Respiratory therapists complete a three-year accredited program with clinical training, pass the Health Professionals Testing Canada national exam (formerly the CBRC exam), then register with the provincial regulator — licensing in eight provinces, national certification elsewhere.
Applies in: across Canada
Becoming a respiratory therapist in Canada is a chain with three links that all have to hold: an accredited three-year program, a national examination, and registration in the province or territory where you will practise. The program and the examination are national in character. The registration is not: eight provinces licence the profession through a regulator, while the remaining provinces and the territories run on national certification. That split is the single most useful fact in this guide, because most career advice online either describes the American system — an associate degree, the CRT and RRT credentials from the United States National Board for Respiratory Care — or describes one college's program as if it were the whole country. Neither is the Canadian path. The Canadian path is the one Job Bank states for NOC 32103: a three-year college or university program in respiratory therapy including clinical training, licensing in eight provinces, and national certification available in the rest.
The work itself is cardiopulmonary care: the diagnosis, treatment, rehabilitation, and education of patients with heart and lung disorders, in hospitals and in community and home-care settings, for patients of all ages. In practice that means ventilatory support, including therapeutic and clinical follow-up and withdrawal management; diagnostic tests such as respiratory volume assessments and blood-gas sampling; clinical monitoring of patients under anaesthesia; mixing, administering, and adjusting medications as prescribed; and taking care of and operating pulmonary and circulatory equipment. In Quebec, where the profession is inhalothérapie and the regulator is the Ordre professionnel des inhalothérapeutes du Québec, a certificate is additionally required to prescribe smoking-cessation medication. The settings are shift work in intensive care, emergency departments, operating rooms, diagnostic laboratories, and sleep and home-care services — work done in close proximity to patients, in personal protective equipment, often at night and on weekends.
The entry credential is the completion of a three-year college or university degree program in respiratory therapy, including clinical training, as Job Bank states it. Accreditation is what makes a program count: Accreditation Canada accredits respiratory therapy education programs, and regulators approve on that basis — the College of Respiratory Therapists of Ontario (CRTO), for example, approves schools accredited by Accreditation Canada, and graduates of approved programs are eligible to register in its Graduate class and to write the national examination.
Do not enrol on a school's marketing claim of accreditation alone. Check two lists before you apply: Accreditation Canada's current program status, and the approved-program list of the regulator in the province where you intend to practise. Programs change status, and new programs start before their accreditation is settled — the CRTO's Ontario list, for example, notes that Fleming College's approved status took effect May 13, 2025, and that Humber Polytechnic has launched a new program whose accreditation status applicants should confirm with the college directly. The Ontario approved list otherwise names Algonquin College in Ottawa, Canadore College in North Bay, Conestoga College in Kitchener, Fanshawe College in London, La Cité collégiale in Ottawa, St. Clair College in Windsor, and The Michener Institute of Education at UHN in Toronto.
Outside Ontario, the same check applies, with the school names differing. In Alberta, the Northern Alberta Institute of Technology in Edmonton and the Southern Alberta Institute of Technology in Calgary both run three-year diploma programs. In British Columbia, Thompson Rivers University's program is accredited and offers both a three-year diploma and a four-year dual-credential route combining the diploma with a Bachelor of Health Science. In Quebec, training is offered mainly in French. The pattern to carry across provinces is the three-year length with clinical training, not any one school's admission grid: admission requirements are set by each school, are competitive, and change. As a sense of the bar, the Northern Alberta Institute of Technology asks for 63% in each of Grade 12 English, mathematics, biology, and chemistry plus an online interview, and the Southern Alberta Institute of Technology asks for at least 60% in mathematics, English, and chemistry at the Grade 12 level. Treat those as two schools' published thresholds, not as a national admission standard, and confirm the current requirements on the program page you will actually apply to.
The program combines classroom study — cardiopulmonary anatomy, chemistry, theory, pharmacology, and pathophysiology — with laboratory work and clinical placements in hospitals and other care settings. The clinical component is not an add-on: Job Bank's requirement is a program "including clinical training," and the placements are where students work in intensive care, emergency, anaesthesia, and diagnostic settings under supervision. Expect placement requirements of the kind other Ontario health programs impose — immunization records, police checks, and current basic life support certification — and assemble them early, because a missing placement document pushes a placement to a later term, which pushes graduation, which pushes the examination.
One decision belongs at application time, not later: language. Quebec's programs are offered mainly in French, and La Cité collégiale in Ottawa is the French-language Ontario option on the CRTO list. Switching languages mid-program is not a realistic option, and practising in Quebec requires the French proficiency the professional system imposes. If you intend to work in a French-language service, apply to the French-language program.
After the program, graduates write the national entry-to-practice examination administered by Health Professionals Testing Canada (HPTC). The name is the trap for anyone researching with older sources: the examination was long known as the CBRC examination, after the Canadian Board for Respiratory Care, which produced it from 1989. On March 2, 2023, Corporations Canada approved the new operating name Health Professionals Testing Canada Inc., because the CBRC name was often confused with a regulatory board. The Manitoba Association of Registered Respiratory Therapists states the rename and the date plainly, and the CRTO's examination fact sheet accepts the HPTC Respiratory Therapist Exam as the approved examination while noting it was formerly the CBRC examination. Job postings, college pages, and study guides that still say CBRC are describing the same examination.
Two practical points follow from the rename. First, apply and pay through HPTC: the CRTO's fact sheet states that first-time writers who are or will be graduates of approved programs are automatically eligible, and that candidates apply and pay directly to HPTC. Second, do not plan around an old candidate manual. Manuals found online from 2020, 2022, and 2023 disagree on the number of questions and the time allowed in each part, which means at least some of them describe a format no longer in use. Confirm the current format, sitting dates, and fee with HPTC itself.
Ontario also publishes the consequence of repeated failure, and it is stricter than most applicants expect. Individuals who fail the examination three times are not eligible to rewrite until they submit a study plan approved by the CRTO Registration Committee; once approved, they may attempt the examination one more time, and if that fourth attempt is unsuccessful, they are not permitted to challenge the examination again until they have re-enrolled in and completed an approved respiratory therapy program. That is an Ontario rule stated in Ontario's registration regulation, not a national attempt limit — but it shows why the examination deserves syllabus-led preparation on the first attempt, not a casual first sitting treated as a practice run.
Registration is where the provincial split bites. In the eight licensing provinces, you must be registered with that province's regulator to practise, and the regulator sets the requirements beyond the program and the examination: good character declarations, language proficiency, currency of education or practice, and its own application and registration fees. In Ontario, the requirements include graduation from a CRTO-approved program, successful completion of the HPTC examination, and the ability to communicate effectively in English or French in a health-care environment. In Alberta, the published requirements are successful completion of an approved education program and an approved examination, two declarations of personal character, at least 1,500 hours of acceptable work experience within the last four years, and at least 48 continuing competency hours within the last two years.
In Prince Edward Island, British Columbia, Yukon, the Northwest Territories, and Nunavut, Job Bank states that a national certification is available instead of provincial licensing. The Canadian Society of Respiratory Therapists (CSRT) is the national professional association behind that certification route, and foreign-trained writers in those jurisdictions have their examination eligibility approved by the CSRT. The distinction matters for mobility: holding the national certification is not the same administrative act as holding a provincial licence, and moving from a certification jurisdiction into a licensing province means applying to that province's regulator, which assesses the application under its own rules. Labour mobility between regulated provinces eases that process, but it does not remove the application.
Graduates do not always have to wait for the examination result before working. Ontario may grant a Graduate Certificate of Registration for up to eighteen months before the approved examination is completed, which lets a new graduate practise under the certificate's conditions while the examination step is finished. Alberta has a provisional registration category for therapists who have completed the education requirement and must work under the supervision of a registered respiratory therapist or another approved regulated health professional. Both routes are time-limited and supervised in effect; neither is a substitute for passing the examination and holding the general certificate.
Registration is not a one-time event. Regulators require evidence of continued practice and continuing competency at renewal, and the numbers are published per regulator rather than nationally. Alberta's picture is the clearest published example: 1,500 practice hours in the four-year period before a renewal application, under Alberta's Respiratory Therapists Profession Regulation, and 48 continuing competency hours within the last two years, as stated on the Alberta ALIS profile. Other regulators publish their own renewal cycles and competency requirements, and the figures differ. Do not carry Alberta's hours into another province's renewal, and do not assume a regulator's renewal rules are the same as its initial-registration rules.
If you trained outside Canada, start with the regulator, not with a school. Ontario's route requires an assessment acceptable to the Registration Committee demonstrating knowledge, skills, and judgement equivalent to a graduate of an approved program, plus any additional education, remediation, or supervised practice the Committee requires, and the HPTC examination, which is non-exemptible. Alberta operates a Foreign Qualification Recognition pathway through its regulator. In both cases the assessment is individual, and the examination eligibility for foreign-trained writers is approved by the regulator or, for the non-regulated provinces, by the CSRT. Contact the regulator in the province where you intend to practise before enrolling in anything, because a bridging course that no regulator asked for is money spent on the wrong step.
A respiratory therapist's day is built around machines that breathe for people and tests that say how lungs and hearts are performing. The core is airway and ventilator management in intensive care: setting up and adjusting ventilators, monitoring blood gases, suctioning and maintaining airways, and weaning patients from ventilatory support. Around that core sit diagnostic tests — pulmonary function testing, cardiac stress testing, sleep studies, and blood analysis — plus anaesthesia assistance, neonatal and paediatric respiratory care, and patient education for chronic conditions such as asthma and chronic obstructive pulmonary disease. Home-care and medical-equipment roles extend the same skills outside the hospital: setting up home oxygen and ventilation, and teaching patients and families to manage equipment safely.
The demands are physical and emotional in the way intensive-care work always is: lifting and positioning patients and equipment, standing for long shifts, working nights and weekends, and making fast decisions with critically ill patients. The work is also team work under medical direction — with physicians, nurses, and other therapists — and documentation-heavy, because ventilator settings, blood gases, and medication adjustments are clinical records other clinicians act on. Post-diploma specialization exists for those who want it: anaesthesia assistance and polysomnography (sleep studies) are the two directions Algonquin College names for its graduates, and education, research, and administration roles open with experience.
The honest answer depends on what you are comparing it with. Against other three-year college health programs, respiratory therapy is distinctive in one way: the gate is genuinely national — one examination, one competency framework — while the licence is provincial, so the credential travels but the paperwork does not automatically follow. That combination rewards the applicant who picks the province first and checks that province's regulator list before applying to a program, and punishes the applicant who assumes a program that is accredited somewhere is approved everywhere. Against a general health-career path, the advantage is clarity of demand: intensive care, emergency, and anaesthesia services need this skill set in every province, the training route is published by the very bodies that run each link, and the examination rename — CBRC to HPTC — is the only recent change that confuses researchers, not the profession itself. If shift work, intensive-care pressure, and a national examination with a hard failure consequence do not put you off, the path rewards preparation done in the right order: accredited program first, examination second, regulator third — and punishes the one assumption every regulator page warns about indirectly: that graduation alone authorizes practice, when the examination and the registration still stand between the diploma and the first shift.
Plan on three years for the accredited respiratory therapy program, which includes clinical training, then the national examination, then registration with the regulator in the province or territory where you will practise. There is no single published total timeline, because program start dates, examination sittings, and regulator processing all vary, and some graduates work under a graduate or provisional certificate while the examination step is completed. The three-year program length is the fixed part; everything after graduation depends on sitting dates and the regulator's queue. Anyone quoting one total number for every province is guessing.
Both names describe the same examination lineage. The Canadian Board for Respiratory Care (CBRC) produced the Canadian entry-to-practice examination, and on March 2, 2023 Corporations Canada approved the new operating name Health Professionals Testing Canada Inc. (HPTC), because the CBRC name was often confused with a regulatory board. Ontario's College of Respiratory Therapists of Ontario accepts the HPTC Respiratory Therapist Exam as its approved entry-to-practice examination and notes it was formerly the CBRC examination. Older study material and job postings that still say CBRC are referring to the same exam. Do not rely on an old CBRC candidate manual for the current format or timing: the manuals found online disagree with each other on question counts and sitting lengths, so confirm the current format with HPTC before you plan study around it.
Job Bank, drawing on the National Occupational Classification (NOC 32103), states that licensing is required in Newfoundland and Labrador, Nova Scotia, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, and Alberta, and that a national certification is available for therapists working in Prince Edward Island, British Columbia, Yukon, the Northwest Territories, and Nunavut. The regulator names differ by province: the College of Respiratory Therapists of Ontario, the College of Respiratory Therapists of Alberta, the Saskatchewan College of Respiratory Therapists, the Manitoba Association of Registered Respiratory Therapists, the Ordre professionnel des inhalothérapeutes du Québec, the Nova Scotia College of Respiratory Therapists, the New Brunswick Association of Respiratory Therapists, and, in Newfoundland and Labrador, the Newfoundland and Labrador Council of Health Professionals. In the non-licensing jurisdictions, the Canadian Society of Respiratory Therapists represents the national-certification route. The practical point: the program and the national examination are common, but the body you register with, and the certificate you hold, depends on where you will practise. Confirm the current position with that body's registration page before you enrol, because regulatory structures change.
Possibly, through the regulator's assessment route, not by repeating the full Canadian program automatically. In Ontario, an internationally trained applicant must meet the education requirement through an assessment acceptable to the Registration Committee, including any additional education, remediation, or supervised practice the Committee requires, and must successfully complete the HPTC examination, which is non-exemptible. Foreign-trained writers need their examination eligibility approved by one of the regulating authorities or by the Canadian Society of Respiratory Therapists, which represents the non-regulated provinces. Alberta's regulator operates a Foreign Qualification Recognition pathway. Because the assessment is case-by-case and the examination requirement cannot be waived in Ontario, contact the regulator in the province where you intend to practise before enrolling in any bridging course or examination preparation.
This guide does not quote a total, because no all-in figure was verified on a regulator or college page at the time of writing. Tuition is set by each college or university and varies between schools, the national examination has its own fee set by HPTC, and each regulator sets its own application and registration fees. Check the tuition page of the school you apply to, the HPTC examination information, and your regulator's fee schedule, and keep the costs of immunizations, police checks, and clinical-placement travel in the same budget. A guide that quotes one total for every school and every province is inventing it.
Where a figure could not be verified on a regulator, accreditation, or college page at the time of writing — the HPTC examination fee and sitting dates, regulator application and registration fees, college tuition figures, and any salary figure — this guide says so and points to the HPTC examination information, the regulator's fee schedule, or the college's own tuition page instead of carrying a secondary source's figure. Check those pages before you pay anything or plan around a date.