Occupational Therapists
Occupational therapists (OTs) are healthcare professionals who treat people with injuries, illnesses, or disabilities to allow them to perform the tasks (also called occupations) that they need or want to do. OTs assess their patients’ needs and desires and work with them to create an individualized treatment plan that will allow them to reach their goals as independently as possible. For example, an OT might:
- Treat a man with vision loss who wants to cook independently by providing him with specialized kitchen tools and demonstrating techniques that he can use to safely operate kitchen equipment
- Treat a teenager with cerebral palsy who want to take their own notes in class by giving them pens with specialized grips and showing them exercises to improve their fine motor control
- Treat a woman who has had one of her arms amputated and struggles to get dressed by providing her with specific movements and tools to help her put on clothing with one hand
OTs are different from physical therapists (PTs). Whereas PTs help patients improve their ability to move their body, OTs help patients improve their ability to carry out the activities of their daily life. For example, a PT might give a patient exercises to improve the range of motion of their hands, while an OT will show the patient how to use special techniques and assistive devices to independently eat, brush their teeth, or drive their car. These two different approaches can be very successful when used in concert, so OTs and PTs often work together.
Job Settings
Most OTs work in healthcare settings, such as in hospitals, skilled nursing facilities, outpatient clinics, and even in patients’ homes. A significant number of OTs also work in education, such as in public elementary or high schools, or as researchers or professors in higher education institutions. Most OTs work full-time, either in a single location or traveling between multiple locations. Some work 8 hours Monday through Friday, while others work irregular schedules, nights, and/or weekends to accommodate patients’ needs.
Daily Responsibilities
The daily responsibilities of an OT depend on the setting in which they work, but many OTs perform similar tasks on a day-to-day basis. An average day may include evaluating patients’ conditions, speaking to patients and their families about their goals, observing patients performing their daily activities, developing treatment plans, demonstrating bodily movements and exercises, teaching patients how to use assistive devices, recording patients’ progress, filling out billing paperwork, or meeting with other healthcare professionals. OTs often work in a team with physicians, nurses, PTs, speech-language pathologists, and other healthcare professionals.
Important Skills
OTs must be empathetic, patient, adaptable, and able to spend much of their time on their feet. They must enjoy solving problems in unconventional ways and be comfortable working with people of all ages and all abilities. Very strong communication skills are also crucial, as OTs often work with people who may struggle to express themselves or understand others. A career as an OT is perfect for those with a caring nature and a passion for improving accessibility for people with disabilities.
Salary
The mean annual salary of an OT in the United States is $87,480, and half make between $70,880 and $103,060. Salary varies by location, from $85,050 in the Boston area to $106,610 in the Los Angeles area. OTs working in healthcare tend to have higher salaries than those working in education.1
Job Outlook
Demand for OTs is growing rapidly due to the United States’ aging population, rising rates of chronic health conditions such as diabetes, and increasing recognition of the usefulness of occupational therapy for people with disabilities. Employment of OTs is expected to grow 16 percent between 2019 and 2029, which is faster than the average medical profession and far above the average growth rate of all occupations. This will result in a projected 22,700 new OT jobs within 10 years.2
Pros and Cons
Pros:
- Rewarding: Many OTs find personal fulfillment in watching their patients make progress
- Great job outlook: Demand for OTs is high and quickly increasing
- Flexibility: OTs can work in many different settings and with many different patient populations depending on their preferences
- Work-life balance: Most OTs work 40 hours per week and never have to be on call
Cons:
- Stress: High productivity expectations in some job settings may cause stress
- Paperwork: OTs must complete paperwork documenting their patients’ progress and billing insurance companies, which some may find tedious
- Emotional difficulty: Working with patients with illnesses, injuries, and disabilities can be emotionally taxing
Career Paths
The first step to becoming an OT is to get a graduate degree in occupational therapy from a graduate program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). As of 2021, OTs can begin to practice with either a Master’s in Occupational Therapy (MOT/MSOT) or a Doctorate in Occupational Therapy (OTD). There are over 150 MOT programs and over 45 OTD programs in the US.
MOT programs typically last 2 to 3 years (including the summer) when attended full-time, although part-time and partially online options are also increasingly offered. MOT programs typically include academic classes, labs, and at least 24 months of fieldwork under the guidance of licensed and practicing OTs. Graduates of MOT programs are qualified to be licensed and practice as OTs, but may not be qualified to teach at a university or perform research.
OTD programs are often the best option for those interested in teaching and/or research. They typically last 3-4 years and, compared to MOT programs, involve more in-depth classes, a greater emphasis on research skills and leadership, more time doing fieldwork, and a capstone project. OTD programs are often classified as either entry-level or post-professional. Entry-level programs admit those with only a bachelor’s degree, while post-professional programs admit only those who already have an MOT and have practiced as an OT.
After completing their graduate degree, all prospective OTs must obtain state licensure. Licensure requirements vary slightly, but all 50 states require licensure applicants to have an MOT or OTD degree and to pass the National Board for Certification in Occupational Therapy (NBCOT) certification exam. Once licensed, an OT can practice independently in their state.
After beginning to practice, some OTs may choose to do an OT fellowship to further their career. OT fellowships last 9-12 months and provide specialized experience in an area of occupational therapy such as pediatrics, gerontology, or physical rehabilitation. OT fellowships are most commonly done after 1-5 years of practice and provide the opportunity for an OT to obtain advanced certification from the American Occupational Therapy Association (AOTA).
NOTE: It is likely that the AOTA and ACOTE will require all MOT programs to transition to the doctoral level, possibly as soon as 2027. However, OTs who have already earned an MOT will be grandfathered and still be able to practice for the rest of their careers without an OTD.
Preparing for Graduate School
Preparation for MOT and entry-level OTD programs is generally similar, but individual programs differ in their requirements. All programs require applicants to have a bachelor's degree and complete specific prerequisite courses. Applicants can often major in any subject, but the required prerequisite courses may be easier to complete as part of a biology or psychology major. Common prerequisites include 2 semesters of human anatomy and physiology with lab, biology with lab, chemistry with lab, physics with lab, neuroscience with lab, general psychology, developmental psychology, abnormal psychology, sociology, and statistics.
Most MOT and OTD programs require a high undergraduate GPA, strong Graduate Record Examinations (GRE) scores, 3-4 letters of recommendation (also called evaluations), a resume, and a personal statement. Additionally, all programs strongly recommend or require that applicants spend at least 40 hours observing practicing OTs, either through volunteering or paid work. Admission is competitive, so in order to improve their chances, prospective applicants should strive to exceed 40 hours of observation time and observe OTs who work in different settings and with diverse populations. Volunteer experience or paid work in non-OT clinical settings or with people with disabilities can also be beneficial.
Most MOT and OTD programs use the Occupational Therapy Centralized Application Service (OTCAS) to allow applicants to submit all of their application materials in one place. Those interested in applying to MOT or OTD programs should carefully research the schools that they are interested in attending and take note of their prerequisites, the GPA and GRE scores of their accepted students, their application requirements and recommendations, and their application deadlines.
Application Timeline
A general application timeline for an MOT or OTD program that uses OTCAS and begins in the fall is shown below. This timeline is meant only to give a general idea of the application process. Applicants should carefully check the deadlines for their specific application year and the programs that they wish to apply to. Some programs have early action deadlines in the early fall, and many use rolling admissions, so application materials should be submitted as soon as possible in order to maximize the odds of admission.
| Pre-Application | Maintain high GPA, complete prerequisite courses, take the GRE, request letters of recommendation, gain OT-related volunteering or work experience, prepare resume, write personal statement |
| Mid-July before year of attendance | OTCAS opens and application materials should be submitted as soon as possible |
| September to November | Early action deadlines for application materials to be submitted to OTCAS |
| November to March | Final deadlines for application materials to be submitted to OTCAS |
| September through May | Programs invite select applicants for interviews |
| March to June | Programs release admission decisions |
| August to September | Programs begin |
Financing Your Education
The total cost of MOT and OTD programs varies widely, from under $10,000 for in-state students at some public universities to over $120,000 at some private universities. MOT programs are generally less expensive than OTD programs. Most universities offer scholarships, financial aid, loans, or other means by which students can reduce the financial burden of getting their degree. Many state universities have significantly lower tuition for in-state students. Additionally, part-time programs can increase affordability by allowing students to work while in school. Prospective OTs should carefully consider their financial situation and the level of debt they are willing to accept when deciding which programs to apply to.
Additional Resources
- US Bureau of Labor Statistics Occupational Outlook Handbook: https://www.bls.gov/ooh/healthcare/occupational-therapists.htm
- Information from American Occupational Therapy Association: https://www.aota.org/Education-Careers/Considering-OT-Career.aspx
- How to become an OT: https://otpotential.com/blog/become-an-occupational-therapist
- Video examples of occupational therapy sessions:
- List of accredited MOT and OTD programs: https://acoteonline.org/schools/
- MOT vs. OTD degree: https://www.myotspot.com/pursue-mot-vs-otd/
- Differences between occupational and physical therapy: https://www.mcphs.edu/about-mcphs/news/occupational-therapy-versus-physical-therapy
- List of assistive devices commonly used by OTs: https://strokengine.ca/en/interventions/assistive-devices/