Becoming an occupational therapist requires a master’s degree or doctoral degree in occupational therapy from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). There is no single undergraduate major required to get in, but you will need specific prerequisite courses before applying to a graduate program. Here’s how the full educational path works.
No Specific Undergraduate Major Required
OT graduate programs do not prefer one undergraduate major over another, and most universities don’t offer a “pre-OT” major. Students successfully enter OT school from backgrounds in biology, psychology, kinesiology, public health, education, business, engineering, and liberal arts. The key is completing the required prerequisite courses, not choosing a particular major.
That said, many students gravitate toward majors in health sciences or psychology because those programs naturally overlap with OT prerequisites, making it easier to fit everything into four years. If you pick a less related major, you may need to add electives or take summer courses to cover the gaps.
Prerequisite Courses You’ll Need
Exact prerequisites vary by program, but most OT schools require at least the following coursework before you apply:
- Human Anatomy and Physiology (usually a two-semester sequence)
- Abnormal Psychology
- Statistics
- Lifespan Human Development (covering infancy through old age)
- Physics
- Behavioral or Social Sciences (anthropology, sociology, or psychology electives)
- Medical Terminology
Some programs require all prerequisites to be finished before you even submit your application, while others allow you to complete a course or two before enrollment. Check each school’s admissions page early so you don’t miss a deadline because of one outstanding class.
Master’s Degree in Occupational Therapy
The most common entry-level route is a Master of Occupational Therapy (MOT) or Master of Science in Occupational Therapy (MSOT). A residential MOT program typically takes about two years of full-time study after your bachelor’s degree. Flexible or part-time formats run closer to three years. Coursework covers anatomy, neuroscience, biomechanics, therapeutic techniques, and clinical reasoning, along with several weeks of supervised fieldwork in real clinical settings.
A master’s degree is sufficient to sit for the national certification exam, get licensed, and practice in any setting, from hospitals and schools to private clinics and home health agencies. The vast majority of practicing occupational therapists hold a master’s degree.
Doctoral Degree in Occupational Therapy
The Doctor of Occupational Therapy (OTD) is a clinical doctorate, not a research PhD. A residential OTD program typically takes about 2.7 years, while flexible formats take around 3.7 years. The extra time, compared to a master’s, goes toward an in-depth capstone project and additional leadership or specialty coursework.
OTD programs generally cost more than MOT programs simply because you’re in school longer. Both degrees lead to the same license and the same credential after passing the certification exam. An OTD may give you a competitive edge if you want to move into program development, academic teaching, or clinical leadership, but it is not required for clinical practice. Employers in most settings hire master’s-level and doctoral-level OTs interchangeably.
Certification and Licensing After Graduation
After graduating from an ACOTE-accredited program, you must pass the national certification exam administered by the National Board for Certification in Occupational Therapy (NBCOT). Passing earns you the credential OTR (Occupational Therapist, Registered). Every state then requires its own license to practice, which typically involves submitting your NBCOT results and completing a state application.
To be eligible for the NBCOT exam, you must graduate with an entry-level occupational therapy degree from an ACOTE-accredited program. If you earned your OT degree outside the United States, you’ll need to go through the Occupational Therapist Eligibility Determination (OTED) process, which evaluates whether your education and fieldwork hours are comparable to U.S. standards. That process carries an $850 application fee, and approval is valid for seven years, meaning you must pass the exam within that window.
The Associate’s Degree Alternative
If a graduate degree feels like more time or money than you want to commit right now, consider the occupational therapy assistant (OTA) path. OTAs need an associate’s degree from an accredited OTA program, which typically takes about two years. After graduating, OTAs pass a separate NBCOT exam and earn the COTA (Certified Occupational Therapy Assistant) credential.
OTAs work under the supervision of occupational therapists. They guide clients through therapeutic exercises, teach new ways to accomplish daily tasks, demonstrate adaptive equipment, and document progress. They do not evaluate patients, design treatment plans, or make independent clinical decisions. The median pay is lower than for occupational therapists, but the shorter, less expensive educational path makes it an appealing entry point. Some OTAs later return to school for a master’s or doctoral degree to become full occupational therapists.
Putting the Timeline Together
From start to finish, the path to becoming a licensed occupational therapist looks like this: four years for a bachelor’s degree, then two to three years for a master’s or roughly three years for a doctorate, followed by the certification exam and state licensing. Most people are ready to practice six to seven years after starting college. If you already have a bachelor’s degree with the right prerequisites, you’re looking at two to three years before you can start working.
The fieldwork component is built into every accredited program, so you won’t need to arrange a separate internship after graduation. Programs require several hundred hours of supervised clinical experience across different practice settings, giving you hands-on skills before you ever sit for the exam.