Applicants Educated Outside of Canada

To practise as a Respiratory Therapist in Ontario, you must be registered with the College of Respiratory Therapists of Ontario (CRTO). You may not work as a Respiratory Therapist or use the Respiratory Therapist title or designation (e.g., GRT, RRT) in Ontario until you have received written confirmation from the CRTO that your certificate of registration has been issued.1  Working as an RT includes participating in an employer’s clinical orientation or training.

If you are applying for registration with the CRTO, and you have not graduated from one of the approved respiratory therapy programs, you will be required to complete the CRTO’s entry-to-practice assessment. The assessment is based on the National Competency Framework (NCF). The NCF is a list of competencies considered essential for entering the practice of respiratory therapy in Ontario. Please note, that applicants who are currently registered in Canada and applying through the labour mobility provisions should review the Applicants from Other Canadian Jurisdictions section.

To start the registration process you must complete the online application, pay the $75.00 application fee, and submit all required documentation to the CRTO. 

The Application and Assessment Guide provides a detailed overview of the registration requirements and process.

1. With the exception of out-of-province Regulated Respiratory Therapists who meet the conditions under O. Reg. 199/23 Exemption-Restricted Titles, including having submitted an application for registration to the CRTO.

Steps in the Application Process

  1. Review the Registration Requirements section and the Application and Assessment Guide
  2. Complete the online application and pay the $75.00 application fee (online Visa or MasterCard transaction).
  3. One or two business days after your online application is received, the CRTO will email you with information on how to access the Applicant Portal and check the status of your application.
  4. Log in to the Applicant Portal to submit (upload) supporting documents, for example, proof of Canadian citizenship, permanent residency status, or a valid work permit.
  5. Ensure that other supporting documentation has been sent to the CRTO from third-party organizations, for example:

Steps in the Entry to Practice Assessment

  1. Application Review and Assessment Fee– To start the assessment process, you will need to submit the $500.00 assessment fee which will cover the Education Review and the Interview (see below).
  2. Education Review– The CRTO will conduct a detailed (content) review of your education program. The purpose of this review is to determine if your educational qualifications are sufficiently similar to the Canadian standard reflected in the NCF. As part of the education program review you will be asked to complete the Education Program Review Worksheet and submit the form to the CRTO office together with supporting documentation (e.g., detailed course outlines, program curriculum/syllabus).
  3. Structured Interview – after the program review is complete, you will be asked to attend a structured interview. The interview will be conducted by two Respiratory Therapists who have been contracted by the CRTO. The interviewers will ask you questions and compare your knowledge, skills, and experience against the competencies listed in the NCF.
  4. Feedback– After the interview, you will receive an interim assessment report. The report will be based on the educational program review and the structured interview. At that time, you will also be asked to meet with CRTO staff to review your interim assessment report and to discuss the next steps in the assessment process.
  5. Clinical Skills Assessment(CSA) – in this final stage of the assessment process, you will be asked to demonstrate your ability to safely and effectively apply your practical skills and clinical reasoning in clinical simulations. The CSAs are conducted by a CRTO approved simulation facility in Toronto. Applications received as of March 1st, 2024 the fee for the CSA is $5,000.00. For detailed information about the CSA, please see the  CSA Guide.
  6. Registration Committee Referral – after you complete all three stages of the assessment process, your application will be referred to a Panel of the Registration Committee. The Panel will review a comprehensive assessment report prepared by the CRTO staff. The report will incorporate the results of the educational review, structured interview, and clinical skills assessment. For more information about the referral process, please see the Referral to the Registration Committee
  7. If the Registration Committee orders to issue you a certificate of registration, you will be asked to submit the applicable registration fee.
  8. After the registration fee is processed, you will receive your certificate of registration. The CRTO will send you an email confirmation when your certificate is issued.

Application and Assessment Process Map


You may not work as a Respiratory Therapist or in any way hold yourself out as a person qualified to practise respiratory therapy in Ontario until after you have been issued a certificate of registration.

All applicants have the option, at any time, to apply for enrollment in a full-time Canadian Respiratory Therapy program (outside of the CRTO application process). For more information, please see the Ontario Colleges Application System (OCAS) at

For information on immigrating to Canada or obtaining a work permist, visit Citizenship and Immigration Canada. For more information on living and working in Ontario, visit Ontario Immigration and HealthForceOntario Access Centre

Once registered, you will be required to:

If you have any questions about the application process, please Contact Us.