How to Become an Occupational Therapist: A Comprehensive Guide

Occupational therapists fill a critical role in the healthcare system, helping patients recover from injuries, overcome disabilities, and fully engage in their physical lives. This guide provides a step-by-step guide on how to become an occupational therapist, from choosing the right undergraduate program to pursuing career opportunities. 

Occupational therapists help people of all skill levels more comfortably perform the activities of daily living to live more independent and fulfilling lives. According to the U.S. Bureau of Labor Statistics (BLS), the demand for occupational therapists is expected to grow by 11% between 2022 and 2032, which is much faster than the average for many other professions and represents nearly 17,000 new jobs.  

All aspiring occupational therapists must first complete an undergraduate program as part of the occupational therapist education requirements. A number of undergraduate majors can prepare students for an occupational therapy graduate program. The most important consideration is to make sure you take OT prerequisites, including courses such as anatomy, physiology, psychology, and sociology.  

Some schools offer a graduate track program to incoming undergraduates that allows them to complete their bachelor’s degree programs as well as an occupational therapy doctorate (OTD) or Master of Science in Occupational Therapy (MSOT) in less time than it would take to complete both programs separately.  

While OTs can come from many different majors, some suggested majors that typically include OT graduate program prerequisites include²:  

Ultimately, undergraduates should choose a major that interests them. This includes options where they know they can achieve a good GPA as well as OT prerequisites courses that fall within or outside their majors.  

Undergraduates should start preparing to apply for graduate occupational therapy programs as soon as it is practical, meaning whenever they decide that is the course they want to pursue. Preparing for a graduate program may mean researching programs of interest, completing prerequisite courses, securing letters of recommendation, and completing required volunteer work.  

To practice as an occupational therapist, OTs must complete graduate programs, which means earning either a Master’s of Science in Occupational Therapy (MSOT) or an Occupational Therapy Doctorate (OTD). During their last undergraduate year of study, aspiring OTs can start applying to graduate programs.  

One important decision that graduate program applicants must make is the choice between a master’s or doctoral program. Both an MSOT and an OTD prepare students to become licensed occupational therapists.  

A doctoral program takes longer to complete and requires a capstone project. At Russell Sage, for example, the OTD capstone experience includes experiential learning, scholarship, and professional service in one or more of the following areas: clinical practice skills, research skills, administration, leadership, program and policy development, advocacy, education, or theory development. 

Aside from the capstone requirement, curriculum and core coursework in both MSOT and OTD programs are similar, including courses such as:  

Clinical experience is a requirement for obtaining a graduate OT degree and being qualified for OT licensing. In addition to classroom lectures and science labs, OT graduate students should expect to complete multiple rounds of fieldwork where they will observe and learn from licensed occupational therapists in a range of specialties and settings.  

Yearly physical examinations, immunizations, and CPR certification are required by fieldwork sites. In addition, many settings require students to be fingerprinted and undergo a criminal history review. 

Student fieldwork is an opportunity to work with diverse populations and service providers. Fieldwork helps students develop an understanding of how occupational therapists can address the needs of underserved populations. Level I fieldwork is largely observational in nature.  

After completing evaluation and intervention coursework, OT students become eligible for Level II fieldwork, which gives them an opportunity to apply didactic material and interact with clients/patients in therapeutic settings. Students are expected to be functioning as entry-level occupational therapists at the end of their Level II fieldwork experience. 

Occupational therapists work with a range of patient populations, which is why training in diverse settings is critical. While an OT may choose to specialize once they have their license, diverse fieldwork settings allow students to find a specialty that speaks to them and that they want to pursue in the long term.  

Occupational therapists must be licensed through the state where they plan to work. Licensing requirements may differ slightly from state to state but typically include completing a graduate OT program and passing a standardized licensing exam.  

The National Board of Certification in Occupational Therapy (NBCOT) offers certification exams for both occupational therapists and occupational therapy assistants (OTAs). In New York, the NBCOT OT exam is required for licensure.  

In New York, OTs are licensed through the New York State Education Department Office of the Professions. To be licensed as an occupational therapist in New York State, applicants must: 

OT license applicants must have completed a baccalaureate or entry-level master’s degree in occupational therapy or a post-baccalaureate certificate in occupational therapy from an institution acceptable to the NYSED, in addition to completing a minimum of six months of supervised OT experience.  

Occupational therapists must also pass the NBCOT OTR examination with a minimum score of 450 and pay the required fees. As of 2024, the fee for licensure as an occupational therapist in NY is $294. 

In terms of what does an occupational therapist do, the answer often depends on the path the OT chooses to pursue after completing foundational education. OTs work in many environments with many different patient populations, depending on whether they choose to specialize and what type of work they want to do.  

According to the BLS, 29% of occupational therapists work in hospitals, and an additional 28% work in private practice with other OTs or specialists, such as speech therapists or audiologists, making up most OT work environments. The remainder work in schools, home healthcare, or skilled nursing facilities. 

New occupational therapists may choose to specialize right away or may work in a facility that allows them access to a diverse range of patients and problems to find the right specialization. The NBCOT offers micro-credentials in several specializations, including:  

As with many careers, the more highly specialized an OT’s skills, the more opportunities they are likely to have and more in demand they are likely to be in their career.  

To maintain licensure, OTs must complete continuing education requirements as outlined by the states where they practice. 

In New York, licensed OTs must complete at least 36 hours of approved continuing education every three years to maintain their licenses. Working toward an occupational therapist certification or micro-credential may fulfill these requirements. 

Occupational therapists have many opportunities as part of the occupational therapy career path as they work in the profession. While OTs may find tremendous satisfaction working with a range of clients, others may choose to specialize in a specific population, such as pediatrics, or a specific type of injury or disability, such as stroke or concussion recovery. Specialization can often lead to more opportunities and higher salaries, as well as chances for teaching engagements and leadership positions. 

Russell Sage College, with campuses in Troy and Albany, New York, offers excellent MSOT and OTD programs for those who want to pursue this rewarding and in-demand career. With a capstone project and excellent career outcomes, Russell Sage is a great place to launch an OT career. Aspiring OTs can find out more about the program to ensure they are fulfilling their prerequisites, plan a campus visit, speak to an admission counselor, or even apply today.