A Respiratory Therapist (RT) is a specialized healthcare practitioner who manages patient breathing across the lifespan. RTs work with individuals experiencing cardiopulmonary problems, from chronic conditions like asthma and emphysema to acute trauma and emergencies. The work involves administering medical gases, managing mechanical ventilators, and performing diagnostic procedures to assess lung function. Entering this profession requires commitment through educational, experiential, and credentialing phases.
Educational Pathways and Timelines
The foundation for becoming a respiratory therapist begins with formal education from an accredited program. Aspiring therapists have two primary routes for entry into the field, each with a distinct timeline and career implications. All programs must be accredited by the Commission on Accreditation for Respiratory Care (CoARC).
The most common path is the Associate of Applied Science (AAS) degree in Respiratory Therapy, which typically takes 19 months to two years of full-time enrollment. This timeline allows the graduate to sit for the national credentialing exams. The AAS degree prepares students for entry-level positions and provides a foundation in cardiopulmonary science and clinical skills.
The second option is the Bachelor of Science (BS) degree in Respiratory Therapy, which requires four years of full-time study. While the AAS qualifies a therapist to practice, the four-year degree may offer more opportunities for career advancement into management, education, or research roles. The additional coursework typically includes advanced topics in leadership and evidence-based practice.
Many therapists who start with an AAS degree later complete a bachelor’s degree through advancement programs, which can take 12 to 24 months. Graduation from a CoARC-accredited program is the first requirement for national certification, regardless of the degree level chosen.
The Crucial Role of Clinical Training Hours
Supervised clinical training is integrated within the educational timeline and represents the practical component of the curriculum. These clinical hours are mandatory for graduation and connect classroom theory with patient care situations. Students must complete between 450 and 1,000 hours of practical experience, though the exact number varies by program and state.
This time is spent primarily in hospitals, where students work under the direct supervision of licensed respiratory therapists. Students gain exposure to diverse patient populations and specialties, including adult critical care, neonatal intensive care, and pulmonary diagnostics. The clinical phase is concentrated, often requiring students to be in the hospital for eight hours a day to master skills like mechanical ventilation and airway management.
Successful completion of these clinical rotations confirms the student’s competency in respiratory care. This experiential phase is a non-negotiable step toward professional practice. Clinical immersion ensures graduates are proficient and confident before they enter the workforce as licensed professionals.
NBRC Certification and State Licensing
The time investment continues post-graduation with securing the necessary credentials and license. All states, except Alaska, require licensure, generally based on passing examinations administered by the National Board for Respiratory Care (NBRC). The first required exam is the Therapist Multiple-Choice (TMC) Examination, which assesses core knowledge for entry into the field.
Achieving the low-cut score on the TMC exam earns the Certified Respiratory Therapist (CRT) credential, the minimum requirement for state licensure. Graduates who achieve the high-cut score on the TMC become eligible for the Clinical Simulation Examination (CSE). Passing both the high-cut TMC and the CSE earns the Registered Respiratory Therapist (RRT) credential, recognized as the standard of excellence by the NBRC and many employers.
Most graduates dedicate 6 to 8 weeks following graduation to study for the TMC exam while the material is fresh. Once the exams are completed, the final step is applying for a state license. Processing the application, background checks, and verification of credentials typically takes two to six weeks, though this varies by state licensing board efficiency.
Variables That Affect the Total Time Investment
The timelines associated with educational pathways represent the minimum time required for a full-time student. Several factors can extend the total time before a therapist is ready to practice.
Prerequisite Coursework
One major variable is the prerequisite coursework required before applying to a CoARC-accredited program. Many programs mandate science courses such as anatomy, physiology, chemistry, and microbiology, which can add six to twelve months if not already completed.
Enrollment Status and Admissions
A student’s enrollment status alters the program duration; a part-time enrollment option may double the AAS timeline from two years to four years. The program’s admissions process can also introduce delays due to competitive entry requirements or capacity limitations. Highly sought-after programs may have application deadlines and wait times for acceptance, adding several months to the start.
Transfer Credits
Transferring credits from previous college work or a prior degree can potentially shorten the overall time, particularly for those pursuing a bachelor’s degree. However, this requires an administrative review that can also take time.
Transitioning to Practice and Entry-Level Employment
With the degree earned and the state license secured, the final phase is the transition into the first professional position. Securing an entry-level job can occur quickly, as the demand for the profession is high. The initial employment period includes a structured orientation or onboarding process at the hiring facility.
This orientation familiarizes the new therapist with the specific equipment, protocols, and culture of the hospital or clinic. Training length varies based on the facility and the complexity of the patient care areas, such as the intensive care unit. Orientations range from two to twelve weeks in general settings, with larger teaching hospitals sometimes offering a four-to-six-month residency program.