What Will it Take to Boost Respiratory Therapy Education?

Respiratory therapists’ entry-level education has evolved from on-the-job-training, to obtaining an Associate’s degree, at minimum, in order to become licensed. This 65- year evolution however, has failed to progress, even though an advanced degree was recommended as early as 1992 for 2001. It is clear we have failed to keep up with our allied health partners such as physical therapy, who now recognize a doctoral degree as the entry–level standard. Over the years, the demand for allied health professionals has continued to steadily grow. Changes in the healthcare system, and the services provided, are placing increased demand on qualified professionals. The level of practitioner education must be augmented, not only to meet the growth demands, but to also allow Respiratory Therapists to use their expertise to conduct research and act as physician extenders, where shortages exist.

Efforts are underway to raise the standards for entry-level practitioners. In fact, the plan is to require a Bachelor’s degree for new professionals by 2015. The American Association for Respiratory Care (AARC) formed the 2015 conferences to identify the areas where RT’s can best be utilized, within their scope of practice, and the type of training required for additional competencies. This initiative does not go without its challenges.

Conferences have been held yearly, since the inception of the proposal, to discuss how to effectively and efficiently increase entry-level education without disturbing the profession as a whole. In 2010, a task force was created to address the initiative goals, and made a single recommendation to the Commission on Accreditation for Respiratory Care (CoARC) regarding the education of Respiratory Therapists. The recommendation is as follows: "1.01 The sponsoring institution must be a post-secondary academic institution accredited by a regional or national accrediting agency that is recognized by the United States Department of Education and must be authorized under applicable law or other acceptable authority to award graduates of the program a baccalaureate or graduate degree at the completion of the program. Programs accredited prior to 2013 that do not currently offer a baccalaureate or graduate degree must transition to conferring a baccalaureate or graduate degree, which should be awarded by the sponsoring institution, upon all RT students who matriculate into the program after 2020.”1 To date, only 53 entry-level baccalaureate and graduate programs for Respiratory Care professionals exist, as compared to 384 Associate level programs within the United States.

Support for a higher entry-level education varies greatly amongst professionals. It appears to be a mix of emotions where job security and professional growth clash. In a recent study, 348 program directors in the United States were surveyed and questioned about entry-level degree requirements. The results showed that 102 would like to require a baccalaureate or master’s degree to become licensed and begin practice, while 241 thought an associate’s degree was suitable.2 The majority of those who supported the associate entry-level degree indicated that obtaining a baccalaureate degree, post licensure, was their preferred route. A comparable study was conducted the following year with surveys being sent to 2368 directors and mangers of respiratory care. Only 663 surveys were returned completed. Despite the poor response rate (28%), the results indicated a non-committal support for improving the entry-level education standard. Two-hundred forty-five prefer the baccalaureate and/or masters’ entry-level requirement, 243, preferred the associate degree as entry-level, and 176 did not have a preference.3 Licensing qualifications were also measured. Result showed that 375 professionals felt an education above associates should be required to obtain a license prior to practice, whereas 461 felt it necessary to obtain a higher degree while practicing. Alarming, yes, but rightfully so.

Change is difficult, yet inevitable. As health care professionals, we must try to find a balance between our profession and our professional lives. While some institutions may not be able to offer higher-level degrees, other solutions should be shaped so that the needs of the health care system, patients, and practitioners are met. In looking toward the future of our profession and the impact we can have on the lives of those who require our services, higher education should not be a question. To be a respected and valued clinician, one must demonstrate a higher level of knowledge, have the ability to use their skills to the highest caliber, and be part of a team of health care professionals whose required education levels are above that of an Associate’s degree.

As stated earlier, the true dilemma comes from the emotional mixture of job security and professional growth. The question is here is not do we need to increase the entry-level standard, but how to do so without wreaking havoc in our current system so everyone can remain employed while increasing our recognition and utilization as a profession. Many educational institutions do not have the ability to award higher-level degrees which makes change impossible for them. Articulation agreements with other educational institutions may be an excellent way for such institutions to remain in the market while meeting the proposed standards. This change is long overdue and it is in evitable in our near future. In order to find a balanced solution, it is time to think outside the box as Respiratory Therapists’ have done so for so many


  1. Barnes TA, Kacmarek RM, Kageler WV, Morris MJ, Durbin CG. Transitioning the respiratory therapy workforce for 2015 and beyond. Respiratory Care. 2011; 56(5):681-690.
  2. Barnes TA, Kacmarek RM, DurbinCG. Survey of respiratory therapy education program directors in the United States. Respiratory Care. 2011; 56(12): 1906-1915.
  3. Kacmarek RM, Barnes TA, Durbin CG. Survey of directors of respiratory therapy departments regarding the future education and credentialing of respiratory therapy care students and staff. Respiratory Care. 2012; 57(5): 710-720.


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