Occupational therapists need a graduate degree, either a master’s or an entry-level doctorate (OTD), from a program accredited by ACOTE, the accrediting council for occupational therapy education. After supervised fieldwork and graduation, you pass the national NBCOT exam and apply for a state license. Most people finish a bachelor’s degree with prerequisite courses first, so the full path usually takes six to seven years after high school.
What OTs actually do all day
Occupational therapy helps people do the everyday things that matter to them, which the field calls occupations: getting dressed, cooking, working, going to school, driving or playing. The patient might be a toddler with a developmental delay, a teenager after a concussion, an adult recovering from a stroke or an older adult who wants to stay safely at home.
- Settings: hospitals, inpatient rehab, outpatient clinics, schools, skilled nursing facilities, home health and mental health programs.
- The work: evaluating what someone can and cannot do, setting goals, teaching new ways to do tasks, recommending equipment and adapting homes, classrooms or workplaces.
- The less visible part: documentation, insurance requirements, team meetings and, in some settings, productivity targets. Helping patients move and transfer is physical work.
If you are drawn to hands-on helping roles in general, our guide to careers for people who like helping compares OT with related options.
Degree options
- Bachelor’s degree first: any major works if you complete the prerequisites, which commonly include anatomy and physiology, psychology, human development and statistics. Psychology, kinesiology and health science are popular choices; see how to choose a major.
- Master’s in occupational therapy: usually two to three years, including classroom work and fieldwork.
- Entry-level doctorate (OTD): usually about three years, adding a doctoral capstone project. Both degrees lead to the same exam and license.
- Combined programs: some schools offer a bachelor’s-to-master’s track that saves time if you know early.
- Occupational therapy assistant (OTA): an associate degree route that leads to its own NBCOT exam and license. Some people work as an OTA first and later return for the OT degree.
Fieldwork, the NBCOT exam and your license
Accredited programs include Level I fieldwork, short observation-style experiences, and Level II fieldwork, which is at least 24 weeks of full-time supervised practice. After you graduate, you sit for the national exam given by the National Board for Certification in Occupational Therapy (NBCOT). Every state then requires a license to practice, usually with renewal and continuing education. Requirements vary by state, so check your state licensing board for occupational therapy before you choose a program, especially if you might move.
A step-by-step path from high school
- Take biology, anatomy if your school offers it, psychology and statistics, and keep your grades strong. Graduate programs are competitive.
- Volunteer or work where OTs practice: a rehab unit, a camp for kids with disabilities, a senior living community.
- Choose a bachelor’s major you will do well in, or start at a community college and transfer; see starting at community college.
- Complete the prerequisites and log observation hours with OTs in at least two settings. Many programs require them.
- Apply to accredited master’s or OTD programs, usually during your last year of college.
- Finish coursework and Level II fieldwork, pass the NBCOT exam and apply for your state license.
Try it before you apply
- Shadow an OT in a school and another in a hospital or clinic. The two days will look completely different.
- Work part time as a rehab aide or in a care setting where you help people with daily tasks.
- Ask a few practicing OTs for informational interviews about caseloads, paperwork and what surprised them.
Who thrives, and why some people leave
OTs who last tend to be patient, creative problem solvers who enjoy small, steady progress and like explaining things in plain language. People who switch out usually cite the documentation load, productivity pressure in some settings, the physical demands of transfers or the emotional weight of patients who do not improve. Many shift settings, for example from a hospital to a school, before deciding to leave the field.
Changing careers into OT
Plenty of OT students arrive from teaching, fitness, caregiving or psychology. You can usually take missing prerequisites at a community college in the evening while you work. Because this is a graduate path, read our guide on whether grad school makes sense and our advice on changing careers. For current pay and outlook, check the Bureau of Labor Statistics Occupational Outlook Handbook.
Where a mentor helps
Becoming an OT takes years of prerequisites, observation hours and applications. A mentor helps a student explore whether OT fits, map the courses and deadlines, stay accountable week to week through college and graduate school, prepare applications and get through the first job search. Mentors are not credentialed career counselors, admissions counselors or licensing experts, so the program and board details stay with those sources. See our career and education mentoring and mentoring for college students.
Related
- Career paths: guides to more careers
- How to become a physical therapist
- How to become a speech-language pathologist
- How to become a physician assistant
- Physical Therapist vs Occupational Therapist: Key Differences
Common questions
Do you need a doctorate to be an occupational therapist?
No. Both an accredited master’s degree and an entry-level doctorate (OTD) lead to the NBCOT exam and a state license. The doctorate adds time and a capstone project.
What is the difference between an OT and an OTA?
An OT evaluates patients and designs the treatment plan, which requires a graduate degree. An occupational therapy assistant carries out treatment under an OT’s supervision and needs an associate degree, a separate exam and a state license.
How is occupational therapy different from physical therapy?
Physical therapy focuses on movement, strength and mobility, while occupational therapy focuses on the daily tasks a person needs to do. The two often work side by side.
What should I major in for OT school?
Any major can work if you finish the prerequisite courses with strong grades. Psychology, kinesiology and health science are common because they overlap with the prerequisites.
Get started
Thinking about occupational therapy and want help building the plan? Call (888) 305 5422, email contact@blackburnmentoring.com or start with a short assessment. A member of our team reviews every assessment personally and sets up a free intro call.