Keep people breathing: ventilators, oxygen, blood gases and the worst nights in the hospital. Two years of college to get licensed.
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What you earn and what it costs to get there.
Median
$82,280
Bottom tenth
$63,660
Top tenth
$118,050
The national median is $82,280 a year, and the bottom tenth start near $63,660. This job has its own line in the federal wage survey, so nothing here is borrowed from a wider group. California, Washington and the Northeast pay well above the middle; much of the South pays below it.
About $64,000 to $72,000
Two years after high school, with an associate degree
Very few two-year degrees start here. Night, weekend and holiday differentials are paid on top from your first month, and they add up fast in a department that runs around the clock.
$118,050 or more
Intensive care and neonatal units, supervisors, expensive states
Overtime and extra shifts drive most of it, and hospitals are short staffed enough that they are always on offer. Specialty credentials in critical care, neonatal work and sleep medicine add a further few dollars an hour.
Tuition, fees, exams and kit. Not rent, food or travel
The low end is a two year community college associate degree at in district rates, about $5,000 for the whole program, plus a few hundred dollars for the entry level national board exam and roughly $300 for the state licence, uniforms, a stethoscope and immunizations. The high end is a four year bachelor's degree at an in state public university at roughly $11,000 a year, plus the advanced board exam and the same licence costs. Either way you finish owing far less than the job pays. Continuing education and licence renewal are small ongoing costs after that.
The community college route usually leaves under $15,000 of debt against a job paying near $80,000. File the FAFSA (Free Application for Federal Student Aid) every year, because Pell Grants cover much of community college tuition and never have to be repaid.
Shift differentials
Extra pay per hour for nights, weekends and holidays, which is most of the schedule in this job.
Three-day weeks
Twelve-hour shifts mean three days on and four off in most hospitals.
Public Service Loan Forgiveness
Nonprofit and government hospitals qualify, cancelling federal loans after 10 years of payments.
Tuition help to finish a bachelor's
Hospitals commonly pay for staff to top an associate degree up to a four-year one.
Overtime whenever you want it
Staffing shortages mean extra shifts are almost always available at a premium rate.
The exact path from high school to qualified.
An accredited two-year degree, national board exams, then a state license.
High school
Grades 11 and 12
Biology, chemistry, algebra and physics. Physics matters more here than in most health careers, because you spend your life on gases and pressure.
Get into an accredited program
Apply a year ahead
It must be accredited by the Commission on Accreditation for Respiratory Care, or the national exams are closed to you. Most are associate degrees at community colleges; some are bachelor's degrees.
Classroom, lab and clinical rotations
2 years
Lung anatomy, ventilator mechanics, blood gas analysis and pharmacology, alongside hundreds of supervised hours in real hospital units.
Pass the board exams
2 to 4 months
The entry exam leads to the CRT (Certified Respiratory Therapist) credential. Score above the higher cut and sit a clinical simulation exam and you earn the RRT (Registered Respiratory Therapist), which most hospitals now require.
State license and first job
1 to 3 months
Apply to your state's licensing board, then join a hospital respiratory department, usually with several months of supervised orientation.
Biology
Anatomy and physiology of the lungs and heart is the spine of the whole program.
Chemistry
Blood gases are chemistry, and you read them several times a shift.
Physics
Pressure, flow and volume are the entire mechanical side of the job.
Algebra
Ventilator settings and drug doses are calculations you cannot get wrong.
Nearly every state licenses respiratory therapists, and you cannot work without that license. The credential behind it is national and comes from NBRC (the National Board for Respiratory Care), which reports more than 313,000 professionals holding its credentials. Two levels matter: the certified level to get started and the registered level that most hospitals actually hire at. The board has announced changes to its examinations coming in 2027, so check the current structure before you plan around it.
Community colleges
Valencia College in Florida and hundreds like it run the standard two-year respiratory care degree.
State universities
A growing number offer it as a four-year degree, which helps later if you want to teach or supervise.
Hospital-linked programs
Some large hospital systems partner with a college and hire their graduates directly.
Check accreditation first
The national accreditation commission lists every approved program. If a school is not on that list, the exams are closed to you.
Things you don't need, but that help.
All earned after you are working, from the same national board.
Adult critical care specialist
For therapists who live in the intensive care unit. One of the most respected add-ons.
Neonatal and pediatric specialist
Babies in the newborn intensive care unit, some weighing under two pounds. Highly specialized and hard to staff.
Sleep disorders specialist
Sleep labs and home testing. Daytime and evening work with no emergencies.
Pulmonary function technologist
Lung function testing in clinics, with regular hours and no weekends.
CPR certification
Required anyway, and you will be on the resuscitation team from your first week.
A job as a hospital transporter or aide
Paid work that teaches you how a hospital actually moves.
Calm under pressure
You are called to the worst moments in the building, and you arrive ahead of the doctor.
A driver's license
Home care and sleep lab jobs involve driving between patients.
Most therapists stay at the bedside because it pays well and the schedule suits them. Others move into charge or supervisor roles, into teaching in a college program, or into selling and supporting ventilators for a device manufacturer, which pays more and stops the night shifts. A growing number top up to a bachelor's or master's and move into advanced practice, management or pulmonary research.
Day to day, pros and cons, where you'd work.
Twelve hours, often overnight. You start with a list of patients across several floors: breathing treatments, checking oxygen, drawing arterial blood and reading the gases. In the intensive care unit you manage ventilators, adjusting settings when a patient's lungs change. Then the alarm goes: a cardiac arrest, a trauma, a baby in trouble. You run, and you are the one who manages the airway. Between all that, charting, equipment checks and teaching a patient with asthma how to use an inhaler.
The good
The hard parts
Things people don't tell you.
The national board issues a certified level and a registered level from the same entry exam: score above the higher cut, sit a clinical simulation exam, and you are registered. Most hospitals now advertise only for the registered level, so treat it as the real target rather than a bonus.
When a patient stops breathing anywhere in the hospital, the respiratory therapist is part of the response and usually takes the airway. Few two-year qualifications put you at the center of a crisis that fast.
The National Board for Respiratory Care has announced a new respiratory therapy examination arriving in 2027. Anyone starting a program now should check the current exam structure with the board rather than relying on an older description of it.
The government occupation profile gives respiratory therapy a Bright Outlook: rapid growth and large numbers of openings expected. An older population with more lung disease, plus what hospitals learned about ventilators during the pandemic, is why.
Last checked September 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise.