Fit testing is an integral component of all respiratory protection programs. The objectives of this study were to describe the fit testing program at St. Michael's Hospital and to survey and compare various components (including: availability, location and resources) of each program in acute care hospitals in the Greater Toronto Area. Particular focus was placed on identifying key challenges in the successful implementation of the various respiratory protection programs. The results indicated lack of uniformity between fit testing programs. Lack of worker support (i.e.: non-compliance with fit testing) and inadequate respirator supply were identified as the main challenges in the implementation of the fit testing programs. Fit testing availability, location, resources and policies were associated with greater compliance. Further research is recommended to determine the impact of these key elements towards a successful fit testing program.