Occupational therapy (OT) is a health profession focused on enabling individuals across the lifespan to participate in the activities of daily life that hold personal meaning. Practitioners help people recover from injury or illness, adapt to physical and cognitive changes, and promote health by addressing the physical, psychological, and environmental factors that affect function. The educational path to becoming an occupational therapist has evolved significantly, introducing a doctoral-level option alongside the traditional master’s degree, which often creates confusion for those entering the field.
Clarifying the Current Entry-Level Education Requirement
The minimum educational standard for occupational therapists in the United States is the graduate level; a bachelor’s degree alone is no longer sufficient for practice. Aspiring occupational therapists must obtain a degree from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). Both the entry-level Master of Occupational Therapy (MOT) and the entry-level Occupational Therapy Doctorate (OTD) are recognized pathways to becoming a licensed practitioner. Graduates of either program are equally eligible to sit for the national certification exam, which is mandatory for licensure in all states.
While the MOT remains a valid credential, many academic institutions are transitioning their programs to the OTD level. Many universities now offer the OTD as their sole entry-level option, aligning with the broader movement toward clinical doctorates in healthcare. The choice between the two degrees often depends on an individual’s career aspirations and commitment to a longer program timeline.
Understanding the Occupational Therapy Doctorate (OTD)
The entry-level Occupational Therapy Doctorate (OTD) is an intensive academic program designed to prepare practitioners for advanced roles in research, leadership, and specialized practice. This degree path generally requires about three years of full-time study following a bachelor’s degree. The curriculum integrates the foundational clinical knowledge required for entry-level practice with advanced training in areas like evidence-based practice, program development, and policy analysis.
A distinguishing characteristic of the OTD is the mandatory doctoral capstone experience and project, which sets it apart from the master’s degree. This capstone is an individualized, in-depth experience that must follow the completion of all didactic coursework and Level II fieldwork. The capstone experience is a minimum of 14 weeks, or 560 hours, focusing on developing expertise in a specific area such as administration, advocacy, or education. The culminating capstone project requires the student to apply advanced knowledge to address a real-world issue within their chosen practice area.
The Master of Occupational Therapy (MOT) Path
The Master of Occupational Therapy (MOT) remains a primary route for individuals seeking to enter clinical practice quickly. MOT programs typically take between two and two and a half years to complete after a bachelor’s degree, offering a shorter time commitment than the doctoral path. This curriculum focuses on foundational practice skills, clinical reasoning, and the professional competencies necessary for providing direct patient care.
The MOT program culminates in the completion of Level II fieldwork, which provides extensive, hands-on clinical experience under the supervision of a licensed occupational therapist. While the curriculum covers the core principles of evidence-based practice, its focus is oriented toward the practical application of these skills in clinical settings.
Comparing the OTD and MOT Degrees
A difference between the OTD and MOT lies in the time and financial commitment required for graduation. The OTD program’s additional year of study, which includes the doctoral capstone, translates directly to higher tuition costs and an extra year of foregone salary. Prospective students must weigh the increased expense and time against the potential for career differentiation that the OTD offers.
Data on entry-level salaries for OTD and MOT graduates show similar pay scales for those entering traditional clinical roles. The OTD does not reliably translate to significantly higher entry-level clinical earning potential compared to the MOT degree. The doctoral degree may provide a competitive edge for positions in academia, advanced clinical specialization, or organizational leadership and program development.
Licensure and Certification Requirements
Regardless of whether a candidate holds an MOT or an OTD, the next required step for professional practice is passing the national certification examination. This exam is administered by the National Board for Certification in Occupational Therapy (NBCOT). Successful completion of this standardized test grants the graduate the credential of Occupational Therapist, Registered (OTR).
To be eligible for the NBCOT exam, candidates must graduate from an ACOTE-accredited program and submit an official transcript verifying the completion of all academic and fieldwork requirements. Passing the NBCOT exam is necessary but not sufficient for practice, as all states require a separate license to work as an occupational therapist. State licensure typically uses the NBCOT exam results as the foundation for granting practice privileges.
The Future of Occupational Therapy Education
The educational landscape for occupational therapy continues to evolve, with ongoing professional discussions about the entry-level degree. Organizations like the American Occupational Therapy Association (AOTA) previously supported the OTD becoming the sole entry-level degree by 2025. However, the profession’s accrediting body ultimately decided to maintain the dual entry-level degrees of both the MOT and the OTD.
This decision means that current MOT holders and those graduating from MOT programs will be able to practice indefinitely, as they are “grandfathered” into the profession. Prospective students should consider the OTD if they have an interest in pursuing roles focused on research, policy, or academic teaching, where the doctoral degree may hold more weight. Conversely, pursuing the MOT offers a more direct and less expensive route to immediate clinical practice.