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A Step-by-Step Guide to Becoming an Occupational Therapist

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A physical therapist examines a female patient's shoulder in a bright clinic, with anatomical posters visible in the background.

Have you been told you have an empathetic, patient, and creative nature? Imagine having a career that would let you use your ability to connect with others as you help them adapt and thrive in their daily lives. As an occupational therapist, you’ll use your special traits to develop personalized strategies that empower people to overcome challenges and live life to the fullest.

Occupational Therapists (OTs) are licensed professionals who treat injured and chronically ill people and those with disabilities across all age groups. They evaluate a patient’s abilities and create treatment plans to provide pain relief and improve their living skills. To become an OT, students must complete the advanced courses and fieldwork toward their master’s degree. Following graduation, they take a national licensing exam to begin their practice. This comprehensive guide walks you through the education and training opportunities in occupational therapy. Learn how to proceed from the associate degree to the master’s degree, and from completing fieldwork requirements to interviewing for an OT job.

Decide on Occupational Therapy

The American Occupational Therapy Association (AOTA) reports that there are approximately 200 occupational therapy programs in the U.S. Applicants must hold a bachelor’s degree and have practical experience in an occupational therapy setting. OT master’s’ degree programs can last from two to three years. To complete the OT degree, students must undertake a minimum of 24 weeks of supervised fieldwork. Given the extensive educational and clinical commitments, students should know whether they’re well-suited to the rigors of academic work and the demands of the profession. The BLS identifies the important qualities of successful OTs as adaptability, strong communication skills, compassion, patience, and interpersonal aptitude. In deciding if an OT career is right for you, consider the following questions:

  • Are you excited about developing relationships with patients and their families?
  • Can you remain comfortable working with patients who get visibly frustrated?
  • Are you a good observer?
  • Do you enjoy teaching (or re-teaching) people routine activities?
  • How are your writing skills?
  • Do you want to make a difference in people’s lives?
  • Are you a good organizer?
  • Do you have physical and emotional stamina?
  • Can you work with a diverse population including infants, children, adolescents, adults, and seniors?

If you answered “yes” to these questions, you may be a great fit for occupational therapy. The following guide can help you find the ideal OT program that offers the classroom education and hands-on practice you need.

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Research Occupational Therapy Programs Online

Occupational therapists are required to complete a master’s degree and up to half a year of supervised fieldwork. OTs are certified and must be licensed in the state where they practice. Depending on your current education and financial ability to pay tuition, you can start your training in an associate or bachelor’s degree program. Upon completion of the associate degree or bachelor’s program students are prepared to sit for national Occupational Therapist Assistant (OTA) exam. Along the way, students gather knowledge in the classroom and gain practical experience through voluntary work at a healthcare facility. From there, you can advance to a graduate program. How you plan to proceed depends on many factors, including where you currently are in your education, your existing work and family obligations, and your ability to attend classes on campus or complete your didactic training online.

Picking Your Degree Path

The first step in your journey is determining the program that best aligns with your educational goals and career aspirations. With a variety of options available, you can find one tailored to your needs. The training follows a sequential path. In high school, taking anatomy, mathematics, and psychology classes is beneficial. After obtaining your diploma, you can pursue a two-year associate degree or enter a four-year baccalaureate program. Now, let’s explore each educational option in more detail.

Starting as an occupational therapy assistant (OTA)

Completing a two-year associate degree is a sound option if you’re starting at the beginning. Many associate programs for OTAs prepare students for entry-level employment in the field. Coursework lays out the foundations of the profession, with studies in psychology, biology, pediatric anatomy, and gerontology.

Associate and bachelor’s degree programs offer students a choice of on-campus or online coursework. Upon completion of the two-year associate degree or four-year bachelor’s program students are prepared for the national Certified Occupational Therapy Assistant (COTA) exam offered by The National Board for Certification in Occupational Therapy (NBCOT).

Once you’ve passed the exam and become licensed, you’ll be able to begin working as an OT assistant and begin accruing at least one year of real-time experience essential for entry into most 2-3-year master’s degree programs. Accelerated OTA-to-OT bridge programs are available that will take you from a bachelor’s to master’s degree or from a bachelor’s degree to doctorate. Most bridge programs require completion of a bachelor’s degree, but some accept associate degree holders if they can complete prerequisite courses prior to admission. Many bridge programs offer instructional lessons online, combined with on-site classes, weekend classes, and required fieldwork. Bridge programs are well-suited for busy adults who want to accelerate time to graduation and save money on tuition.

A bachelor’s degree in a related field

To be accepted into a master’s OT program, students should hold a bachelor’s degree in a related field such as exercise science, kinesiology, psychology, speech pathology, or biology. Some master’s programs do not stipulate what sort of undergraduate majors are required for accepted as long as the applicant holds a four-year degree. Bachelor’s-to-master’s bridge programs generally require students to complete two semesters of bachelor’s-level work before moving on to the post-graduate degree. The undergraduate degree may be offered on campus or through an online hybrid program. A bachelor’s degree program is best suited for students who intend to advance from their OTA education and employment to OT status.

The master’s degree in occupational therapy

The master’s is the primary degree for launching a certified occupational therapy career and is the minimum educational attainment to become a licensed OT. The degree takes 2-3 years to complete. Five-year bridge programs combine bachelor’s degree/master’s degree curriculum and culminate with the award of the OT degree. The degree increases your earning power over the OTA designation. Salary.com reports a median wage for OTs from $95,815 – $100,507 compared to the $59,630 to $72,726 median wage for OTAs. Read more about hybrid and online master’s degrees in occupational therapy.

Considering the doctorate

According to the AOTA, the foundation curricula for the accredited entry-level master’s degree and entry-level doctoral programs may overlap. From there, doctoral programs add on additional semesters to cover advanced clinical practice and research skills, OT theory, program administration, policy development, and OT advocacy. To evaluate whether the doctoral degree is a good option, consider your career goals, the length of program, location, and costs. When you get to this point in your career, you’ll be well acquainted with the added managerial, research, and administrative aspects that come with OTD careers. The guiding question is whether you want to (or can afford to) spend money on doctoral tuition for an additional 16 months beyond the OT. According to PayScale, the median annual salary for an OTD is $69,000.

Selecting a School

Once you’ve figured out the ideal career path for your goals, it’s time to compare OT schools and their programs. Some degrees are only available on campus, while hybrids mix online learning with location-specific hands-on experience. As you start looking into the right programs for you, here’s a handy checklist to help you find the perfect fit:

  • Is the school regionally accredited, following the standardized AOTA Model Curriculum?
  • What is the school’s ranking?
  • How long does it take to complete your degree (including fieldwork)?
  • What are the class sizes or the professor-to-student ratio?
  • Is the cost of the program affordable?
  • Is financial aid available?
  • What is the completion rate for master’s students?
  • How many graduates pass their licensing examinations?
  • Is there job placement assistance?

Can You Become an Occupational Therapist Online?

Many students considering the profession want to know if there are online OT degree programs that fit well with their commitments to family or work According to the AOTA, there are no accredited entry-level OT or OTA programs available entirely online. However, there are online and hybrid OT programs with the option to complete didactic courses online and complete fieldwork and labs at a clinical location. Online OT programs vary by requirement, but distance courses can comprise from 24–90% of the curriculum, depending on the institution. Here are some common options for online students pursuing their post-graduate OT:

Mostly online programs

Many institutions offer a hybrid degree, combining an online component with a campus-based classes. Some programs can be completed in 24 months of full-time study. These online programs are well-suited for students who cannot compromise their existing obligations. The advantage of these programs is the flexibility of online scheduling and completing coursework at the time and place of your choice. Classes may be delivered through streaming video, multimedia, and voice conferencing. The fieldwork components are pursued at a clinical location convenient to the student. It’s imperative that students choose their OT program carefully to ensure that all online coursework is accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). If they’re not, you may not be eligible to take certification and licensing examinations.

Partially online programs

Partially online occupational therapy programs provide convenience and accessibility, allowing students to complete the online portion of their studies from anywhere. They combine the benefits of online learning, such as flexibility and self-paced study, with hands-on experience through in-person sessions. This blended approach caters to diverse learning styles while allowing students to receive the same rigorous education and training as those who attend fully on-campus programs. On-campus segments in some programs might take place multiple days a week, while hybrid programs offer accelerated weekend courses for on-campus training. Although this option may not be ideal for busy students due to more frequent campus visits, it does provide increased face-to-face interaction with faculty, advisors, and peers. With their self-paced studies and extended on-campus time, flexible online programs could take longer to complete. For instance, a Florida-based institution requires three years to finish the coursework and fieldwork.

To learn more about the online option, read our page dedicated to online occupational therapy schools and programs.

Submit Your Applications

Now that you’ve determined the best pathway into the profession, you’re ready to create a list of optimal degree programs, the best colleges and universities, and a checklist of application requirements. Note the application deadlines and enrollment dates for each institution you’re considering and create a to-do list to complete your application on time. You may want to apply for financial aid at this time as well. You can do that at the Free Application for Federal Student Aid (FAFSA) website. Here are a few things to focus on as you prepare your applications:

Satisfy the pre-requisites

You can view admission requirements at the OT program websites of your target institutions. If required for any programs you’re interested in, you’ll need to schedule and take the Graduate Record Examinations (GRE) test and submit your scores to potential programs. While not all programs may require it, for those that do, your scores can make a difference in your admissions ranking. Most programs will require you to complete a battery of prerequisite courses prior to applying or during a session before the enrollment date. Common prerequisites total 19-21 units, and OT programs require the completion of a BA or BS degree from an accredited institution. You’ll also have to report 30-100 voluntary observation hours completed during undergraduate work. Individual prerequisite courses include studies and labs in:

  • Medical Terminology
  • Biology
  • Human Physiology
  • Introduction to Statistics
  • Oral Communications
  • Sociology or Anthropology
  • Anatomy
  • Psychology

Prerequisites vary for admission to PhD programs in OT. The common ones include:

  • Master’s degree
  • GPA of 3.5
  • Introductory statistics course
  • Graduate level research methods course

Application process & fees

Most institutions that offer post-graduate OT programs prefer to have formal applications submitted through the Occupational Therapist Centralized Application Service (OTCAS). The application includes relevant GPA, admission essays, and letters of recommendation. OTCAS gathers all necessary application information and documentation through a single account and allows students to submit applications to as many schools as they wish. The application cost is $155 for the first school and $67 for each program thereafter. Be sure your target school participates in OTCAS applications. If not, visit the applications section of the institution’s website to learn about requirements, deadlines, and fees.

PhD programs typically use the OTCAS application system as well. Others may have their own admission screening process and fees. You’ll need to submit all your college transcripts, letters of recommendation, test scores and an essay detailing your educational and career objectives.

Pass Your Classes

Students need to pass all the coursework in their OT program to qualify for testing for certifications and licensing via the Occupational Therapist Registered (OTR) exam. Individual courses and requirements may vary by institution, but accredited programs follow the AOTA model curriculum mandates. They must meet the standards of educational accreditors such as the Accreditation Council for Occupational Therapy Education.

Overall common master’s degree coursework covers:

  • Pre-OT courses in human development, kinesiology, nervous system and musculoskeletal anatomy
  • Foundations of occupational therapy (theory and practice)
  • Biomechanical applications
  • OT research techniques
  • Public and professional engagement
  • Clinical neuroscience
  • Screening and evaluation
  • Clinical populations (family, pediatrics, adolescence, adulthood, gerontology)
  • Therapy interventions
  • Clinical applications in psychology
  • Orthotics and prosthetics
  • Community-centered OT
  • Seminar in OT topics
  • Health promotion and wellness
  • Professional development
  • OT management of services
  • A scholarly project in occupational therapy
  • Fieldwork

Fieldwork is typically comprised of two sequential courses.

Complete Hands-on Fieldwork

Hands-on fieldwork is an essential component required by graduate-level OT programs. AOTA has a breakdown of requirements for fieldwork.

Level 1 fieldwork commences during the academic year while students are still attending classes, and level 2 fieldwork is undertaken near the end of the degree program. Students integrate their theoretical learning with real-life practice in a clinical setting. The AOTA states that each program can set its required hours for Level 1 fieldwork. However, for AOTA-approved Level 2 fieldwork, students must complete a minimum of 24 full-time weeks. As you progress through Level 2, assignments become more challenging, allowing you to work with diverse clinical populations. This hands-on experience also offers valuable networking opportunities with healthcare professionals, helping you establish lifelong connections with peers, mentors, and potential employers. Take a look at some fieldwork courses and descriptions from OT programs.

University of St. Augustine. Fieldwork IIB:

“Students will demonstrate entry-level competency and standards of practice within this second practice area. Includes weekly online interaction with faculty to facilitate student learning through reflective practice.”

University of Florida, College of Public Health & Health Professions Fieldwork Level II:

“Includes an in-depth experience in delivering occupational therapy services to clients, focusing on the application of purposeful and meaningful occupation and research, administration, and management of occupational therapy services. It is recommended that the student be exposed to a variety of clients across the life span and to a variety of settings.”

Earn Your License (& Certifications)

OTs are required to be licensed in every state by passing the examination offered by the National Board for Certification in Occupational Therapy (NBCOT). NBCOT test candidates must hold a master’s degree from an accredited institution and have satisfied the school’s fieldwork requirements. Upon passage of the examination, OTs can use the designation of Occupational Therapist, Registered (OTR). The American Occupational Therapy Association (AOTA) maintains a listing of OT regulatory agencies and contact information for all states and territories.

While not required to enter the profession, AOTA recommends earning additional certifications as a means of increasing your knowledge base and skill sets for specialized areas of practice. Certifications can also pave the way to advancement in the OT field. Because there are continuing education requirements for maintaining certification, OTs should demonstrate to their employers the completion of ongoing specialty training. Available board specializations include:

  • Gerontology
  • Low Vision
  • Mental Health
  • Pediatrics
  • Physical Rehabilitation
  • Driving and Community Mobility

Apply to Jobs

When it comes time to apply for jobs, there are many ways to find ones you’d like to apply to. Check the job boards at national employment websites as well as specialized job listings at OT associations and organizations. Perhaps people in your network know of openings. While you’ll apply with a cover letter and resume, there is no single boilerplate cover letter and resume that will satisfy the OT hiring manager. Successful applicants will read the job description carefully and tailor their resumes, emphasizing their unique fit to the job requirements. The process includes learning as much as possible about each company or employer. As you prepare your resume for the job, discover how to emphasize qualifications that separate you from the pack. The narrative of your resume should be accomplishment driven, emphasizing how you contributed to fieldwork and professional roles. Be sure to cite educational achievement and applicable certification and licensure. Because some larger employers use an automated applicant tracking system (ATS) to ferret out unprepared candidates, you should note the keywords used in the employment listing and use them in listing your qualifications. The following websites offer sample occupational therapist resumes and tips to make them attractive to employers:

Face-to-Face Interviews

Landing the interview usually means you’ve passed the initial screening process and are in the competition for the OT opening. AOTA recommends that candidates put their best foot forward by practicing for the interview. There are more generalized questions that come up early in the interview, and some are asked just to break the ice. But thereafter, the interview gets down to business and you should be prepared to support and expand upon the highlighted qualifications that you cited in your resume. Here are 10 key questions you may face when interviewing:

  1. What are the best qualities to have as an OT?
  2. What OT certifications (or specializations) do you have?
  3. Why are you interested in this opening and why are you a good fit?
  4. What are your accomplishments in education or practice?
  5. How did you handle challenges from patients in your fieldwork?
  6. What would you specially contribute to our organization?
  7. How would your peers describe you?
  8. What motivates you to pursue a career in OT?
  9. Where do you see your career heading in the next five years?
  10. How do you handle feedback or constructive criticism?