How to Become a Respiratory Therapist

Respiratory therapists evaluate and treat patients with breathing disorders — from premature infants with underdeveloped lungs to adults with COPD, asthma, pneumonia, and COVID-related complications. They work in some of the most critical areas of the hospital: ICUs, emergency departments, neonatal units, and pulmonology clinics. If you want a healthcare career with real clinical impact and strong earning potential, respiratory therapy deserves serious consideration.

The BLS reports respiratory therapists earn a median annual wage of $70,540. ICU-based and travel RTs often earn $80,000–$100,000+. Employment is projected to grow 13% through 2033 — much faster than average.

What Does a Respiratory Therapist Do?

RTs are the lung specialists of the clinical team. Core responsibilities include:

• Assessing patients' lung function through pulmonary function testing
• Managing mechanical ventilators in ICU settings
• Delivering aerosol medications and breathing treatments
• Performing arterial blood gas (ABG) analysis
• Assisting with intubation and airway management procedures
• Educating patients on inhaler technique, airway clearance, and disease management
• Responding to respiratory codes and cardiac arrest teams

Step 1 — Complete an Accredited Respiratory Therapy Program

Programs are accredited by the Commission on Accreditation for Respiratory Care (CoARC). Two program types lead to entry-level practice:

• Associate degree (most common): 2 years — covers respiratory anatomy, physiology, pharmacology, equipment operation, and clinical rotations
• Bachelor's degree: 4 years — preferred for management, education, and advanced practice roles

Clinical rotations are a significant component — expect rotations through adult ICU, neonatal ICU, emergency department, and pulmonary function labs.

Step 2 — Pass the NBRC Exams

The National Board for Respiratory Care (NBRC) administers the credentialing exams for respiratory therapists:

1. TMC (Therapist Multiple Choice Exam): Entry-level exam — passing at the "Entry Level" cut score earns you the CRT (Certified Respiratory Therapist) credential
2. RRT (Registered Respiratory Therapist): Achieved by passing the TMC at the "Advanced Practitioner" cut score and passing the CSE (Clinical Simulation Exam). This is the professional standard for hospital employment.

Most employers require or strongly prefer the RRT credential. Aim for the advanced practitioner score on your TMC from the start.

Step 3 — Earn Advanced Credentials

Specialty credentials from NBRC significantly increase earning potential:

• RRT-NPS (Neonatal/Pediatric Specialist): NICU and pediatric critical care — $75,000–$95,000
• RRT-ACCS (Adult Critical Care Specialist): Adult ICU specialist credential
• RRT-SDS (Sleep Disorders Specialist): Sleep lab and polysomnography focus
• CPFT/RPFT (Pulmonary Function Technologist): Diagnostic lung testing

Respiratory Therapy Career Outlook

The respiratory therapy field was reshaped by COVID-19, which dramatically highlighted the critical role RTs play in ICU care. Many hospitals have expanded respiratory therapy staffing and increased pay scales in response. Travel respiratory therapists — working 13-week contracts at understaffed hospitals — can earn $90,000–$120,000 per year with housing stipends.

Check out our Respiratory Therapist career profile for CoARC-accredited programs and salary maps by state.