- Administer breathing treatments
- Set up oxygen systems
- Monitor patients
- Assist with mechanical ventilation
- Perform respiratory assessments
- Interpret clinical information
- Work with healthcare teams
Clinical education allows students to develop practical skills before entering independent professional practice.
Step 7: Graduate From the Respiratory Therapy Program
After completing:
- Academic coursework
- Laboratory requirements
- Clinical rotations
- Program examinations
students graduate with their respiratory therapy degree.
Graduation does not automatically mean you can begin practicing independently.
The next steps usually involve credentialing and state licensure.
Step 8: Pass the NBRC Credentialing Examination
The National Board for Respiratory Care (NBRC) administers professional credentialing examinations for respiratory therapists.
This area is especially important in 2026 because the examination system is changing.
Current pathway through December 31, 2026
Under the current system, eligible graduates generally begin with the Therapist Multiple-Choice Examination (TMC).
Candidates who meet the appropriate score requirements can earn the Certified Respiratory Therapist (CRT) credential and may qualify to continue toward the Registered Respiratory Therapist (RRT) credential.
Candidates meeting the high-cut-score requirements may qualify for the Clinical Simulation Examination (CSE).
The exact credential earned depends on:
- Eligibility
- Examination scores
- Completion of required examinations
Because credentialing requirements can change, candidates should verify their individual pathway directly with the National Board for Respiratory Care.
Important 2027 NBRC Exam Change
Beginning January 1, 2027, NBRC is implementing a new Respiratory Therapy Examination.
Under the new system:
- Candidates meeting the lower cut score earn the CRT credential.
- Candidates meeting the higher cut score earn the RRT credential.
The new RT Examination will replace the TMC as the main entry examination beginning January 1, 2027.
The Clinical Simulation Examination will continue temporarily for eligible candidates from the older examination pathway and is scheduled to end on December 31, 2027.
Because this transition is happening now, students graduating in late 2026 or 2027 should check the current NBRC respiratory therapy examination requirements before applying.
What Is the CRT Credential?
CRT stands for Certified Respiratory Therapist.
It is an NBRC professional credential.
Under the upcoming 2027 examination system, candidates who achieve the lower cut score on the Respiratory Therapy Examination can earn the CRT credential.
Credentialing rules differ from state licensing, so earning the CRT does not necessarily complete every requirement to begin working.
What Is the RRT Credential?
RRT stands for Registered Respiratory Therapist.
It is considered the advanced standard respiratory therapy credential offered by NBRC.
Under the new examination system beginning January 1, 2027, eligible candidates who reach the higher cut score on the Respiratory Therapy Examination can earn the RRT credential.
Employers may prefer or require the RRT credential for certain positions.
Step 9: Apply for State Licensure
Professional certification and state licensure are related but different.
The Bureau of Labor Statistics states that respiratory therapists must currently be licensed in all states except Alaska.
Requirements vary by state.
A state licensing board may require:
- Graduation from an approved program
- NBRC credentialing
- Application fee
- Background check
- Verification of education
- Verification of examination results
- Continuing education
- Renewal fees
Do not assume that passing the NBRC examination automatically gives you permission to practice.
Check the respiratory care licensing board for the state where you plan to work.
Certification vs. Licensure
These terms are often confused.
Certification or credentialing
Professional credentialing is typically awarded by organizations such as the NBRC after candidates meet education and examination requirements.
Examples include:
- CRT
- RRT
Licensure
Licensure is authorization from a state government to legally practice respiratory therapy in that state.
Depending on the state, you may need both.
Step 10: Apply for Respiratory Therapist Jobs
After completing the necessary education, credentialing, and licensing requirements, you can begin applying for jobs.
According to the Bureau of Labor Statistics, hospitals employ the majority of respiratory therapists.
Respiratory therapists may work in:
- Hospitals
- Emergency departments
- Intensive care units
- Neonatal ICUs
- Pulmonary clinics
- Physician offices
- Nursing facilities
- Home healthcare
- Sleep centers
In 2025, approximately 80% of respiratory therapists worked in hospitals, according to BLS.
What Does a New Respiratory Therapist Do?
Entry-level respiratory therapists may perform duties such as:
- Giving breathing treatments
- Administering oxygen
- Monitoring respiratory status
- Setting up respiratory equipment
- Assisting with ventilators
- Collecting blood samples
- Performing respiratory tests
- Educating patients
- Documenting treatment
- Responding to emergencies
Responsibilities vary by facility and level of training.
Our article on what respiratory therapists do provides a more detailed breakdown of day-to-day duties.
How Long Does It Take to Become a Respiratory Therapist?
For many students, becoming a respiratory therapist takes approximately two to four years.
An associate degree is typically the shortest standard education pathway.
However, total time may be longer if you need to complete:
- Prerequisites
- General education courses
- Waiting-list requirements
- Remedial courses
A bachelor’s degree typically takes around four years when pursued full-time from the beginning of college.
We cover the timeline in more detail in our guide on how long it takes to become a respiratory therapist.
Can You Become a Respiratory Therapist in Two Years?
Potentially.
Some associate-degree respiratory therapy programs can be completed in about two years once a student enters the professional program.
However, the total timeline may be longer if prerequisite courses must be completed before admission.
Applicants should look at:
- Prerequisite semesters
- Program length
- Clinical requirements
- Credentialing examination timing
- State licensing processing
rather than simply assuming that every program takes exactly 24 months from high school to employment.
How Much Does Respiratory Therapy School Cost?
Costs vary widely.
Factors include:
- Community college vs. university
- Public vs. private institution
- In-state vs. out-of-state tuition
- Associate vs. bachelor’s degree
- Living expenses
Additional expenses may include:
- Textbooks
- Uniforms
- Clinical equipment
- Background checks
- Immunizations
- Drug screening
- CPR certification
- Examination fees
- Licensing fees
- Transportation to clinical sites
A community-college associate program may cost substantially less than a private four-year program.
Compare total program cost rather than tuition alone.
What Classes Should You Take in High School?
Students interested in respiratory therapy should prioritize:
- Biology
- Chemistry
- Physics
- Algebra
- Anatomy and physiology, if available
Strong communication skills are also useful because respiratory therapists spend significant time:
- Talking with patients
- Explaining treatments
- Communicating with physicians and nurses
- Documenting clinical care
What Skills Do Respiratory Therapists Need?
The profession requires more than technical knowledge.
Important skills include:
Critical Thinking
Respiratory therapists may need to quickly evaluate changing breathing patterns and patient responses.
Attention to Detail
Small changes in:
- Oxygen levels
- Ventilator settings
- Respiratory rate
- Blood gas results
can be clinically important.
Communication
RTs must explain procedures clearly to patients and communicate effectively with the healthcare team.
Compassion
Patients may be:
- Frightened
- Breathless
- Critically ill
- Unable to communicate normally
Calm and compassionate care matters.
Physical Stamina
Respiratory therapists may stand for long periods and help move or position patients.
Ability to Work Under Pressure
RTs frequently work in:
- Emergency departments
- ICUs
- Rapid response teams
- Code situations
The role can require quick decisions in stressful environments.
How Much Do Respiratory Therapists Make?
According to the U.S. Bureau of Labor Statistics, the median annual wage for respiratory therapists was $82,280 in May 2025.
The lowest 10% earned less than $63,660, while the highest 10% earned more than $118,050.
Pay varies based on:
- State
- City
- Experience
- Employer
- Shift
- Credentials
- Specialty
- Overtime
Our detailed salary guide explains how much respiratory therapists make.
Respiratory Therapist Salary by Work Setting
BLS reported the following median annual wages in May 2025 for major employers:
| Work Setting | Median Annual Wage |
|---|---|
| Hospitals | $82,730 |
| Skilled nursing facilities | $79,270 |
| Physician offices | $77,890 |
These are national median figures and do not guarantee a specific salary.
What Is the Job Outlook for Respiratory Therapists?
The employment outlook is stronger than the average for all U.S. occupations.
BLS projects employment of respiratory therapists to grow 9% from 2025 to 2035.
Approximately 8,600 openings per year are projected on average during that period.
Demand is expected to be supported partly by:
- An aging population
- Chronic respiratory conditions
- COPD
- Pneumonia
- Smoking-related disease
- Air-pollution-related respiratory problems
- Continued need for emergency and critical care
Where Do Respiratory Therapists Work?
Common settings include:
- Hospitals
- Intensive care units
- Emergency departments
- Neonatal intensive care units
- Skilled nursing facilities
- Pulmonary clinics
- Physician offices
- Home healthcare
- Sleep laboratories
- Rehabilitation programs
Hospitals remain the largest employer.
Do Respiratory Therapists Work in the ICU?
Yes.
Respiratory therapists play an important role in critical care.
ICU responsibilities may include:
- Mechanical ventilation
- Airway management
- Oxygen therapy
- Blood gas assessment
- Emergency respiratory support
- Ventilator adjustments
- Assisting with intubation
- Weaning patients from ventilation
Some RTs later pursue additional critical-care credentials.
Do Respiratory Therapists Work With Babies?
Yes.
Respiratory therapists may work in neonatal intensive care units and care for premature or critically ill newborns.
Responsibilities may include:
- Oxygen therapy
- Ventilatory support
- Airway management
- Monitoring respiratory status
Respiratory therapists can also work with children in pediatric settings.
Can Respiratory Therapists Specialize?
Yes.
After gaining education and experience, RTs may pursue specialized work or additional credentials in areas such as:
- Adult critical care
- Neonatal and pediatric care
- Pulmonary function testing
- Sleep disorders
- Asthma education
Specialty requirements vary.
NBRC offers several additional specialty credentials for qualified respiratory therapists.
Can Respiratory Therapists Advance Their Careers?
Yes.
Potential advancement paths may include:
- Senior respiratory therapist
- Clinical specialist
- Department supervisor
- Respiratory care manager
- Educator
- Program director
- Pulmonary function specialist
- Sleep specialist
- Critical care specialist
Additional education may help with leadership, management, education, or advanced clinical roles.
Associate Degree or Bachelor’s Degree: Which Should You Choose?
An associate degree can provide the standard entry route into respiratory therapy.
A bachelor’s degree may be worth considering if you want:
- Leadership opportunities
- Management
- Education
- Research
- Graduate education
- Greater long-term career flexibility
However, the bachelor’s degree generally costs more and takes longer.
For someone focused on entering clinical practice quickly and affordably, an accredited associate program may make more financial sense.
Is Respiratory Therapy School Hard?
Respiratory therapy programs can be academically and clinically demanding.
Students must learn:
- Cardiopulmonary physiology
- Pharmacology
- Mechanical ventilation
- Patient assessment
- Blood gas interpretation
- Emergency care
- Clinical decision-making
Clinical training can also involve early mornings, hospital shifts, and exposure to critically ill patients.
The program is achievable, but it requires consistent study and comfort with science and hands-on healthcare.
Do You Need Medical School to Become a Respiratory Therapist?
No.
Respiratory therapists are not physicians.
You do not need:
- Medical school
- An MD degree
- A DO degree
The typical entry route is an accredited respiratory therapy degree followed by credentialing and state licensure.
Do You Need a Bachelor’s Degree?
Not necessarily.
According to BLS, respiratory therapists typically need an associate degree.
Some employers prefer candidates with bachelor’s degrees.
The correct choice depends on your location, employer, and long-term career plans.
Can You Become a Respiratory Therapist Online?
Some respiratory therapy programs may offer portions of coursework online.
However, respiratory therapy is a hands-on clinical profession.
Entry-level programs require practical laboratory work and supervised clinical education.
A program advertised as entirely online with no clinical component should be investigated carefully.
Always verify its accreditation and eligibility for NBRC credentialing.
Can You Become a Respiratory Therapist Without College?
For the standard current U.S. entry pathway, no.
NBRC’s standard educational eligibility requires at least an associate degree from an appropriate entry-to-practice respiratory therapy program.
Short online certificates do not replace professional respiratory therapy education.
Do Respiratory Therapists Need Continuing Education?
Usually.
Credential and license renewal may require:
- Continuing education
- Renewal fees
- Continuing competency requirements
Requirements differ between NBRC credential maintenance and individual state licensing boards.
Check both.
How to Choose a Respiratory Therapy School
Before enrolling, evaluate:
Accreditation
Confirm the program’s current status through CoARC.
Graduation Rate
Look at how many enrolled students successfully complete the program.
Credentialing Exam Performance
Ask about graduates’ NBRC examination performance.
Job Placement
Programs may publish employment outcomes for recent graduates.
Clinical Sites
Find out where students complete clinical rotations.
Cost
Compare:
- Tuition
- Fees
- Books
- Clinical expenses
- Transportation
- Living costs
Degree Type
Decide whether an associate or bachelor’s program better fits your goals.
Questions to Ask Before Enrolling
Ask prospective programs:
- Is the program currently CoARC accredited?
- What degree will I earn?
- How long does the program take after prerequisites?
- Which prerequisite courses are required?
- What is the total estimated cost?
- Where are clinical rotations completed?
- What percentage of students graduate?
- What percentage pass NBRC exams?
- What percentage find jobs after graduation?
- Will the curriculum prepare me for the 2027 NBRC examination structure?
That final question is particularly relevant for students entering school now.
Is Becoming a Respiratory Therapist Worth It?
That depends on your goals.
Potential advantages include:
- Entry with an associate degree
- Median pay above the national median for all occupations
- Strong projected employment growth
- Direct patient care
- Work in critical-care settings
- Opportunities to specialize
Potential challenges include:
- Nights, weekends, and holidays
- Exposure to infectious disease
- Physically demanding work
- Emergency situations
- Critically ill patients
- Emotional stress
- Continuing education and licensing requirements
The profession may be a strong fit for someone who enjoys:
- Science
- Technology
- Patient care
- Problem-solving
- Fast-paced clinical work
A Simple Respiratory Therapist Career Roadmap
| Stage | What You Need to Do |
|---|---|
| High school | Focus on biology, chemistry, physics, and math |
| College preparation | Complete required prerequisites |
| RT education | Enroll in an appropriate CoARC-accredited program |
| Degree | Earn at least an associate degree |
| Clinical training | Complete supervised rotations |
| Credentialing | Pass applicable NBRC examination requirements |
| State licensing | Apply where required |
| First job | Hospitals are the largest employer |
| Career development | Maintain credentials and consider specialization |
The Bottom Line
The standard path to becoming a respiratory therapist in the United States is:
High school → accredited respiratory therapy program → associate or bachelor’s degree → clinical training → NBRC credentialing → state license → employment.
For most students, the process takes around two to four years, although prerequisites and program structure can extend that timeline.
An associate degree is currently the typical entry-level education.
Before choosing a school, verify that its respiratory therapy program meets current CoARC and NBRC requirements.
Students graduating around 2027 should pay particular attention to the NBRC credentialing transition. Beginning January 1, 2027, a new Respiratory Therapy Examination will determine CRT and RRT credentialing based on two cut scores.
The career outlook remains favorable. Respiratory therapists earned a $82,280 median annual wage in May 2025, and employment is projected to grow 9% between 2025 and 2035.
Frequently Asked Questions
How long does it take to become a respiratory therapist?
Most students take about two to four years. An associate respiratory therapy program commonly takes about two years after required prerequisites, while a bachelor’s degree usually takes around four years.
What degree do you need to become a respiratory therapist?
Respiratory therapists typically need at least an associate degree in respiratory therapy from an appropriate accredited entry-to-practice program. Some employers prefer candidates with bachelor’s degrees.
Can you become a respiratory therapist in two years?
Yes, some students can complete an associate respiratory therapy program in about two years after prerequisites. The total timeline may be longer if prerequisite courses must be completed first.
Do respiratory therapists need a license?
Yes in most of the United States. BLS reports that respiratory therapists must be licensed in all states except Alaska, although requirements vary by state.
What is the difference between CRT and RRT?
CRT means Certified Respiratory Therapist, while RRT means Registered Respiratory Therapist. They are professional credentials issued by the National Board for Respiratory Care. Starting January 1, 2027, the new Respiratory Therapy Examination will use two cut scores to determine CRT and RRT credentials.
What exam do respiratory therapists take?
Through the end of 2026, eligible candidates typically follow the existing NBRC TMC and, where applicable, CSE pathway. Beginning January 1, 2027, NBRC will introduce a new Respiratory Therapy Examination that awards CRT or RRT credentials according to the score achieved.
How much do respiratory therapists make?
The median annual wage for respiratory therapists was $82,280 in May 2025 according to the U.S. Bureau of Labor Statistics. Actual earnings vary by location, experience, employer, shift, and specialty.
Is respiratory therapy a growing career?
Yes. BLS projects respiratory therapist employment to increase 9% from 2025 through 2035, with about 8,600 openings projected annually on average.
Is respiratory therapy school difficult?
It can be demanding because students study anatomy, physiology, pharmacology, cardiopulmonary diseases, mechanical ventilation, and critical-care concepts while also completing clinical training.
Do you need a bachelor’s degree to become a respiratory therapist?
No. An associate degree is currently the typical entry-level education, although some employers prefer applicants with bachelor’s degrees.
Can you become a respiratory therapist completely online?
Entry-level training cannot realistically be completed entirely online because respiratory therapy programs require hands-on laboratory and supervised clinical experience. Some academic coursework may be available online.
Where do respiratory therapists work?
Most work in hospitals, including emergency departments, intensive care units, and neonatal ICUs. Others work in nursing facilities, physician offices, pulmonary clinics, home care, sleep centers, and other healthcare settings.
