Quick Answer

Becoming an occupational therapist requires a bachelor's degree with the right prerequisites, followed by a master's degree (or entry-level doctorate) from an ACOTE-accredited program, which usually takes about two to two and a half years plus supervised fieldwork. You then pass the NBCOT certification exam and get licensed in your state. The median wage is $98,340 a year, and the role is frequently confused with physical therapy.

Most people arrive at "how to become an occupational therapist" already tangled up in a comparison with physical therapy, and that confusion is the real question hiding underneath. Which one pays more, which one fits me, and is the required master's degree worth the time and cost? Occupational therapy is a strong, stable, well-paid career, but choosing it well means understanding what it actually is and how it differs from the field people constantly mix it up with.

The short version of the difference: physical therapy focuses on movement, strength, and pain, while occupational therapy focuses on helping people do the everyday activities that make up a life, from dressing and cooking to returning to work or school after an injury, illness, or disability. Both require a clinical graduate degree. Below is the full path, the salary reality, and a clear breakdown of OT versus PT so you can decide before you commit.

The Bureau of Labor Statistics projects 14% growth for occupational therapists from 2024 to 2034, much faster than the average for all occupations, with about 10,200 openings each year1. An aging population and expanding roles in schools and mental health keep demand strong.

If you are still deciding between the two fields, it helps to read how the path compares to becoming a physical therapist side by side.

Expert Tip

Get observation hours in more than one OT setting before you apply. Occupational therapy is far broader than most applicants expect, spanning pediatrics, hand therapy, mental health, and geriatric rehab, and programs want to see that you understand that range. Shadowing in two or three different settings both strengthens your application and helps you confirm the field is what you think it is.

What Does an Occupational Therapist Actually Do?

Occupational therapists help people regain or build the skills they need for daily living and meaningful activity. That might mean helping a stroke patient relearn how to cook, adapting a workspace for someone with a repetitive strain injury, supporting a child with a developmental delay in the classroom, or helping an older adult stay safe and independent at home. The tools range from targeted exercises to adaptive equipment to changes in the environment itself.

Setting shapes the work more than anything else.

Hospitals and rehabilitation. You help patients recover function after surgery, injury, or a medical event, often working alongside physical and speech therapists.

Schools and pediatrics. You support children with disabilities or developmental delays so they can participate in school and daily routines.

Hand therapy and outpatient clinics. A specialized, well-compensated niche focused on the hands and upper extremities.

Mental health and community settings. You help people manage daily functioning around mental illness, substance use, or disability.

Important

The master's is a real financial commitment, and the field is drifting toward the entry-level doctorate, which adds time and cost without necessarily raising pay. Weigh program tuition against the median salary carefully, and know that in some settings, especially skilled nursing and rehab, therapists face heavy productivity quotas that make the day feel more like a treadmill than the person-centered care the field advertises.

Education Requirements

A bachelor's degree with the right prerequisites. Your major can vary, but programs expect coursework in anatomy, physiology, and psychology. A kinesiology degree or a psychology degree both line up well with OT prerequisites.

A master's or entry-level doctorate from an ACOTE-accredited program. The graduate program runs roughly two to two and a half years and includes classroom work plus supervised fieldwork rotations. A master's is enough to enter the field; the doctorate is optional and aimed at leadership, research, or teaching.

The NBCOT exam and a state license. After finishing your program and fieldwork, you pass the national certification exam from the National Board for Certification in Occupational Therapy, which every state requires for licensure2.

$98,340

Median annual wage for occupational therapists, May 2024

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The Step-by-Step Path

  1. Earn a bachelor's and complete the prerequisites. Anatomy, physiology, and psychology are standard requirements.
  2. Bank observation hours across settings. Programs want breadth, and you want to confirm the field fits.
  3. Apply to ACOTE-accredited master's or doctoral programs. Admission is competitive.
  4. Complete the graduate program and fieldwork. Classroom study followed by supervised clinical rotations.
  5. Pass the NBCOT certification exam2.
  6. Get your state license and begin practicing.

How OT Pay Varies

The median is $98,340, with a range from under $67,090 at the bottom tenth to more than $129,830 at the top1. Setting drives much of the difference. Home health, skilled nursing, and hand therapy tend to pay above the median, while school-based roles often pay less but offer a school calendar and steadier hours. Geography matters as well, with higher pay in higher-cost regions. Many therapists raise their income over time by specializing, picking up per-diem work, or moving into higher-paying settings.

OT vs PT: How to Choose

The two fields are constant companions and constant sources of confusion. Physical therapy centers on movement, strength, mobility, and pain, and PTs often work with orthopedic and neurological recovery. Occupational therapy centers on function and participation, helping people do the specific activities their lives require. Pay is broadly similar, though the physical therapist path now generally requires a doctorate, while OT still accepts a master's.

Choose OT if you are drawn to creative, whole-person problem solving and the daily-life side of recovery. Choose PT if movement science, athletics, and physical rehabilitation pull at you more. Shadowing both is the fastest way to feel the difference, and people who do rarely stay confused for long. Those interested in the population-health side of either field sometimes add a public health focus.

What to Study Before OT School, and the OTA Alternative

Because occupational therapy requires a graduate degree, your undergraduate years are really about two things: finishing the prerequisites and proving you understand the field. Handling both well is what separates admitted applicants from waitlisted ones.

Choose an undergraduate major you can excel in while completing OT prerequisites such as anatomy, physiology, and psychology. A kinesiology degree and a psychology degree both line up naturally, but many majors work if you plan the science coursework deliberately. Grades in those prerequisite sciences carry real weight in admissions, so protect them and avoid overloading a single term with the hardest labs.

Spend time observing in more than one OT setting during college. Programs want applicants who have seen occupational therapy in action, and shadowing in pediatrics, a hospital, and a hand-therapy or mental-health setting both strengthens your application and confirms the field is what you expect. Applicants who picture only one version of OT often discover in their first job that the work is far broader than they imagined.

Get involved in something that shows you can work with people who are struggling, whether that is volunteering, caregiving, or a job in a care setting. Occupational therapy is fundamentally about helping people regain function and independence, and admissions readers look for evidence that you can do that patiently and creatively. A semester of consistent volunteer work says more than a long list of clubs. Experience connecting with people across different backgrounds helps too, since the work is built on human relationships.

It is also worth understanding the difference between an occupational therapist and an occupational therapy assistant before you commit to the longer path. An occupational therapy assistant, or OTA, works under an OT's direction, needs only an associate degree, and reaches the field faster and far more cheaply, though at lower pay and with a narrower scope of practice. If the length or cost of the master's gives you pause, the OTA route is a legitimate alternative worth comparing rather than dismissing, and some people start as an OTA and bridge to the full OT credential later.

Finally, research programs early. Tuition, length, and whether a school offers a master's or an entry-level doctorate vary widely, and the cost of the graduate degree is the single biggest factor in whether OT pays off for you. A program that costs twice as much for the same median salary is a very different investment, and that comparison is far easier to make before you apply than after you hold an acceptance and a deadline. Treat the cost of each program as seriously as its reputation, because both follow you for years after graduation.

Frequently Asked Questions

How long does it take to become an occupational therapist?

Plan on about six to seven years. That is four years for a bachelor's plus roughly two to two and a half years for a master's, including supervised fieldwork. An entry-level doctorate adds time.

Do you need a master's degree to be an occupational therapist?

Yes. A master's from an ACOTE-accredited program is the minimum credential to practice in every state, and the field is increasingly offering an entry-level doctorate as an alternative. A bachelor's alone does not qualify you.

What is the difference between an occupational therapist and a physical therapist?

Physical therapy focuses on movement, strength, and pain, while occupational therapy focuses on helping people perform daily activities and participate in life. Their settings overlap and they often work together, but their goals and training emphasis differ. Pay is broadly comparable.

How much do occupational therapists make?

The median wage is $98,340 a year, ranging from under $67,090 to more than $129,830 depending on setting, geography, and experience. Home health, skilled nursing, and hand therapy tend to pay above the median.

Is occupational therapy a good career?

For many people, yes. It offers strong pay, fast job growth, and varied settings, along with meaningful person-centered work. The main tradeoffs are the cost of the graduate degree and, in some settings, heavy productivity expectations.

Can you become an OT with a psychology degree?

Yes. A psychology degree is a common and well-aligned undergraduate path, since it covers several OT prerequisites. You still need to complete any remaining science requirements and then earn the ACOTE-accredited graduate degree.

Can occupational therapy assistants become occupational therapists?

Yes, though it usually means more schooling. An occupational therapy assistant holds an associate degree and works under an OT's direction, and moving up to the full OT role generally requires completing the accredited graduate degree. Some people use the assistant role to earn income and confirm that the field fits before committing to the master's.

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Footnotes

  1. U.S. Bureau of Labor Statistics. (2025). Occupational Outlook Handbook: Occupational Therapists. BLS. https://www.bls.gov/ooh/healthcare/occupational-therapists.htm ↩ ↩2

  2. National Board for Certification in Occupational Therapy. (2025). Certification eligibility. NBCOT. https://www.nbcot.org/ ↩ ↩2

  3. American Occupational Therapy Association. (2025). Become an OT practitioner. AOTA. https://www.aota.org/ ↩