Occupational therapists help people of all ages live more independent and satisfying lives by enabling them to perform the everyday activities that are important to them. They work in various settings, including hospitals, schools, rehabilitation centers, and private homes, designing personalized interventions for each client. The path to becoming an occupational therapist is a structured process involving specific educational achievements, hands-on training, and formal certification.
Fulfill the Educational Requirements
The first step to entering the occupational therapy field is completing a graduate-level degree from an accredited institution. Aspiring professionals must earn a Master of Occupational Therapy (MOT) or a Doctor of Occupational Therapy (OTD) from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). This accreditation ensures that the program meets the standards necessary for national certification and state licensure. Without this specific accreditation, a graduate will not be eligible to sit for the required national exam.
Before applying to a graduate program, students must first complete a bachelor’s degree. While there is no single required major, many applicants choose fields like psychology, biology, kinesiology, or health sciences to build a strong foundation. Admission into an MOT or OTD program is competitive and requires the completion of specific prerequisite courses. Common requirements include anatomy and physiology with labs, developmental or abnormal psychology, and statistics.
The choice between an MOT and an OTD program often depends on career goals. An MOT degree is typically shorter, focusing on preparing students for clinical practice. An OTD program is longer and includes advanced coursework in areas such as research, leadership, and advocacy, preparing graduates for roles in academia, policy development, or advanced clinical practice. Both degrees include the necessary coursework and fieldwork to qualify for the national certification exam.
Complete Supervised Fieldwork Experience
Following the classroom-based portion of an occupational therapy program, students must complete extensive supervised fieldwork. This hands-on training is a mandatory component of any ACOTE-accredited program and translates academic knowledge into practical skills. Fieldwork provides students with real-world experience in various practice settings, allowing them to work directly with clients under the guidance of a licensed occupational therapist.
The fieldwork requirements are divided into two stages: Level I and Level II. Level I fieldwork is introduced early in the curriculum and is often observational, designed to give students a broad understanding of the needs of diverse client populations in different settings. These experiences help students become comfortable in clinical environments and see how occupational therapy principles are applied day-to-day.
Level II fieldwork is more intensive and constitutes the core of the hands-on training. Students must complete a minimum of 24 full-time weeks of in-depth clinical training. During this time, they are responsible for patient evaluation, intervention planning, and treatment implementation under the direct supervision of an experienced OT. This is where students develop their clinical reasoning, professional behaviors, and confidence for practice upon graduation.
Pass the National Certification Exam
After graduating from an accredited MOT or OTD program and completing all fieldwork, the next step is to pass the national certification exam. This examination is administered by the National Board for Certification in Occupational Therapy (NBCOT) and is the standard for professional certification.
Passing the NBCOT exam earns the credential “Occupational Therapist, Registered” (OTR), which signifies that the therapist has met the national standards for competency. The exam is comprehensive, covering the full scope of occupational therapy practice. It assesses a candidate’s knowledge in areas such as evaluation and assessment techniques, the process of planning and implementing interventions, and understanding professional ethics and responsibilities.
Eligibility to sit for the exam requires proof of graduation from an ACOTE-accredited program and the successful completion of all required fieldwork. Candidates must apply for eligibility through the NBCOT.
Obtain a State License
The final step before an individual can legally practice is obtaining a state license. All states require occupational therapists to be licensed, and this process is managed by a state-specific regulatory board. Licensure ensures that a practitioner has met the legal requirements to provide occupational therapy services within that jurisdiction.
While all states use the results of the NBCOT certification examination as a primary requirement for licensure, specific requirements can vary from one state to another. Applicants must submit their NBCOT exam results, proof of their graduate degree, and documentation of their completed fieldwork hours to the state board.
Some states may have additional stipulations. These can include passing a state-specific jurisprudence exam, which tests knowledge of the laws and regulations governing practice in that state. Applicants are typically required to undergo a criminal background check and pay various application and licensure fees.
Key Qualities for Success
- Empathy and Compassion: Connecting with patients on a human level is fundamental to occupational therapy. Empathy allows a therapist to understand a patient’s emotional and physical struggles, while compassion drives the desire to help them overcome those challenges. This connection builds trust and motivates patients throughout their recovery journey.
- Communication Skills: Occupational therapists must be able to communicate clearly and effectively with a wide range of individuals. This includes explaining complex treatment plans to patients in simple terms, educating families and caregivers on how to provide support, and collaborating with other healthcare professionals to ensure coordinated care.
- Problem-Solving Abilities: Every patient is unique, with different goals, abilities, and environments. Effective occupational therapists are skilled problem-solvers who can design creative and customized treatment plans. They must continuously assess a patient’s progress and adapt interventions to overcome any challenges that arise.
- Patience and Flexibility: Progress in occupational therapy can sometimes be slow and nonlinear. Therapists need a great deal of patience to support clients through setbacks and celebrate small victories. Flexibility is also important, as therapists must be prepared to adjust their approach in response to a patient’s changing needs or unexpected circumstances.
- Physical Stamina: The work of an occupational therapist can be physically demanding. Therapists are often on their feet for long periods and may need to assist patients with mobility, transfers, or other physical tasks. They also frequently demonstrate exercises and activities, which requires a good level of physical fitness.