How to Become a Respiratory Therapist in Hawaii

Hawaii’s Department of Commerce and Consumer Affairs, Professional and Vocational Licensing division governs the practice of respiratory therapy in the state. This governing body only started licensing respiratory therapists as independent medical professionals in 2011. This being the case, there are relatively few licensed RTs operating in the state. In fact, there were only 230 licensed RTs in Hawaii as of May 2013. However, the average annual income among these allied health professionals is one of the highest in the country, coming in at $66,110.

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Because the requirement for RT licensure is a recent development in the state, there is, as of yet, no respiratory therapy board that operates under Hawaii’s Professional and Vocational Licensing division. Rather, the PVL division handles all licensing, regulation, and discipline concerns related to respiratory therapists throughout the state.

Follow these steps in order to become a respiratory therapist in Hawaii:

Complete an Accredited RT Degree Program
Pass the Required Examination(s)
Apply For Respiratory Therapy Licensure
Maintain Licensure and Pursue Further Education



Step 1. Complete an Accredited RT Degree Program

The first step you must complete before you can be licensed is to earn your degree from a Commission on Accreditation for Respiratory Care (CoARC) accredited program. The minimum acceptable degree that you can hold while qualifying for licensure in Hawaii is an associate’s degree. However, there are schools that offer bachelor’s degrees, which you may pursue to enhance your credentials and practice options.

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There is only one college in Hawaii that offers a degree in respiratory therapy, but if you earn your degree in another state you may fulfill the educational qualifications for practicing in Hawaii.

Some of the classes you can expect to take while earning your degree are:

  • Microbiology
  • Respiratory Care Science
  • Respiratory Care Techniques
  • Neonatal/Pediatric Respiratory Care

Regardless of where you earn your degree, you will be required to complete a clinical rotation. Clinical experience allows you to earn hands-on experience as a respiratory therapist in a controlled environment. The length and intensity of these clinicals will depend on the degree that you are pursuing and the educational institution that you are attending.



Step 2. Pass the Required Examination(s)

For initial licensure in Hawaii, you must pass the Therapist Multiple-Choice (TMC) Examination, leading to the Certified Respiratory Therapist (CRT) credential. If you wish to work in more advanced practice settings, you may go through the exam process required for the Registered Respiratory Therapist (RRT) credential. Both exams are national qualifying exams administered by the National Board for Respiratory Care (NBRC).

CRT Exam

The CRT exam is an entry-level exam that will test your mastery of basic abilities, knowledge, and skills related to respiratory therapy. The test is broken down in the following way:

  • 160 total multiple-choice questions
    • Only 140 questions are scored, while 20 are used as pretest questions by the NBRC

  • There are three distinct content areas that are covered in this exam
    • Clinical data
    • Equipment
    • Therapeutic procedures

  • In order to take this examination, you must have earned at least an associate’s degree from a college or university with an accredited respiratory therapy program
  • There is a free practice test offered by the NBRC for the CRT exam

RRT Exam

The RRT credential is the advanced respiratory therapist credential used to denote the abilities, knowledge, and skills that are expected of advanced respiratory therapists.

The multiple-choice exam that you must take to earn the RRT is the same Therapist Multiple-Choice (TMC) Examination required to earn the CRT, but you are required to achieve a higher passing score before you may move on to the clinical simulation component required for the RRT credential.

The clinical section, called the Clinical Simulation Examination (CSE), is made up of 22 patient management problems, 20 of which are scored. You are allowed four hours for this section.

You may take both sections of the exam on the same day, if scheduling allows.

The only city in Hawaii that hosts a testing center for the CRT and RRT exams is Honolulu.



Step 3. Apply For Respiratory Therapy Licensure

After completing at least your CRT exam, you may apply for licensure as a respiratory therapist by fulfilling these requirements:

  • Be at least 18 years old
  • You must be a U.S. citizen or authorized to work in the United States
  • Submit an application form
  • Pay the appropriate application fee
    • If you are applying between July 1, 2014 and June 30, 2017 – $285
    • If you are applying between July 1, 2017 and June 30, 2018 – $210

  • You must verify your level of certification by attaching a verification letter from the NBRC
  • If you are already licensed in another state, you may apply for a license through endorsement

You may submit all application materials to:

Respiratory Therapists Program
DCCA-PVL Licensing Branch
P.O. Box 3469
Honolulu, HI 96801



Step 4. Maintain Licensure and Pursue Further Education

Respiratory therapist licenses in the state of Hawaii are renewed every three years by June 30th, regardless of the issuance date. The current validity period stretches from July 1, 2014 to June 30, 2017.

The license renewal fee is $285.

The state of Hawaii does not currently have any continuing education requirements, but that is not to say that you should not look to continue your education individually. By pursuing a post-baccalaureate degree, you will be able to increase your pay, provide better care for your patients, and increase your career opportunities.

There are around thirty hospitals in Hawaii that support respiratory therapist jobs, two of which are considered strong performing:

  • Queen’s Medical Center – Honolulu
  • Kaiser Permanente Moanalua Medical Center – Honolulu

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