How to Become a Respiratory Therapist

A respiratory therapist cares for patients who have trouble breathing — from newborns with underdeveloped lungs to adults with asthma, COPD, or critical illness. Becoming one follows a clear, structured path: an accredited associate or bachelor's degree, a national board credential from the NBRC, and a state license. It is a clinical, patient-facing career with strong demand and defined advancement.

This guide is informational only and is not career or medical advice. Program, credentialing, and licensing rules change, so confirm current requirements with the accrediting and certifying bodies and your state board before making decisions.

What a Respiratory Therapist Does

Respiratory therapists (RTs) assess, treat, and monitor patients with cardiopulmonary conditions. On any given shift, an RT might manage a ventilator in an intensive care unit, administer breathing treatments, perform lung-function testing, respond to emergencies, or educate a patient on managing a chronic condition at home.

RTs work across many settings — hospitals, emergency departments, neonatal and pediatric units, sleep labs, home health, and rehabilitation. The role is hands-on and collaborative, working alongside physicians and nurses as part of the care team. Because it is a genuinely clinical, patient-facing position, it suits people who want direct involvement in treatment and are comfortable in high-acuity environments.

The Education Path

The foundation of this career is a degree from a program accredited by the Commission on Accreditation for Respiratory Care (CoARC). This accreditation is not optional in practice — it is the gateway to board eligibility.

• Associate degree: The traditional entry point, typically two years, covering anatomy, physiology, pharmacology, cardiopulmonary science, and extensive supervised clinical rotations.
• Bachelor's degree: Increasingly common and often preferred for advancement, leadership, and specialized roles.

An important, evolving detail: the field has been moving toward requiring the advanced-level credential for licensure, and eligibility rules for the board examinations are changing. Confirm the current degree and program-level requirements directly with CoARC and the NBRC before you enroll, because the pathway that qualifies you can depend on when you graduate. You can locate accredited programs through the CoARC program directory.

Strong clinical rotations are the heart of the degree. When you later build your resume, those rotations are among your most valuable evidence — our guide on the healthcare resume skills section covers how to present clinical experience so it reads as job-ready.

Certification: CRT and RRT

Credentialing is handled by the National Board for Respiratory Care (NBRC), and it centers on the Therapist Multiple-Choice (TMC) Examination. How you perform on that exam determines your credential.

The CRT is the entry-level credential. The RRT is the advanced credential most hospitals now prefer, and it generally requires both a higher score on the TMC exam and success on a separate Clinical Simulation Examination. Because board-eligibility policies are changing, verify the current exam structure and degree prerequisites with the NBRC directly.

State Licensure

Certification alone does not let you practice. Nearly every state that regulates respiratory care requires a state license, and those licenses are almost universally built on holding the NBRC's CRT or RRT credential. Beyond the credential, states may require additional items such as basic and advanced life-support certifications (for example BLS, ACLS, PALS, or NRP), an application, and fees.

Requirements differ from state to state, so check with the specific state board where you intend to work. If you plan to relocate, confirm how your credential and license transfer before you move.

Salary, Outlook, and Advancement

Respiratory therapy is a stable, in-demand allied-health career. For authoritative, current figures on pay and projected growth, consult the U.S. Bureau of Labor Statistics (BLS) Occupational Outlook Handbook, which the BLS updates regularly — this is the reliable source rather than any single quoted number.

Advancement is well-defined. With the RRT credential and experience, therapists can move into specialty areas such as neonatal-pediatric, adult critical care, or sleep, and into supervisory, education, and management roles. Many of these specialties carry their own additional NBRC credentials.

One reason the outlook holds steady is that respiratory care spans the full arc of life and acuity — neonatal units, emergency departments, chronic-disease management, and home health all rely on RTs. That breadth gives the career resilience: when demand shifts in one setting, trained therapists can often transfer their skills to another. It also means you can shape a long-term direction, from high-intensity critical care to community-based patient education, without leaving the profession.

Preparing for the Job Search

Once credentialed and licensed, a focused job search makes the difference. Keep a few principles in mind:

• Feature your credentials prominently. RRT or CRT, plus your license and life-support certifications, belong near the top of your resume.
• Show your clinical range. Name the units and patient populations from your rotations — ICU, neonatal, emergency — to signal readiness.
• Prepare for behavioral interviews. Respiratory care is high-stakes and team-based, so employers probe how you handle pressure and communicate. Practicing structured answers, as covered in our STAR method for healthcare interviews guide, helps you tell those stories clearly.
• Keep credentials current. Track your NBRC recertification and state renewal deadlines from day one.

Frequently Asked Questions

How long does it take to become a respiratory therapist? Typically about two years for an associate degree, or four for a bachelor's, followed by passing the NBRC exam and obtaining a state license. Because eligibility rules are shifting toward advanced-level requirements, confirm the current path with CoARC and the NBRC.

What is the difference between CRT and RRT? Both come from the NBRC. The CRT is the entry-level credential earned by passing the TMC exam at the standard level; the RRT is the advanced credential, earned with a higher TMC score plus the Clinical Simulation Examination, and is preferred by many employers.

Do I need a license to work as a respiratory therapist? In nearly all regulating states, yes. State licensure is required and is built on holding the NBRC credential, sometimes with added requirements like life-support certifications. Check your specific state board.

Is an associate or a bachelor's degree required? Historically an associate degree was sufficient, but the field is moving toward advanced-level requirements for the top credential and licensure. Verify current degree requirements with CoARC and the NBRC before enrolling.

What is the job outlook for respiratory therapists? Demand is strong and generally growing. For current growth projections and wage data, refer to the BLS Occupational Outlook Handbook as the authoritative source.

The Takeaway

Becoming a respiratory therapist means completing a CoARC-accredited degree, earning the NBRC's CRT or RRT credential through the TMC examination, and securing a state license — a clear, well-marked path into a hands-on clinical career with strong demand and defined advancement. Because degree and board-eligibility rules are actively changing, confirm the current requirements with CoARC, the NBRC, and your state board, and check the BLS Handbook for the latest pay and outlook data before you commit.