How to become an occupational therapist

1. 1Earn a bachelor's degree with OT prerequisites

   Time: 4 yearsCost: Undergraduate tuitionSources 1

   OT graduate programs accept any major, but they expect science and social science prerequisites, often anatomy and physiology, biology, psychology (including abnormal or developmental psychology) and statistics. Kinesiology, psychology, exercise science and health sciences are common majors because they cover most of these. Keep science grades strong, since programs weigh them heavily. Some universities offer combined bachelor's-master's tracks that save time.

2. 2Get observation or work experience in OT settings

   Time: Alongside collegeSources 1

   Many programs want applicants to have observed or volunteered with occupational therapists, and some require a set number of hours. Try to see more than one setting, such as a hospital rehab unit, a school and an outpatient hand clinic, because OT looks very different in each. Working as a rehab aide or occupational therapy assistant is another way to build experience. Ask the OTs you shadow for recommendation letters.

3. 3Choose an ACOTE-accredited master's or doctoral program

   Time: One application cycleCost: Application feesSources 2, 4, 7, 9

   U.S.-educated candidates must graduate from an entry-level OT program accredited by ACOTE to take the NBCOT exam, so check accreditation before applying. Both the entry-level master's and the entry-level doctorate (OTD) lead to the same exam and license. An OTD adds coursework and a doctoral capstone of at least 14 weeks full time and suits people interested in teaching, research or leadership; a master's is usually shorter and less expensive.

4. 4Complete the OT program and supervised fieldwork

   Time: 2-3 years (master's); longer for a doctorateCost: Graduate tuitionSources 1, 2, 7, 9

   Coursework covers anatomy, kinesiology, neuroscience, mental health, pediatrics, and evaluation and treatment methods. You then complete supervised fieldwork, including at least 24 weeks of full-time Level II fieldwork in settings such as hospitals, schools or skilled nursing facilities. Full-time placements leave little room for a paying job, so plan your finances. Doctoral students also complete an individual capstone project.

5. 5Pass the NBCOT exam to earn the OTR

   Time: Within months of graduatingCost: $540 (online application, 2026)Sources 3, 4

   After graduating, apply to NBCOT for the OTR certification exam; the online application costs $540, and a retake costs $430. Applications stay valid for three months, and results are not released until NBCOT receives your final transcript showing the degree awarded. Passing lets you use the Occupational Therapist Registered (OTR) title, and states use the exam to qualify you for a license.

6. 6Apply for your state license and maintain it

   Time: 1-2 months, then ongoingCost: State license fee; NBCOT renewal $65 online every 3 yearsSources 1, 3, 8, 6

   Every state requires OTs to be licensed. Apply to your state board with NBCOT verification, transcripts and fees, and complete any state law exam or background check it requires. To keep the license, you complete continuing education on the state's schedule. NBCOT certification is renewed separately every three years, for $65 online and 36 renewal units; whether your state requires it varies. Check your state in the CareerOneStop License Finder.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Task analysis

An OT has to break a task like getting dressed into its parts to see exactly which step a patient cannot manage and why.

Creative problem solving

When a skill cannot be restored, the OT invents another way, from a modified utensil to a new routine.

Adaptability

Treatment plans change constantly as patients improve, plateau or get worse, and each setting has different goals.

Patient and family communication

Progress depends on patients and caregivers practicing at home, so goals and techniques must be explained clearly.

Physical strength and safe handling

Helping patients transfer from bed to chair or stand at a sink requires correct body mechanics to avoid injury.

Documentation

Insurers, Medicare and school districts require detailed, timely notes to justify continued therapy.

O*NET 31.0 rates these skills as most important for the occupation: active listening, monitoring, reading comprehension, writing, speaking.

Training cost

$61.5K–$117K

Before financial aid

Time

6-7 years

Typical path

Median pay

$100,330

All US jobs: $50,980

Payback once qualified

1.2–2.4 yrs

Pay above the all-jobs median vs. cost

Our data has no national tuition figure for OT graduate programs, so this range uses College Scorecard median federal loan debt for the rehabilitation and therapeutic professions family, which also includes physical therapy and other fields: $61,500 for master's graduates and $117,112 for first professional (doctoral) graduates. Actual costs depend on public or private school and residency. Not included: the bachelor's degree, the NBCOT exam fee ($540 online), state license fees and living costs during unpaid fieldwork.

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Physical therapist$102,760 median

  Requires a separate Doctor of Physical Therapy degree and the national PT exam; OT coursework in anatomy and kinesiology can cover some prerequisites.

• Speech-language pathologist$97,870 median

  Requires a master's in speech-language pathology and the national SLP exam, a full new graduate program.

• Rehab director or healthcare administrator$123,860 median

  Experienced OTs often move into rehab management; a master's in health administration or business helps for larger roles.

• Specialist OT (hand therapy, pediatrics, driver rehabilitation)

  Gain experience in the specialty and earn a voluntary specialty certification from the relevant professional body.