Occupational therapy (OT) is a health profession dedicated to helping people across the lifespan participate in the activities of daily life. Occupational therapists promote independence and function for clients with physical, developmental, or emotional challenges by adapting tasks and environments. This career path is increasingly in demand, offering a rewarding blend of science, creativity, and direct patient interaction. Becoming an occupational therapist requires advanced education, national certification, and state licensure.
Understanding the Educational Requirements
A graduate-level education is mandatory for entry into the field, requiring either a Master of Occupational Therapy (MOT) or a Doctor of Occupational Therapy (OTD) degree. Both degrees prepare students for entry-level practice and must be earned from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). Graduation from an ACOTE-accredited program is a prerequisite for sitting for the national certification exam.
The OTD typically includes a capstone project and additional training in areas like research, advocacy, and leadership, often taking one academic year longer than the MOT. Students can choose the degree that best fits their career goals, as the OTD is not currently mandated as the entry-level degree. Most graduate programs do not require a specific undergraduate major but mandate a comprehensive set of prerequisite courses.
These prerequisite courses usually focus on the life and social sciences. Common requirements include human anatomy and physiology with laboratory components, physics, statistics, and several psychology courses such as abnormal or developmental psychology. Many programs also require a minimum grade point average and documentation of observation hours in various OT settings.
Completing Essential Fieldwork and Clinical Practice
After completing academic coursework, aspiring occupational therapists must complete mandatory clinical fieldwork. This practical training is structured into two distinct levels to ensure students can apply theoretical knowledge in real-world settings. Level I fieldwork introduces students to the profession, focusing on observation and participation in service delivery.
Level II fieldwork is a full-time clinical experience that must be successfully completed before a student is eligible for the certification exam. The minimum requirement for Level II is 24 weeks of supervised experience, typically divided into two separate 12-week placements. This structure allows the student to gain exposure to diverse client populations and practice environments.
Students are closely supervised by a licensed occupational therapist who provides mentorship and evaluates performance in patient assessment, intervention planning, and professional conduct. Fieldwork acts as a bridge between the academic setting and professional practice, providing the necessary hands-on skills to function as an independent clinician.
Securing National Certification and State Licensure
The final steps to legally practice involve passing a standardized examination and obtaining state licensure. Graduates must first apply to take the certification exam administered by the National Board for Certification in Occupational Therapy (NBCOT). Successfully passing this exam grants the candidate the Occupational Therapist Registered (OTR) credential, signifying they have met the national standard of competence for entry-level practice.
National certification does not grant the legal authority to practice; that authority comes from state licensure. Every state has a regulatory board that issues the license, which is the legal permission to work within that jurisdiction. The state board requires proof of graduation from an ACOTE-accredited program and verification of a passing score on the NBCOT exam.
State requirements often extend beyond these core steps. These can include a criminal background check, a state-specific application, and the payment of various fees. Some states also require applicants to pass a jurisprudence exam, which tests knowledge of the state’s specific laws governing occupational therapy practice. Candidates must consult the licensing board in the state where they intend to work, as requirements vary significantly by location.
Developing Skills for the Profession
Success in occupational therapy relies on a specific set of interpersonal and cognitive skills that complement academic and clinical training. Empathy and compassion enable the therapist to connect with clients and understand the emotional and psychological impact of their challenges. This ability to see the world from the client’s perspective is important for building a therapeutic relationship.
Effective communication requires the therapist to be an active listener who can understand complex patient narratives and clearly explain treatment plans to clients and their families. Problem-solving skills allow the therapist to think creatively and adapt interventions, as every client presents unique needs and environmental barriers. Therapists often devise customized solutions, such as modifying equipment or changing the sequence of a task to promote greater independence.
Where Occupational Therapists Work and Career Growth
Occupational therapists enjoy a strong job outlook, with employment projected to grow faster than the average for all occupations. The median annual wage was approximately $96,370 in 2023, though this amount varies based on the work setting and geographic location. Therapists work in diverse environments, including:
- Hospitals
- Skilled nursing facilities
- Outpatient clinics
- Schools
- Home health agencies
Career growth often involves specialization, allowing therapists to focus practice on a particular population or area, such as pediatrics, geriatrics, or hand therapy. Specialization is achieved through advanced training, professional development, and experience. Maintaining licensure requires ongoing professional development, with most states mandating a specific number of continuing education contact hours biennially. These requirements, which can range from 20 to 30 hours, ensure therapists remain current with the latest research and practice techniques.
Starting Your First Role
The transition from student to practicing professional requires a focused approach to the job search. Leveraging the experience gained during Level II fieldwork is helpful, as this practical time demonstrates the ability to manage a caseload and apply clinical skills. Resumes should highlight specific accomplishments and responsibilities from fieldwork placements, treating them as professional work experience.
Interview preparation should involve articulating a clear understanding of the profession’s philosophy and demonstrating the soft skills required for client interaction. Candidates should be prepared to explain how specific clinical challenges were resolved during training. Networking with former fieldwork supervisors and academic faculty can also provide valuable leads and mentorship opportunities. Securing the first role marks the start of a career dedicated to enhancing the lives and independence of others.