How to Become an Occupational Therapist

Becoming an occupational therapist requires graduate education, supervised fieldwork, national certification, and state licensure. The process is designed to prepare practitioners to help people develop, recover, improve, or maintain the skills needed for everyday life.

Most future occupational therapists first complete a bachelor’s degree and prerequisite courses before earning an entry-level master’s or doctoral degree from an accredited occupational therapy program. Graduates must then pass the national certification examination and satisfy the licensing requirements of the state in which they plan to practice.

Although individual timelines vary, the path generally includes six major steps.

What Are the Steps to Becoming an Occupational Therapist?

The general path to becoming a licensed occupational therapist in the United States is:

Complete a bachelor’s degree and any required prerequisite courses.
Learn about occupational therapy through observation, employment, volunteering, or related experiences.
Earn an entry-level occupational therapy master’s or doctoral degree from an ACOTE-accredited program.
Complete the program’s required fieldwork and, for an entry-level OTD, a doctoral capstone experience.
Pass the National Board for Certification in Occupational Therapy examination.
Apply for an occupational therapy license in the state where you intend to practice.

Requirements can vary by educational program and state, so prospective students should review program admissions criteria and state licensing rules carefully.

Step 1: Complete a Bachelor’s Degree and Prerequisite Courses

Entry-level occupational therapy programs require applicants to complete undergraduate education before beginning graduate-level professional study. Students commonly earn a bachelor’s degree before entering a master’s or Doctor of Occupational Therapy program.

There is no single undergraduate major required for every occupational therapy program. Students may come from backgrounds such as:

Biology
Exercise science
Health science
Kinesiology
Psychology
Sociology
Human development
Education
Fine Arts

Choosing a particular major is generally less important than completing the prerequisite courses required by the occupational therapy programs to which you plan to apply.

Common prerequisites may include anatomy and physiology, psychology, statistics, sociology, human development, medical terminology, or other science and behavioral-science courses. Requirements differ among programs, so students should begin reviewing admissions criteria early in their undergraduate education.

Prospective USM students can review the Doctor of Occupational Therapy admissions requirements for the University of Saint Mary current admissions requirements and application instructions.

Step 2: Learn About Occupational Therapy

Before applying to a graduate/doctoral program, it is valuable to develop a clear understanding of the profession and the populations occupational therapists serve. Some programs may require or recommend occupational therapy observation, volunteer work, employment, or other relevant experience.

Exposure to the profession can help prospective students understand how occupational therapy differs across settings. An occupational therapist working in a school, for example, may have different daily responsibilities from one practicing in a hospital, outpatient clinic, mental health program, or home-health setting.

Ways to learn more about the profession may include:

Observing an occupational therapist when permitted by the practice setting
Volunteering in a hospital, rehabilitation program, school, senior community, or disability-services organization
Working in a healthcare, education, caregiving, or community-service role
Interviewing occupational therapy practitioners about their work
Exploring different patient populations and practice settings

Students should follow each organization’s privacy, safety, and observation requirements. They should also document experiences if programs ask applicants to report observation or service hours.

To explore the profession further, read What Is Occupational Therapy? and What Does an Occupational Therapist Do?

Step 3: Earn an Accredited Occupational Therapy Degree

To enter practice as an occupational therapist in the United States, students must complete an entry-level master’s degree or professional doctorate in occupational therapy. The American Occupational Therapy Association confirms that both degree levels remain pathways into the profession.

Students should select a program accredited by the Accreditation Council for Occupational Therapy Education, commonly known as ACOTE. Graduation from an ACOTE-accredited entry-level occupational therapy program is required for eligibility to take the national OTR certification examination.

Master’s Degree in Occupational Therapy

Entry-level master’s programs may award credentials such as a Master of Occupational Therapy or Master of Science in Occupational Therapy. These programs prepare graduates for entry-level practice and NBCOT examination eligibility.

Doctor of Occupational Therapy

An entry-level Doctor of Occupational Therapy program, or OTD, also prepares students to enter the profession. In addition to foundational clinical preparation, an OTD includes doctoral-level work and a capstone experience that may emphasize clinical practice, leadership, advocacy, education, research, program development, or another area of professional interest.

A doctorate is not currently the only required entry-level degree for occupational therapists. Both appropriately accredited master’s and doctoral programs provide routes into practice.

Students interested in doctoral preparation can explore the University of Saint Mary Doctor of Occupational Therapy program in the greater Kansas City area.

Step 4: Complete Fieldwork and Doctoral Experiences

Fieldwork is an essential part of occupational therapy education. It allows students to apply classroom knowledge, develop clinical reasoning, practice professional behaviors, and work with clients under appropriate supervision.

Occupational therapy curricula generally include Level I and Level II fieldwork. Level I experiences introduce students to practice, client needs, and the occupational therapy process. Level II fieldwork provides more extensive preparation for delivering occupational therapy services and developing entry-level competence.

Students in entry-level OTD programs also complete a doctoral capstone experience and project. The capstone allows students to pursue in-depth learning in an area such as:

Clinical practice
Leadership or administration
Advocacy
Education
Research
Policy development
Program development
Emerging areas of occupational therapy practice

Review the USM OTD curriculum, fieldwork, and capstone experiences for additional information about the University of Saint Mary program.

Step 5: Pass the NBCOT Certification Examination

After completing an eligible occupational therapy degree, graduates apply to take the national certification examination administered by the National Board for Certification in Occupational Therapy.

NBCOT requires OTR candidates educated in the United States to graduate from an entry-level occupational therapy program accredited by ACOTE. Candidates must complete the application and eligibility process before scheduling the examination.

After passing the exam, graduates may use the designation OTR, which stands for Occupational Therapist, Registered. Certification and state licensure are related but separate credentials: NBCOT administers national certification, while state regulatory agencies grant the legal authority to practice.

Students can review current eligibility, application, examination, and certification information through NBCOT’s certification process.

Step 6: Obtain an Occupational Therapy License

Occupational therapists must be licensed by the jurisdiction in which they practice. According to AOTA, all 50 states, the District of Columbia, Puerto Rico, and Guam regulate occupational therapy practice through licensure.

Although requirements vary, applicants commonly must:

Graduate from an accredited occupational therapy program
Complete required fieldwork
Pass the NBCOT certification examination
Submit an application and required fees
Provide transcripts, examination results, or other documentation
Complete a background check or state-specific jurisprudence requirement when applicable

Because requirements differ, graduates should contact the occupational therapy licensing board in the state where they intend to work. AOTA provides an overview of occupational therapy state licensure and links to regulatory information.

Licenses must generally be renewed periodically. Continuing education, professional-development activities, ethics training, or other requirements may apply depending on the state.

How Long Does It Take to Become an Occupational Therapist?

The total timeline depends on the student’s undergraduate preparation, selected graduate degree, program structure, and whether prerequisites are completed before application.

A common pathway includes approximately four years to complete a bachelor’s degree, followed by an entry-level occupational therapy graduate program. Master’s programs commonly take approximately two to three years, while entry-level OTD programs frequently take about three years.

Students may need additional time if they must complete missing prerequisites, repeat coursework, gain required experience, or take a break between undergraduate and graduate study.

The University of Saint Mary entry-level OTD program is designed to be completed in three years after required undergraduate preparation.

How Can You Prepare for Occupational Therapy School?

Strong applicants demonstrate academic readiness and a thoughtful understanding of occupational therapy. Helpful preparation can include:

Completing prerequisites early and maintaining strong academic performance
Learning about multiple occupational therapy settings and populations
Developing communication, teamwork, observation, and problem-solving skills
Participating in service, leadership, employment, or volunteer experiences
Building professional relationships with potential references
Reviewing application requirements well before the deadline
Preparing a clear personal statement explaining your interest in occupational therapy

Applicants should also consider program format, location, cost, faculty support, fieldwork preparation, capstone opportunities, mission, and overall fit—not only whether they meet minimum admissions requirements.

Frequently Asked Questions

What degree do you need to become an occupational therapist?

You must earn an entry-level master’s degree or professional doctorate in occupational therapy from an appropriately accredited program. Both degree levels can prepare graduates for NBCOT examination eligibility and entry into the profession.

Can you become an occupational therapist with a bachelor’s degree?

A bachelor’s degree alone does not qualify someone to practice as an occupational therapist. It generally provides the undergraduate preparation needed to apply to a graduate occupational therapy program.

Do you have to pass an exam to become an occupational therapist?

Yes. Graduates must pass the NBCOT examination to earn the OTR credential and satisfy the examination component generally required for state licensure.

Is an occupational therapist license valid in every state?

No. Occupational therapy licenses are issued by individual jurisdictions. Practitioners who move or work across state lines must ensure that they hold the appropriate authorization for each location in which they practice.

Is occupational therapy school competitive?

Admissions standards and applicant demand vary by program. Completing prerequisite courses successfully, gaining a clear understanding of the profession, preparing strong application materials, and applying by the stated deadlines can improve an applicant’s readiness.

Begin Your Path to Becoming an Occupational Therapist

The University of Saint Mary entry-level Doctor of Occupational Therapy program prepares students to become compassionate, skilled, and ethical practitioners through classroom instruction, laboratory learning, simulation, fieldwork, and a doctoral capstone.

Located in the greater Kansas City area, the three-year program combines hands-on professional preparation with individualized faculty support and leadership development rooted in USM’s Catholic and Vincentian mission.

Explore the USM Doctor of Occupational Therapy program, review the admissions requirements, or examine the OTD curriculum and fieldwork sequence.

Request information about the Saint Mary OTD program