Pulmonologist vs. Respiratory Therapist: What’s the Difference?

12/12/2023

Respiratory care is an important field of medicine — it literally helps keep people breathing. If you’re interested in working in this field, you may be exploring what type of role is right for you.

To assist you in your research, we’re highlighting the difference between two common roles in respiratory care: a pulmonologist and a respiratory therapist. Keep reading to learn the differences in what these two medical professionals do, where they work and what is required to start these careers.

Pulmonologist vs. Respiratory Therapist: Comparing Roles

What does a pulmonologist do?

A pulmonologist is a physician who specializes in diagnosing, treating and managing conditions
related to the respiratory system, such as those affecting the lungs, throat or windpipe.

Pulmonologists treat more serious respiratory conditions, including but not limited to:

Asthma (more severe cases)
Bronchitis
Cystic fibrosis
Emphysema
Chronic obstructive pulmonary disease (COPD)
Lung disease
Pulmonary hypertension
Sleep apnea
Tuberculosis (TB)

Pulmonologists frequently coordinate with other medical professionals such as cardiologists, pathologists, nurses and respiratory therapists to help patients access the level of care they need.

When treating patients, a pulmonologist may conduct physical exams, order and interpret lab tests and imaging, prescribe medications and more. Though they generally don’t perform surgeries, pulmonologists can perform biopsies.

While pulmonology is its own specialty within internal medicine, pulmonologists may choose to specialize their practice even further, such as by focusing on a specific condition (e.g., pulmonary fibrosis or COPD) or on a certain patient population (e.g., pediatric or geriatric pulmonology).

What does a respiratory therapist do?

A respiratory therapist (RT) is a licensed medical professional who provides evaluation, treatment and care for people who have breathing challenges such as asthma, COPD or lung disease. An RT may apply breathing treatments directly or teach the patient to perform treatments on their own at home.

Respiratory therapists work with patients of all ages, from newborns with underdeveloped lungs to elderly individuals with advanced respiratory conditions.

According to the California Employment Development Department’s Occupational Profile for respiratory therapists, respiratory therapist duties include:

Explaining treatment procedures to the patient
Setting up and operating devices that aid patients in breathing such as mechanical ventilators, therapeutic gas administration apparatuses, environmental control systems and aerosol generators
Checking, cleaning, testing and maintaining respiratory therapy equipment and ordering repairs and replacements as needed
Monitoring the patients’ physiological responses to their respiratory therapy and consulting with their physician in the case of a negative reaction
Reading prescriptions, measuring arterial blood gasses and reviewing patient information for the purpose of assessing the patient's condition
Sending blood analysis results to the patient’s physician
Collaborating with other healthcare professionals (e.g., the patient’s primary care physician, pulmonologist, nurses, etc.) to help manage care for the patient
Providing emergency respiratory care, which may include procedures such as artificial respiration, external cardiac massage and cardiopulmonary resuscitation
Maintaining patient records

Where do pulmonologists and RTs work?

Common pulmonologist work environments include:

Intensive care units (ICUs) and other hospital departments
Pulmonary medical practices
Multidisciplinary group practices
Sleep labs

Respiratory therapists work in some of the same environments, though they also work in patients’ homes and nursing care settings. Here are some common work environments for respiratory therapists:

General medical and surgical hospitals
Outpatient care centers
Nursing care facilities
Home healthcare services
Doctors’ offices

Differences in Education Requirements

Education & Training Requirements for Pulmonologists

Pulmonologists must complete a higher level of education than respiratory therapists.
Pulmonologist education and training includes:

A four-year bachelor’s degree
Four years of medical school
A three-year residency in internal medicine
A two- to three-year pulmonology-focused fellowship

Therefore, if you are seeking to become a pulmonologist, you must complete a minimum of 13 years of education and training.

Education & Training for Respiratory Therapists

To become a licensed respiratory therapist In California, you must earn a minimum of an associate degree from an education program for respiratory care that is accredited by the Commission on Accreditation for Respiratory Care (CoARC). Additionally, your degree must be from an institution or university that is accredited by a regional accreditation agency or association recognized by the U.S. Department of Education.

Sufficient work experience
Good standing of licensure in another state
Previous good standing of licensure in California
Sufficient military experience and training (learn more about the requirements for military service members)

Associate programs typically take about two years or less. ACC’s Respiratory Therapy program can be completed in as little as 20 months.

Certification & Licensure Requirements

Pulmonologist Certification & Licensure in California

To practice medicine as a physician in California, you must obtain a Physician’s and Surgeon’s (P&S) License from the Medical Board of California.

P&S License eligibility requirements include:

Attendance and graduation from a U.S., Canadian, or an international medical school approved by the Board pursuant to Business and Professions Code (BPC) section 2084
Credit for either 12 (U.S. and Canadian medical school graduates) or 24 (international medical school graduates) months of board-approved postgraduate training (BPC section 2096)
Passage of all required examinations (BPC section 2170)

Learn more about the requirements for a Physician’s & Surgeon’s License in California.

To be recognized as a board-certified pulmonologist, you must pass the Pulmonary Disease Certification Exam administered by the American Board of Internal Medicine (ABIM) after completing your pulmonology fellowship. And in order to take that exam, you must first be certified by the ABIM as an internal medicine specialist, according to the ABIM’s Pulmonary Disease Policies.

Some physicians choose to obtain dual certification in pulmonary disease and critical care medicine. This requires at least three years of accredited combined training, with 18 months being clinical training.

Respiratory Therapist Certification & Licensure in California

To work as a respiratory therapist in California, you need to obtain your Respiratory Care Practitioner (RCP) license from the Respiratory Care Board of California. In addition to meeting the educational requirements above, you must also complete the following:

Register for a BreEZe account and complete your RCP application online following these step-by-step instructions.
Submit a passport-style photo that was taken within 60 days of submitting your application.
Pay the $300 application fee (and an additional $49 if you’re submitting fingerprint cards in place of a live scan).
Submit an official copy of your transcript(s) showing the completion of your respiratory care program and the awarding of a minimum of an associate degree (must be sent from the awarding institution directly to the Board).
Obtain a Registered Respiratory Therapist (RRT) credential from the National Board of Respiratory Care (NBRC), which requires passage of the Therapist Multiple-Choice Examination (TMC) and the Clinical Simulation Examination (CSE).

If you have a Certified Respiratory Therapist (CRT) credential that you earned before Jan. 1, 2015, you are not required to take the exams mentioned above.

Interested in Becoming a Respiratory Therapist?

American Career College has a CoARC-accredited Respiratory Therapy program in Southern California that allows you to earn your associate degree in as little as 20 months. Upon completion of the program, students are eligible to take the Certified Respiratory Therapist (CRT) and RRT exams (written and clinical simulation) offered by the National Board for Respiratory Care (NBRC).

The program is taught in a blended format, which means it includes both online classes and in-person instruction at ACC’s Los Angeles, Ontario and Anaheim campuses. Learn more about the Respiratory Therapy program at ACC.

The Respiratory Therapy (Associate of Occupational Science) programs in Anaheim (#200554) and Ontario (#200566) are accredited by the Commission on Accreditation for Respiratory Care (CoARC). CoARC 264 Precision Blvd., Telford, TN 37690; Phone (817) 283-2835 / Fax (817) 510-1063 / www.coarc.com.

The Respiratory Therapy (Associate of Occupational Science) program (#200657) in Los Angeles holds Provisional Accreditation from the Commission on Accreditation for Respiratory Care (www.coarc.com). This status signifies that a program with an Approval of Intent has demonstrated sufficient compliance with the Standards (through submission of an acceptable Provisional Accreditation Self Study Report (PSSR) and any other documentation required by the CoARC, as well as satisfactory completion of an initial on-site visit), to be allowed to admit students. It is recognized as an accredited program by the National Board for Respiratory Care (NBRC), which provides enrolled students who complete the program with eligibility for the Respiratory Care Credentialing Examination(s). The program will remain on Provisional Accreditation until it achieves Continuing Accreditation

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