Becoming an Occupational Therapist: Education, Certification, and Career Paths
Occupational therapy (OT) is a healthcare profession focused on helping individuals of all ages participate in the activities they find meaningful. Occupational therapists (OTs) work with patients who have conditions that are mentally, physically, developmentally, or emotionally disabling. The goal of an occupational therapist is to help patients with medical issues and complications to live more independently. This can include teaching new techniques, using special equipment, or adjusting environments at home or work. If you’re passionate about helping people regain independence, overcome challenges, and improve their daily lives, a career in occupational therapy (OT) could be the perfect fit.
What Occupational Therapists Do
Occupational therapists are healthcare specialists skilled in helping people perform everyday tasks that make life feel meaningful again. OTs are unique in that they use evidence-based interventions to help patients participate in the activities they find most meaningful. An OT’s day is usually spent working with a series of patients on a set schedule. They begin by understanding the person’s needs and then create a plan to improve their ability to do everyday activities. OTs evaluate and assess patient needs, then create and follow therapy plans of care (POCs) consisting of discrete goals for functional recovery.
Occupational therapists work with doctors, nurses, physical therapists, occupational therapy assistants, and other team members to treat patients of all ages, from infants to the elderly. They work in various settings, including hospitals, rehabilitation hospitals, psychiatric hospitals, offices and clinics, school systems, nursing homes, and home health agencies. They typically work 40-plus-hour weeks during daytime hours, including some weekends and holidays.
Much of an OT’s job involves troubleshooting patient challenges and determining the right types of interventions to address those problems. It’s worth noting that OTs spend quite a bit of their time filling out paperwork, too. Each patient’s case must be documented, and the documentation rules and frameworks set forth by different payers and regulatory entities can be very involved. That means that occupational therapists realistically spend a significant portion of each day writing notes about cases and communicating with other members of the care team.
Skills and Qualities of Successful Occupational Therapists
Individuals interested in becoming an occupational therapist typically have excellent communication and interpersonal skills. Occupational therapists blend science with a healthy dose of compassion and creativity. OTs need to be somewhat analytical, but also patient and encouraging. They should enjoy science (especially anatomy and kinesiology) and like working with the general public.
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Much of what an OT does involves educating patients, family members, and caregivers-so it’s vital that OTs understand how to effectively teach and communicate. OTs also need to be very safety-oriented. One of the biggest issues that fieldwork coordinators face is students’ lack of safety awareness. Much of an OT’s job centers on keeping patients and family members safe, which can be a challenge. Lastly, a good OT should be able to work collaboratively with others on a multidisciplinary team. Much of an OT’s work involves providing a holistic perspective on what a patient truly wants out of the recovery process.
Steps to Becoming an Occupational Therapist
Here are the basic steps for becoming an occupational therapist:
- Earn a Bachelor's Degree: Although a bachelor’s degree in occupational therapy isn’t required, earning a bachelor’s degree is the first major step toward becoming an OT. The first step to becoming an occupational therapist is completing the educational requirements for acceptance into OT school. It is recommended to earn a bachelor's degree in a relevant area, such as biology, health science, or psychology. Common majors include biology, kinesiology, psychology, and health science. These programs typically provide the foundational knowledge necessary for advanced studies in occupational therapy. If you received a degree in another area, don't worry, OTD programs require specific prerequisite courses that anyone can complete. Prerequisite courses are typically in subjects like anatomy, physiology, and psychology, among others.
- Gain Relevant Experience: While you are working on your undergraduate degree, you may need to start logging the required volunteer/observation hours for occupational therapy school. Volunteer or work experience in a healthcare setting is invaluable. Many, but not all, OT programs require or highly recommend applicants to have hands-on experience. This can be achieved by volunteering in hospitals, clinics, or schools where you can observe and assist OTs. Each program has its own requirements, but you’ll generally want to work in at least a few different settings, and it’s also wise to explore different types of patient populations. All applicants are required to complete a total of 30 hours of observational hours in at least two (2) diverse OT settings. Diverse settings are settings that service clientele that are significantly different: inpatient, outpatient, long term care, school-based, elders, pediatrics, orthopedics, rehabilitation, etc. Upload documentation verifying your observation hours to OTCAS.
- Complete Prerequisite Courses: One of the most important steps to becoming an occupational therapist is completing the prerequisites for your graduate degree. General prerequisites must be completed before entering the OTD program and can be completed at any accredited college or university. Anatomy, Physiology, Statistics, and Abnormal Psychology should be less than 5 years old from the application date.
- Pursue a Graduate Degree: After completing your bachelor's degree, the next step is to enroll in an accredited graduate program in occupational therapy. This is a big step. You’ll need to decide whether you want to pursue a master’s degree or a doctorate degree. To become a licensed OT, you must complete an accredited occupational therapy degree program. When looking for an occupational therapy degree, it’s important to choose a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). This ensures the education you receive meets the quality standards needed for certification and state licensure. Pursue a Master of Occupational Therapy (MOT) or Doctor of Occupational Therapy (OTD). In addition to the required coursework, the curriculum for both programs will include the fieldwork hours you need to sit for the certification exam. USAHS also offers a Post-Professional Doctor of Occupational Therapy (PPOTD). This degree is for practicing OTs with either a bachelor’s or master’s degree in occupational therapy who are looking to expand their occupational therapy qualifications and knowledge.
- Fieldwork Experience: Fieldwork is a vital part of any occupational therapy degree. Fieldwork is where future occupational therapists put their training into action. These experiences might take place in schools, hospitals, outpatient rehab centers, mental health clinics, or skilled nursing facilities. UM-Flint provides access to advanced facilities and resources. Experienced faculty. The OTD faculty at UM-Flint consists of experienced professionals who are leaders in the field of occupational therapy.
- Pass the National Certification Exam: Once you complete your occupational therapy degree and fieldwork, the next step is to pass the national certification exam. After earning an MOT or OTD, you must pass the National Board for Certification in Occupational Therapy (NBCOT) exam. Passing the NBCOT exam earns you the title “Occupational Therapist, Registered” (OTR). After completing your graduate-level occupational therapy program, you must pass the National Board for Certification of Occupational Therapy (NBCOT) exam in order to become certified as an occupational therapist.
- Obtain State Licensure: After becoming an OTR, you must apply for a license to practice in your state. Once you pass the NBCOT, get licensed in the state where you choose to practice. Licensing requirements may vary by state. Some states may require continuing education or jurisprudence exams to keep their licenses current. One thing to keep in mind is that each state in the US has its own rules and regulations for practicing as an OT.
- Continuing Education: You will then need to take continuing education courses throughout your career to keep your license active. (This is the case in nearly all states, though there are a few exceptions. OT is a dynamic field that continually evolves with new research and techniques. As an OT, you will need to engage in ongoing professional development to stay current with the latest advancements.
Choosing the Right OT Program
There are tons of different occupational therapy schools across the US. When looking for an occupational therapy degree, it’s important to choose a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). This ensures the education you receive meets the quality standards needed for certification and state licensure.
While some are considered better than others (in terms of how selective they are, the accolades of their staff, etc.), I recommend that you take rankings with a giant slab of salt. That’s because there’s no evidence that graduating from a highly ranked school yields better job opportunities or higher pay upon graduation.
Instead of focusing on rankings, I would encourage you to ask yourself: Are the alumni from the school doing the work that YOU aspire to? I recommend exploring the mission and philosophy of each occupational therapy school you are considering. This gives you a sense of who they are and what kind of research interests them. I strongly recommend digging into the cost of the program you’d like to attend.
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Career Opportunities and Specializations
After getting licensed, many occupational therapists decide to focus their skills on a specific area of care. What are the types of occupational therapy? Specializing can open up more career opportunities, improve patient outcomes, and align your work with your interests. After completing all the requirements, you’re ready to begin your career.
With additional training and experience, some occupational therapists move into management roles with more responsibilities or start their own practices. Some therapists complete a doctorate degree and become professors while others earn specializations to increase career opportunities. You can become a clinic owner, or you can opt to specialize and remain an employee. You can also pursue a number of different non-clinical (or alternative) OT careers. The other benefit of having a wide scope of practice is that there are many settings in which you can work-and many OTs do wind up switching settings when they’re ready for a change of pace. For example, it is common to work in more demanding settings, such as SNFs and acute care, right out of school.
Job Outlook and Salary
According to the Bureau of Labor Statistics (BLS), occupational therapy jobs are on the rise, with employment of OTs projected to grow 14% between 2024 and 2034. This is due to the growth in the number of people with disabilities who require therapy services and as the large baby-boom generation ages and remains active later in life. The median annual doctor of occupational therapy salary for OTs in the United States is $98,340.
As you weigh your earning potential, keep in mind that numerous factors may impact your salary as an OT. Years of experience, specialization, location of practice, and setting all affect your compensation. Also, some employers pay hourly rates, while others pay salaries. Some states pay a higher occupational therapy salary than others, but it’s also helpful to consider the cost of living.
Challenges and Rewards of the Profession
Occupational therapy can be a heartwarming job, but it can also be physically and emotionally demanding. For this reason, many OTs experience burnout at some point in their careers. Unfortunately, becoming an occupational therapist is not cheap, which means many OTs find themselves managing student debt. Occupational therapists must complete at least a master’s degree program-on top of any expenses associated with their undergraduate education. While debt can certainly be managed through frugal living and wise school selection, many OTs do find themselves in quite a bit of debt upon graduation.
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As noted previously, OT is very fulfilling. You are working with patients when they are at their most vulnerable, and you are teaching many of them skills that enable them to build lives they feel are worth living. Another nice thing about occupational therapy is that it’s fairly easy to find OT jobs anywhere you go. Occupational therapists also enjoy a decent amount of flexibility in their jobs. Many professions pretty much require you to work full-time. However, OTs who need more flexibility in their schedules are often allowed to go part-time or PRN (i.e., working as-needed shifts). Working as an OT is also rewarding because you help people improve their quality of life.
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