How to Become a Respiratory Therapist in Ontario

Written November 13, 2026

The short answer

Register with the College of Respiratory Therapists of Ontario (CRTO). You need an approved respiratory therapy program, the Health Professionals Testing Canada (HPTC) exam for a general certificate, and written confirmation from the CRTO that your certificate has been issued before you work — including before an employer's clinical orientation. The application fee is $75. If you have met everything except the exam, a temporary graduate certificate may cover you for up to 18 months.

This guide covers the Ontario registration process only. It gives no advice on whether a particular program qualifies.

Step 1: Complete an approved respiratory therapy program

An applicant must have successfully completed a respiratory therapy program offered in Canada that, at the time of completion, was approved by the Registration Committee, or have completed a program acceptable to the Committee plus any additional education, remediation or supervised practice it requires, and demonstrated equivalent knowledge, skills and judgement through an assessment the Committee accepts.

For approved-program graduates, the proof is an official final transcript sent directly to the CRTO by your school. Recent graduates may have an email confirmation of completion accepted first, but the official transcript must still arrive within eight weeks of completing the program.

One limit is absolute. The CRTO cannot register applicants who were trained in another health profession — such as nursing, medicine, or anesthesia — even if they have experience providing respiratory care. The education requirement is set in regulation and is non-exemptible: the College has no authority to make an exception, so respiratory care experience in another profession is not a substitute for a respiratory therapy program.

Step 2: Apply to the CRTO

You do not have to wait until every requirement is finished. You may submit your application before you complete all the requirements — for example while finishing graduation requirements, waiting for exam results, or waiting for a work permit — and your application file will be open for up to 12 months. As part of the application you pay a $75 application fee online by Visa or MasterCard, and the fee is non-refundable.

The rest of the application covers the remaining registration requirements:

• Language proficiency. You must be able to communicate effectively in English or French in a healthcare environment. You meet it if your first language is English or French, if your respiratory therapy program was taught in English or French, or if you achieve an acceptable score on a CRTO-accepted language test.
• Eligibility to work in Canada. You must be a Canadian citizen, a permanent resident, or authorized under the Immigration and Refugee Protection Act to practise respiratory therapy. Proof can be a birth certificate, current passport or citizenship card, a permanent resident card or record of landing, or a valid work permit. You may still begin the application if you do not yet meet this requirement.
• Currency. You completed your program or assessment within the last three years, or you practised respiratory therapy for at least 1,125 hours in the past three years.
• Suitability to practise. You answer questions about your conduct and practice history, disclose offences and any misconduct, incompetence or incapacity proceedings or findings in any profession or jurisdiction, and submit a Vulnerable Sector Check (VSC).

Applicants who do not meet the requirements are referred to the Registration Committee for consideration.

Step 3: Graduate certificate first, if you still owe the exam

The examination requirement for a general certificate is the HPTC Respiratory Therapist exam, and it is non-exemptible. But you do not have to sit idle while you wait to write it.

Applicants may be granted a Graduate Certificate of Registration before completing the approved examination, and a graduate certificate may be issued for up to 18 months. The graduate class is for applicants who have met the other registration requirements, including the education requirement, but have not yet passed the HPTC exam. It is temporary, not a permanent alternative to the exam.

First-time writers who are, or will be, graduates of approved programs are automatically eligible to write the HPTC exam, and candidates apply and pay HPTC directly. If you fail the exam three times, you are not eligible to rewrite until you submit a study plan for approval by the Registration Committee — treat the early attempts accordingly.

Step 4: General certificate, then keep currency

Pass the HPTC exam and meet the remaining requirements, and the CRTO issues a General Certificate of Registration. Only then — once you have written confirmation that the certificate has been issued — may you work as a respiratory therapist or use the title and designations such as GRT or RRT in Ontario. That bar includes employer orientation and training: you cannot start clinical orientation on the promise of registration.

Currency does not end at registration. The same three-year test continues to apply: recent completion of your program or assessment, or at least 1,125 hours of respiratory therapy practice in the past three years, in clinical or non-clinical roles that use your respiratory therapy knowledge.

If you were educated outside Canada

Applicants who did not graduate from an approved program go through the CRTO's entry-to-practice assessment, based on the National Competency Framework for entry to practice. The sequence on the College's page for applicants educated outside Canada is: complete the online application and pay the $75 application fee, log in to the applicant portal and upload supporting documents such as proof of status in Canada and a Vulnerable Sector Check, have a course-by-course credential evaluation and authentication report sent from a member of the Alliance of Credential Evaluation Services of Canada, and then pay a $500 assessment fee to start the assessment, which covers the education review and the interview. After the education review and structured interview, the final assessment stage is a clinical skills assessment at a CRTO-approved simulation facility in Toronto, which carries a separate $5,000 fee, and the completed assessment is then referred to a panel of the Registration Committee.

Applicants currently registered in another Canadian jurisdiction should use the labour mobility route instead of the international assessment route.

What the opened pages do not state

The CRTO pages opened for this guide state the $75 application fee and the $500 assessment fee on the internationally educated route, but they do not state a current annual registration fee for a general or graduate certificate in the material opened, so this guide gives none. Check the CRTO's current fee schedule before you budget the full cost of registration.

Related guides:

• How to Become a Respiratory Therapist in Canada — the national picture for respiratory therapy registration.
• How to Start Getting Your Foreign Respiratory Therapy Credentials Recognized in Canada — the credential-recognition route for internationally educated respiratory therapists.
• How to Become a Medical Laboratory Technologist in Ontario — Ontario registration for another laboratory and testing profession, for comparison.
• How to Become a Physiotherapist in Ontario — Ontario registration for another regulated health profession.

Sources

• College of Respiratory Therapists of Ontario, Registration Requirements and How to Meet Them — the approved-program education requirement and the assessment alternative, the rule that applicants trained in another health profession cannot be registered, language proficiency, eligibility to work in Canada, the 1,125-hour currency rule, suitability disclosure, and the Vulnerable Sector Check.
• College of Respiratory Therapists of Ontario, Apply Now — applying before all requirements are complete, the $75 non-refundable application fee paid online, the application file staying open for up to 12 months, and the bar on working or using the title before written confirmation of registration.
• College of Respiratory Therapists of Ontario, Examination Fact Sheet — the HPTC Respiratory Therapist exam as the approved examination, the Graduate Certificate of Registration before the exam for up to 18 months, applying and paying HPTC directly, and the study-plan rule after three failed attempts.
• College of Respiratory Therapists of Ontario, Applicants Educated Outside of Canada — the entry-to-practice assessment based on the National Competency Framework, the credential evaluation from an Alliance of Credential Evaluation Services of Canada member, the $500 assessment fee covering the education review and interview, the clinical skills assessment in Toronto with a separate $5,000 fee, and referral to a Registration Committee panel.