How can foreign respiratory therapists work in the United States? The Coronavirus pandemic has created a shortage of respiratory therapists. Chronic low-level respiratory diseases were already the fourth-leading cause of death in the US before Covid-19. Respiratory therapists are essential in caring for patients who have trouble breathing. They test patients with lung capacity, and perform chest physiotherapy to remove mucus and fluid from the lungs. and Respiratory therapists are needed in order to use ventilators safely and properly. See,

Unfortunately, the H-1B is generally not an option for Respiratory Therapists. Because the US Dept of Labor’s OOH (Occupational Outlook Handbook) states that Respiratory therapists need at least an associates degree, although some employers may prefer a bachelor’s degree, most Respiratory Therapist positions would not qualify for the H-1B since according to the US government, a bachelor’s degree is not required.

Additionally, Respiratory Therapists are not included in the list of occupations for the TN visa, so Canadians who are licensed RTs in Canada will not be able to get a TN visa on that basis.

However, Respiratory Therapists who are managing or supervising other RTs, or who have advanced certifications in a specialized area, may qualify for the H-1B if the employer can show that they only hire applicants who have at least a bachelor’s degree, and that the job duties are so complex and advanced that they require an employee with a specialized degree.

So how can a foreign RT come to the U.S. to work as a respiratory therapist in the U.S.? The foreign RT would have to have his or her educational credentials evaluated as the equivalent of a US degree in respiratory therapy. The foreign RT would also have to take the multiple choice part of the NBRC licensing exam. See the web site for the NBRC,

While the NBRC has many testing centers outside the U.S., many countries lack testing centers so an RT abroad would have to travel to another country in order to take the test. Pakistan has two testing centers, one in Karachi and one in Lahore. Similarly, India has three testing centers, in Bangalore, Chennai and Mumbai. Many countries in Latin America and the West Indies do not have an NBRC testing center, for example, Barbados, Belize, Chile, Colombia, Dominican Republic, all lack testing centers. However, nationals from those countries may be able to travel to Buenos Aires Argentina or Mexico City Mexico in order to take the test. It may be easier to obtain a visa to travel to Argentina or Mexico than it is to get a B visa to come to the U.S. to take the exam, which is the other option.

Similarly, in the Middle East, Jordan and Kuwait lack test centers, but you may be able to travel to NBRC testing centers in Cairo Egypt or in Dubai UAE.

Coming to the U.S. temporarily to take the NBRC test is a valid basis for a B visa. However, if unable to get a B visa, a foreign RT who does not have an NBRC testing center in his or her home country should explore which other countries in his or her region do have test centers.

Foreign respiratory therapists may be eligible for the J-1 exchange visitor visa to work for one year as a J-1 intern if they have recently graduated from university, or for 18 months as a J-1 trainee. J-1 trainees must have a university degree or professional certification plus at least one year of work experience abroad, or else five years of work experience in the occupation abroad. These are often not the best option, due to the short duration and the fact that many J-1s also have a two-year foreign residency requirement. So, once the one year or 18 months is completed, depending on the country, the RT may have to return to his or her home country for two years.

Having gotten their educational credentials evaluated for US equivalency, passed the NBRC licensing exam and obtained the NBRC certification, the foreign RT may be sponsored for the PERM labor certification by a hospital or other health care employer. The hospital would have to advertise the job and show that there is a shortage of US workers in their geographical area to perform the job. Then the hospital would file an I-140 on the RT’s behalf, and the RT would go for consular processing and come to the U.S. as a green card holder. The PERM labor certification has more flexibility in terms of categorizing a position as professional. The recent proclamation by President Trump does not apply to health care professionals, and would likely not apply to RTs, depending on the hospital’s requirements.

Because of extreme backlogs in the third employment preference for India and China, however, the PERM is not such a great option for these nationals. Nationals of El Salvador, Guatemala, Honduras, Mexico, the Philippines, Vietnam, have a wait of more than three years, which can go by quickly.

Foreign national RTs who are already in the U.S. may have work authorization through other immigration benefits eligibility, such as through asylum applications, as the derivative of a spouse’s status, through DACA or TPS. They may also be sponsored by a hospital or other health care organization for their green card. Those already in the U.S. have an advantage, as they may apply for state licensure, and already be working for the employer hospital or health care organization with work authorization.

Copyright 2020 © Heidi J Meyers, all rights reserved.