How to become a Respiratory Therapist (RRT)
Respiratory Therapists evaluate, treat, and manage patients with breathing or cardiopulmonary disorders — from neonatal-intensive-care ventilator management to outpatient COPD therapy. About 137,000 RTs work nationally per BLS, concentrated in hospital critical-care + emergency settings.
Education
Two accredited pathways: an Associate of Science in Respiratory Therapy (typically 2 years at a community college) or a Bachelor of Science in Respiratory Therapy/Care (4 years). Both qualify the candidate to sit for the credentialing exams. CoARC (Commission on Accreditation for Respiratory Care) accredits programs; only graduates of CoARC programs are eligible for the NBRC exams.
Credentialing
The National Board for Respiratory Care (NBRC) administers two exams: the Therapist Multiple Choice (TMC) and the Clinical Simulation Examination (CSE). Passing the TMC at the lower cut score = CRT (Certified Respiratory Therapist). Passing both TMC at the higher cut + CSE = RRT (Registered Respiratory Therapist), the standard credential most hospitals require. RRT is required at most US hospitals and is the credential most employers post for.
State license
After NBRC certification, candidates apply for state licensure (49 states + DC license RTs; Alaska does not). Renewal is typically every 2 years with continuing-education requirements.
Specialties + advanced credentials
RTs can earn advanced specialty credentials through NBRC: NPS (Neonatal/Pediatric Specialist), ACCS (Adult Critical Care Specialist), SDS (Sleep Disorders Specialist), CPFT/RPFT (Pulmonary Function Technologist). Many hospital RTs specialize in NICU, adult ICU, ECMO, or sleep medicine after a few years of bedside experience.
Practice settings
Hospitals employ ~80% of RTs — ICU, ED, NICU, PACU, and the floor for cardiac/pulmonary monitoring. The rest spread across home respiratory care (CPAP/BiPAP, home oxygen), sleep labs, pulmonary rehab clinics, and dive-medicine + transport teams. The role expanded significantly during COVID-19; demand remains elevated.