How to become an Occupational Therapist (OTR/L)
Occupational Therapists help patients regain independence in activities of daily living (ADLs) after injury, illness, developmental delay, or aging: feeding, dressing, work tasks, school participation. About 152,000 OTs practice nationally per BLS, with growth projections among the highest of any healthcare profession (12% over 2024-2034).
Pre-OT undergraduate
Most OT programs require a bachelor's degree + specific prereq courses: anatomy + physiology, neuroscience, statistics, psychology (lifespan + abnormal), sociology, and ~40-60 hours of observation across multiple OT practice settings. Common undergraduate majors: psychology, kinesiology, exercise science, biology, though any major satisfying prereqs is acceptable.
Graduate program
Two accredited entry-level paths since ACOTE's 2027 deadline removed: Master of Occupational Therapy (MOT, ~2-2.5 years) or Doctor of Occupational Therapy (OTD, ~3 years). Both qualify graduates for licensure. The OTD adds a 14-16 week doctoral capstone but is not currently required for general practice. Curriculum covers anatomy, kinesiology, neurology, occupational science, intervention planning, evidence-based practice, and 24+ weeks of full-time Level II fieldwork.
Licensing
After graduation, candidates sit for the NBCOT (National Board for Certification in Occupational Therapy) exam. Pass = OTR (Occupational Therapist, Registered) credential. State licensure is administered separately by each state, all 50 + DC license OTs. Many states also license Certified Occupational Therapy Assistants (COTAs), the associate-degree-level OT support role.
Practice settings
Outpatient hand therapy, acute-care hospital, pediatric (schools + early intervention), skilled-nursing + long-term care, home health, mental-health, and emerging telehealth-based ergonomic + return-to-work consulting. Pediatric OT (school-based + early-intervention) and adult outpatient hand therapy are the two highest-volume specialty paths.
Compensation
BLS reports median annual OT salary around $93k-$98k. Home-health + travel OT pay highest hourly; school-based OT typically lowest (but with school-year schedule + benefits). Specialty hand therapy (CHT credential) commands a premium.