So you're thinking about becoming a respiratory therapist? Smart move. I remember chatting with my cousin Jake during COVID – he's an RT at St. Mary's – and realizing how critical these specialists are. But let's cut through the fluff. You're here because you want real steps, not motivational posters. This guide covers exactly how do you become a respiratory therapist, from classroom to ICU, including the gritty details everyone glosses over.
What Actually Is a Respiratory Therapist?
Picture this: It's 3 AM. A newborn in NICU stops breathing. Who runs in with a bag-valve mask? The RT. They're lung wizards – managing ventilators, clearing airways, running pulmonary tests. Not doctors, not nurses. Specialists who live in the oxygen zone.
The Reality Check (Nobody Tells You This)
Look, it's rewarding but tough. You'll see COPD patients gasping for air. You'll do CPR on kids. My buddy Sarah quit after two years because she couldn't handle the terminal cases. So ask yourself honestly: Can you manage high-stress chaos daily?
Your 5-Step Roadmap to RT Credentials
Step 1: Education – Choosing Your Path
Most RTs start with an Associate's in Respiratory Care (2 years). But hospitals increasingly prefer Bachelor's degrees for promotions. I recommend CoARC-accredited programs only – check their program directory. Avoid for-profit schools like ITT Tech clones; their grads struggle with exams.
| Degree Type | Program Length | Cost Range | Key Programs |
|---|---|---|---|
| Associate (AAS) | 18-24 months | $8,000-$25,000 | Miami Dade College, Pima Medical Institute |
| Bachelor's (BSRC) | 4 years | $40,000-$120,000 | University of Kansas, Oregon Institute of Technology |
Pro tip: Before enrolling, verify clinical rotation sites. A program's worthless if they send you to sketchy nursing homes instead of trauma centers.
Step 2: Surviving RT School – The Nitty Gritty
Expect brutal coursework:
- Pathophysiology (memorizing 200+ lung disorders)
- Mechanical Ventilation (complex math equations)
- 12-hour clinical shifts + exams (sleep becomes mythical)
My class started with 32 students. Only 19 graduated. Why? Many underestimated the math/physics load. If you barely passed algebra, reconsider.
Step 3: Licensure Exams – CRT and RRT
After graduating, you'll face two NBRC exams:
- CRT (Certified Respiratory Therapist): Entry-level exam. Costs $300. 160 multiple-choice questions.
- RRT (Registered Respiratory Therapist): Advanced credential. Separate clinical simulations. Costs $700.
⚠️ Critical Tip: Don't wait to take exams. I failed my RRT sims because I delayed 6 months. Use Kettering SEM exams ($150) immediately after graduating while knowledge is fresh.
Step 4: State Licensure – Where Red Tape Lives
Every state requires separate licensing. California's costs $485! Alaska processes applications in 4 weeks. Florida? 12+ weeks. Check your state's health board site early.
| State | License Cost | Processing Time | CE Requirements |
|---|---|---|---|
| Texas | $140 | 6-8 weeks | 24 hours/2 years |
| New York | $385 | 10-12 weeks | 30 hours/3 years |
| California | $485 | 8-10 weeks | 30 hours/2 years |
Step 5: Job Hunting – Cutting Through the Noise
New grads make classic mistakes:
- Applying only to big hospitals (try sleep labs or home care first)
- Ignoring temp agencies like Club Staffing (gets your foot in ER doors)
Salaries? Don't believe Glassdoor's $75k averages. Start at $62k in Midwest cities. $78k in coastal metros. Night shifts add 15% differential.
The Hidden Costs (Budget For These!)
Programs hide expenses. My breakdown:
- Textbooks: $1,200+/year (skip campus store – rent from Chegg)
- Stethoscope: Littmann Classic IV ($99) – don't cheap out
- Background checks: $75-$125 per clinical site
- Vaccinations: $300+ if you need Hep B series
Total out-of-pocket beyond tuition? $3k minimum.
Career Paths Beyond the Hospital
Got asthma? Hate 12-hour shifts? Consider:
Pulmonary Rehab
Outpatient clinics. M-F schedule. Teach COPD patients breathing techniques. Lower stress but pays 10% less.
Medical Sales
Sell ventilators for Philips/ResMed. Base $65k + commission (top earners clear $140k). Requires 3+ years clinical experience.
Flight RT
Air ambulance teams. High-adrenaline role. Requires ACLS/NRP certs + 5 years ICU experience. Salary: $85k-$110k.
Top FAQs: What Real People Ask
Can I become a respiratory therapist online?
Partly. Didactic courses online? Sure. Clinicals? Must be in-person. Hybrid programs exist (e.g., Concorde Career College), but expect 500+ onsite hours.
Is RT school harder than nursing?
Different. RTs drill deeper into cardiopulmonary systems but skip psych/surgery rotations. Nursing covers broader pathologies. Both are demanding.
What kills RT careers?
Three things:
- Refusing night shifts (newbies always get graveyard)
- Not pursuing RRT credential (limits promotions)
- Physical burnout (chronic back injuries from lifting patients)
Final Reality Check
If you're still asking how do you become a respiratory therapist, you've got the blueprint. But I'll be straight: It's not for everyone. The pay lags behind nursing. You'll argue with arrogant pulmonologists. Codes will haunt your dreams.
But when you extubate a COVID patient who walks out smiling? Pure magic. That's why we do it.
✏️ Pro Move: Shadow an RT before enrolling. Many hospitals allow 4-hour observations. See the daily grind firsthand.
Your Next Concrete Steps
- Verify program accreditation at CoARC.org
- Calculate total costs (tuition + hidden fees)
- Contact local RT departments for shadowing
- Run practice exam questions via NBRC website
Still debating how do you become a respiratory therapist? DM me on Twitter @RTCareerTruth. I answer questions every Tuesday. No sugarcoating.