How to Become a Respiratory Therapist in North Carolina

As of May 2013, North Carolina ranked in the top third of states in the U.S. in terms of employment of respiratory therapists.

The North Carolina Respiratory Care Board regulates the practice of respiratory care through the licensure of respiratory care practitioners. The Board recognizes a respiratory care practitioner as any person licensed by the Board to engage in the practice of respiratory care.

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If you want to become a respiratory therapist in North Carolina, you must be able to successfully complete the following:

Complete an Approved Education Program in Respiratory Therapy
Apply for a Provisional License, if Necessary
Take the Entry-Level Examination for Licensure
Apply for Licensure as a Respiratory Care Practitioner in North Carolina
Apply for Advanced Practice Registration
Maintain your Respiratory Therapist License



Step 1. Complete an Approved Education Program in Respiratory Therapy

The first step to becoming a respiratory care practitioner in North Carolina involves the completion of a respiratory therapy education program approved by the Commission on Accreditation for Respiratory Care (CoARC).

There are currently 14 CoARC-accredited programs in North Carolina, 14 of which are associate degree (AS, AAS) programs. In 2012, 834 individuals applied to respiratory therapy programs in North Carolina, a slight decrease from 2011, which had 880 applicants.

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CoARC-accredited programs may be associate or bachelor degree programs. Currently, the minimum requirement for licensure in North Carolina is an associate’s degree; however, the Bureau of Labor Statistics reports that, due to an increase in competition in this profession and due to demand from employers, candidates are more often choosing to complete a bachelor’s degree.

Although each respiratory therapy degree program will differ slightly in terms of structure and curriculum, you can expect your CoARC-accredited program to be designed to allow you to master skills in patient assessment and the treatment of cardiopulmonary diseases. You can also expect the degree to culminate in a clinical experience that will allow you to apply your education in a real-world setting and interact with members of the healthcare team.

Coursework in a respiratory degree program often includes study in:

  • Anatomy and physiology
  • Microbiology
  • Therapeutics/diagnostics
  • Pathophysiology
  • Critical care concepts



Step 2. Apply for a Provisional License, if Necessary

You may apply for a provisional license if you have completed your educational requirements but have not taken the required examination. To qualify for the provisional license, you must show proof that you have registered to take the NBRC entry-level examination.

During the provisional licensure period, which may not exceed 12 months, you must work under the direct supervision of a respiratory care practitioner.

The required application forms and information regarding provisional licensure are available by contacting the Board at 919-878-5595.



Step 3. Take the Entry-Level Examination for Licensure

To qualify for licensure as a respiratory therapist in North Carolina, you must take and pass the National Board for Respiratory Care’s (NBRC) entry-level examination, the Certified Respiratory Therapist (CRT) examination.

Upon passing the CRT examination and achieving the CRT credential, you may choose to take the Registered Respiratory Therapist (RRT) examination and achieve the RRT credential, which is considered the “standard of excellence” is respiratory care.

Although not required for initial licensure in North Carolina, you must pursue the RRT credential if you plan to apply for advanced practice registration in North Carolina (see Step 5).

All NBRC examinations are administered through AMP assessment centers. Therefore, you must register to take either the CRT or RRT examination through AMP’s online registration system. In North Carolina, you may take the examination at one of the following AMP assessment centers:

  • Asheville
  • Charlotte
  • Durham
  • Fayetteville
  • Gastonia
  • Greensboro
  • Raleigh
  • Wilmington
  • Winston-Salem



Step 4. Apply for Licensure as a Respiratory Care Practitioner in North Carolina

You can apply for a respiratory therapist license in North Carolina by completing a paper Application for Licensure or through the North Carolina Respiratory Care Board’s online services system.

In addition to the completion of the application for licensure, you must provide the Board with:

  • A 2×2 passport-style photograph
  • An official transcript from the respiratory care program from which you graduated (must be sent directly to the Board from the educational institution)
  • A copy (front and back) of your current BLS/CPR certification from the American Heart Association or the American Red Cross or the American Safety and Health Institute
  • Verification of your NBRC credential (complete Attachment 1 of the application packet and mail it back to NBRC, along with a $5 fee if you are an active NBRC member or $20 if you are an inactive member)
  • Licensure/application for $175 made payable to the North Carolina Respiratory Care Board
  • Notarized affidavit (Section H of the application packet)

You must mail the application packet and related documentation in a 9×12 envelope via UPS or FedEx so you can track delivery.

You can expect to receive a notice when the Board receives your application, which includes a background check packet. You must return the enclosed fingerprint card, related forms, and a $38 money order or certified check to the Board. Your license will not be issued until the NC SBI processes your fingerprints. You can expect this process to take about 2 weeks.



Step 5. Apply for Advanced Practice Registration

You may pursue advanced practice registration (endorsement) for your North Carolina in the following areas:

  • Conscious Sedation (Moderate Sedation)
  • Critical Care Advanced Practice Transport
  • ECMO (Extracorporeal membrane oxygenation
  • Advanced cardiac stress testing (pharmaceutical stress testing)

To qualify for one or more of the above endorsements, you must possess specific training, education, and experience credentials, as well as the RRT credential. More information on advanced practice registration for respiratory therapists in North Carolina can be found here.



Step 6. Maintain your Respiratory Therapist License

All respiratory care practitioner licenses in North Carolina must be renewed annually. Renewals can be completed online. You can expect to receive a renewal notice about 30 days prior to the expiration date of your license.

You must complete 12 hours of continuing education annually to qualify for renewal. You can view a list of approved North Carolina CE providers here. Although currently all CE can be completed through home-study or self-study courses, the Board is proposing a change to CE requirements, requesting that license holders should receive at least 6 hours of CE from workshops, panels, lectures, seminars, or symposiums, all of which provide opportunity for direct interaction between the speakers and the participants. Updated information on the outcome of this proposal can be found on the Board’s website.

The largest employer of respiratory therapists is undoubtedly hospitals. Therefore, licensed respiratory care practitioners in North Carolina often find an abundant of employment opportunities through the state’s largest hospital systems:

  • Pitt County Memorial Hospital, Greenville
  • Carolinas Medical Center, Charlotte
  • Duke University Hospital, Durham
  • Forsyth Medical Center, Winston-Salem
  • Wake Forest Baptist Medical Center, Winston-Salem

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