Work abroad as a respiratory therapist: US, UK, Ireland, EU

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   1. Decide which country and which title you are aiming for

   Only the USA licenses respiratory therapists, and only after a US-accredited programme. In the UK and Ireland the realistic title is respiratory physiologist; in Germany it is MT-F or, if you are also a nurse or physiotherapist, the DGP Atmungstherapeut. Decide this first, because it changes every later step.
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   2. Compare your training with the target role

   Respiratory physiology roles focus on lung function testing, blood gases, sleep studies and oxygen and ventilation assessment. RT programmes focused mainly on ICU ventilation may leave gaps in diagnostic testing. Map your transcript and clinical logs against the PTP respiratory and sleep physiology outcomes or the German MT-F training before you apply.
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   3. Request detailed course documents

   Equivalence bodies need transcripts, syllabuses and hours for each course, with certified translations where needed. For US programmes, ask for documents that a college can use to assess transfer credit. Start early, because universities can be slow.
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   4. Pass the language test

   AHCS accepts IELTS 7.0 with no element below 6.5, TOEFL iBT 100 or C1 Advanced. Germany needs German at B2 for MT-F recognition, and the Netherlands needs Dutch in practice. Results usually need to be recent.
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   5. Collect references and good standing letters

   Ask supervisors to confirm your clinical experience in writing, and ask every regulator you have been licensed with, including Gulf authorities, for a good standing or verification letter. AHCS may check with overseas competent authorities during screening.
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   6. Apply for equivalence or recognition

   Apply to AHCS for PTP equivalence in the UK, to the IICMP for an Irish physiologist post, or to your German state authority for MT-F recognition. Respond to any request for more evidence quickly, because the evidence window is limited.
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   7. For the USA, enroll in a CoARC-accredited program

   Contact accredited US programs about transfer credit or advanced standing. After graduating, sit the NBRC TMC exam and, for the RRT, the Clinical Simulation Examination, then apply to the state board. Some states, such as California, require the RRT.
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   8. Secure a job and visa

   In the UK, respiratory physiologists are listed under occupation code 2259, which is eligible for the Health and Care Worker visa with a licensed sponsor. Check official immigration sites for each country before resigning from your current post.

There is no national pay scale for respiratory therapists outside the USA. The UK and Ireland pay the nearest role, respiratory physiologist, on public scales shown below with their effective dates. Germany and the Netherlands have no official figure we could confirm. The US figure is for licensed respiratory therapists, a route that needs a US-accredited program.

• UK£32,073 to £39,043 (Band 5), 2026/27NHS Agenda for Change in England from 1 April 2026. NHS Health Careers lists healthcare science practitioners in respiratory physiology at Band 5; clinical scientists at Bands 6 to 8a.
• Ireland€45,224 to €66,708 (HSE Respiratory Physiologist, from 1 June 2026)HSE consolidated pay scales. Senior €55,665 to €72,890; Chief I €60,591 to €76,749.
• GermanySet by collective agreement or employerWe could not confirm MT-F or Atmungstherapeut pay from an official source.
• NetherlandsSet by employerThere is no respiratory therapist profession and no official figure.
• USA$82,280 median annual wage (May 2025)US Bureau of Labor Statistics, respiratory therapists. Employment is projected to grow 9 percent from 2025 to 2035.

Career paths depend on the title you work under. In the USA they build on NBRC credentials; in the UK and Ireland they follow healthcare science grades.

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   US specialty credentials

   After the RRT, the NBRC offers specialty credentials: Adult Critical Care (RRT-ACCS), Neonatal/Pediatric (RRT-NPS), Sleep Disorders (SDS) and Pulmonary Function Technologist (CPFT, RPFT). Each has its own exam and eligibility rules.
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   UK healthcare science progression

   Respiratory physiologists can progress to senior practitioner posts or, through the Scientist Training Programme or STP equivalence, to clinical scientist, a protected HCPC title paid at Bands 6 to 8a.
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   Irish physiologist grades

   The HSE has Respiratory Physiologist, Senior, Chief I and Chief II grades, each with its own pay scale.
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   Sleep and ventilation services

   Specialist roles in home ventilation, sleep medicine and oxygen services exist in all these countries, often within multidisciplinary teams led by respiratory physicians.
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   Education and leadership

   Experienced practitioners lead departments, train students and run quality programmes. University posts usually need a master's degree.

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   Paying for a US credential evaluation expecting it to unlock the NBRC exams. The NBRC says foreign respiratory therapy education does not qualify for the TMC.

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   Looking for a CoARC-accredited program outside the USA. CoARC says there are none.

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   Applying to the HCPC as a respiratory therapist. The HCPC has no such register; the UK route is AHCS equivalence or a different profession.

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   Ignoring the registration line in job adverts. Registration for respiratory physiologists is voluntary in law, but an employer can still make it a condition of the post.

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   Applying for an Irish respiratory physiologist post without IICMP equivalence. Job specifications say it is required to take up the post.

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   Expecting to train as a DGP Atmungstherapeut in Germany without a nursing or physiotherapy qualification. Other professions are not admitted.

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   Underestimating German or Dutch. MT-F recognition needs German at B2, and Dutch employers expect Dutch.

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   Building a portfolio around ICU ventilation only. UK and Irish physiology roles are heavily diagnostic, so show lung function and sleep testing.

• Review of your qualifications, transcripts, experience and current registration

• Check against the published requirements of the regulators you choose

• Check of how recent your practice is and whether any gap in practice affects your route

• English or other language requirement for each route, with any exemption you may qualify for

• Comparison of routes and countries, with the trade-offs explained

• List of the exams, aptitude tests or adaptation periods each route is likely to involve

• Written roadmap: exams, English test, documents, fees and timeline

• Budget built from the official regulator, exam and verification fees, kept separate from our own fee

• Flags for slow steps to start first, such as primary source verification and language learning

• A call to walk you through the plan and answer your questions

What our eligibility assessment includesPackages and fees