How to Become an Occupational Therapist

Key points

• The route has four parts: an ACOTE-accredited entry-level OT degree, supervised fieldwork inside that program, the NBCOT exam, and a state license.
• The entry-level degree is a master’s or a doctoral degree, depending on the program.
• A degree alone does not grant a license, and admission does not guarantee that you will be eligible for certification.
• This guide covers the United States. Other countries have their own systems.

Step 1: Education before the OT program

OT programs are graduate-level entry programs. You usually need a bachelor’s degree first, plus prerequisite courses that each program sets for itself. There is no single required major. See pre-OT pathways and the pre-OT page. Some schools offer combined pathways; see combined OT degrees.

Step 2: An accredited entry-level OT program

NBCOT states that U.S.-educated applicants must have graduated from an ACOTE-accredited program, with an entry-level OT degree for the OTR credential. ACOTE says the same thing in its public guidance: one must graduate from an ACOTE-accredited program to be eligible to take the NBCOT certification examination.

The BLS Occupational Outlook Handbook states that occupational therapists typically need a master’s degree in occupational therapy to enter the occupation, and that master’s programs usually take 2 to 3 years. ACOTE also accredits entry-level doctoral programs and lists OT master’s and OT doctorate programs as separate categories in its school directory. ACOTE’s public guidance states there is no mandate regarding OT doctoral-degree-level education: institutions may offer a master’s, a doctorate or both. So a doctorate is not universally required. See master’s vs OTD, master’s programs and entry-level OTD programs.

Not all doctorates are entry-level. A post-professional OTD is aimed at people who are already practising, and a PhD is a research degree. Neither is an alternative first route unless the program says it is an ACOTE-accredited entry-level program. See entry-level vs post-professional OTD and OTD vs PhD.

Step 3: Fieldwork inside the program

BLS notes that programs include supervised clinical experience, and that candidates must graduate from an accredited program that includes fieldwork before they can sit for the licensing exam. Fieldwork is in person, in clinical or community settings. Online coursework does not remove it; see online coursework and in-person fieldwork.

Step 4: The NBCOT exam

After graduating, you apply to NBCOT for the certification exam. Passing allows you to use the OTR credential, according to NBCOT, and BLS says the qualifying exam also allows use of the title Occupational Therapist Registered. Details are in NBCOT certification and state licensure. NBCOT states that certification is not the same as licensure.

Step 5: State licensure

BLS states that all states require licensure and that requirements vary by state; at a minimum candidates must pass a qualifying exam. Each state board decides what it requires, so confirm with the board in the state where you plan to work. NBCOT points applicants to a directory of state board contacts. Use our states pages for study locations, not for licensing rules.

Step 6: Keeping credentials current

BLS states that therapists must complete a set number of continuing education hours to keep their state license and certification. The amount depends on the state and on NBCOT’s renewal rules, so check both.

Choosing a program

When you compare programs, check:

• Whether the specific program is ACOTE-accredited, on ACOTE’s own list, at the degree level you are applying to. See understanding ACOTE accreditation.
• Whether the program is entry-level, not post-professional.
• Where fieldwork takes place and how placements are arranged.
• Total cost and funding; see tuition and funding and scholarships.
• Application route and deadlines; see applying through OTCAS and admissions.

What we cannot tell you

We do not predict whether you will be admitted, will pass the exam or will be licensed in a given state. Those decisions belong to the program, NBCOT and the state board.

Sources

Checked 2026-11-03.

• BLS, Occupational Therapists: https://www.bls.gov/ooh/healthcare/occupational-therapists.htm
• NBCOT, get certified: https://www.nbcot.org/get-certified
• NBCOT, eligibility: https://www.nbcot.org/get-certified/eligibility
• NBCOT, state boards: https://www.nbcot.org/state-boards
• ACOTE, students and the public: https://acoteonline.org/students-public/