Respiratory therapists need at least an associate degree from a CoARC-accredited program, though many earn a bachelor’s. After graduating, you take the NBRC’s Therapist Multiple-Choice exam; a higher score qualifies you for the Clinical Simulation exam and the RRT credential. Almost every state then requires a license. The path typically takes two to four years after high school.
What respiratory therapists do
- Critical care: managing ventilators, airway support and arterial blood gases in intensive care units.
- Emergency and rapid response: being part of the team at codes and breathing emergencies.
- Newborns and children: neonatal and pediatric units with tiny patients and specialized equipment.
- Chronic care: asthma and COPD education, pulmonary rehab, sleep labs and home care.
Hospital shifts often run twelve hours, including nights, weekends and holidays. You walk a lot and spend much of the shift on your feet.
Choosing a program
- Associate degree: the most common entry route, about two years including clinical rotations.
- Bachelor’s degree: more programs and employers favor it, and it opens doors to leadership, education and specialty roles.
- Degree advancement: many RTs start with an associate and finish a bachelor’s online while working.
Make sure the program is accredited by CoARC, the Commission on Accreditation for Respiratory Care, or you may not be eligible for the exams. Our guides on starting at community college and certificates vs associate degrees can help.
Exams and licensure in general terms
The National Board for Respiratory Care runs the credentialing exams. The Therapist Multiple-Choice exam has two cut scores: the lower earns the CRT credential and the higher makes you eligible for the Clinical Simulation exam. Passing both earns the RRT, which many hospitals expect. Specialty credentials exist for neonatal, pediatric, adult critical care, sleep and pulmonary function work. State licensure is required in almost every state. Requirements vary by state, so check your state licensing board.
Path from high school, in order
- Take biology, chemistry, algebra and physics. Gas laws and math show up in daily work.
- Volunteer in a hospital or work as a patient care aide.
- Apply to an accredited program and complete prerequisites like anatomy and microbiology.
- Use clinical rotations to try adult ICU, neonatal and emergency settings.
- Pass the NBRC exams and get your state license.
- Look for new grad roles with good orientation, then consider specialty credentials or a bachelor’s.
Before you commit
- Shadow a respiratory therapist in an ICU for part of a shift.
- Ask for informational interviews with RTs in adult, neonatal and home care settings.
- Take an anatomy and physiology course and see if you enjoy the lungs and heart in detail.
- Compare with nursing and paramedic work, which share some skills.
Who thrives and why some switch
RTs who thrive stay calm in emergencies, like technology and machines, and enjoy teaching patients and families. People leave because of shift work, physical demands, stress in critical care and limited advancement without a bachelor’s. Many move into education, management, sales for equipment companies or advanced practice roles. Check the Bureau of Labor Statistics Occupational Outlook Handbook for current pay and outlook.
Changing careers into respiratory care
Respiratory care works well for adults who want meaningful hospital work in about two years. EMTs, medical assistants and military medics often bring useful skills. See changing careers and health science degree options.
Where a mentor helps
A mentor helps a student compare programs, plan prerequisites, stay on track through tough science courses and clinicals, and prepare for the NBRC exams. For high school students, a parent stays involved throughout. Mentors are not credentialed career counselors, admissions counselors or licensing experts; they help you do the research and the work yourself. See career and education mentoring and mentoring for high school students.
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Common questions
How long does it take to become a respiratory therapist?
An associate program takes about two years, and a bachelor’s takes about four. You also need to pass the NBRC exams and get a state license.
What is the difference between CRT and RRT?
Both come from the NBRC. The CRT is earned at the lower cut score on the multiple-choice exam, while the RRT requires the higher cut score plus the Clinical Simulation exam.
Do respiratory therapists need a bachelor’s degree?
An associate degree is the usual minimum, but more employers prefer a bachelor’s, especially for leadership and specialty roles.
Where do respiratory therapists work?
Mostly in hospitals, including ICUs and emergency departments, but also in sleep labs, pulmonary rehab, long-term care and home care.
Get started
Curious about respiratory care and want help planning the steps? Call (888) 305 5422, email contact@blackburnmentoring.com or start with a short assessment. A member of our team reviews every assessment personally and sets up a free intro call.