What Occupational Therapy School is Really Like

Last Updated on July 11, 2022 by Laura Turner

Where to Begin?

Students seeking a career in occupational therapy may be unsure of where to start and what to expect. When I began applying to OT school, it seemed like no schools were the same. I discovered that most schools did not even have the same admission criteria. As I began interviewing, I learned that some things were more important to certain schools than others. For instance, I interviewed at one school that thought I didn’t understand OT well because I mentioned a strong research interest! However, other schools like my alma mater saw this as a good quality in an applicant. Over the years, I’ve spoken to students from different programs and learned that my initial hunch was correct—every program is a little different.

With that said, each program must meet the Accreditation Council for Occupational Therapy Education (ACOTE®) Standards to remain accredited. How a program meets those standards may vary, but all OT graduates should graduate with roughly the same baseline knowledge and skills.

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Degree Paths and Entry-Level Standards

Historically, there were currently three different occupational therapy degree paths: the combined bachelor’s/master’s (BS/MS), the entry-level master’s (typically MS, though there were MA programs), and the entry-level doctorate (OTD). However, since 2007, newly-graduating occupational therapy practitioners have been required to obtain a master’s degree. In 2027, the new entry-level standard will be a doctorate. Individuals who received their bachelor’s before 2007 were “grandfathered in,” meaning that you may often find older OTs practicing with a bachelor’s degree. AOTA states that the same will happen for those who obtained a master’s degree before 2027.

Many master’s programs have made the switch to OTD. This change did not significantly impact the time to degree completion because master’s programs often had the same amount of credit hours as typical professional doctorate degrees.

The Occupational Therapy Doctorate (OTD) takes approximately 6.5 years (2.5 years for the OTD curriculum and a 4-year bachelor’s degree).

Degree Coursework

Students can pursue an entry-level OTD whether or not they have a bachelor’s degree in a health-related field, as long as they complete the necessary prerequisites for admission. This was my path—I had an unrelated bachelor’s degree, took additional coursework over several years, and was admitted to UW-Milwaukee (Note: the author completed an MS degree, but the coursework is applicable for the OTD degree which is the new standard). The course sequence in our curriculum has had some minor changes, and a few of us took uncommon or unique electives, but for the most part, this list accurately reflects my time at OT school.

Year 1

The first year of our occupational therapy curriculum focused on establishing a robust scientific foundation, including a review of anatomy with a cadaver lab, neuroscience, and biomechanics. We also learned about different OT theories and frames of reference and took courses to strengthen our skills in communication, sociocultural factors in patient care, and evidence-based practice. Group work was heavily emphasized—I had never done so many group projects before! This group work improved students’ abilities to work together effectively because most OT health care settings require working closely with other health professionals. The first year was the most science-heavy term and required the most late-night studying.

Clinical observation was also introduced in our first year. There was a service-learning component in our first-semester seminar, with possible volunteer opportunities including coaching a team in the Special Olympics, spending time with patients in hospice care, and working with refugees. In our second semester, we had our first Level I fieldwork placement. This was a 40-hour experience that could be completed over winter break in one week or in smaller segments once per week throughout the semester. Delivering skilled OT services was not part of service-learning or the Level I placements—these experiences were intended to help the student become comfortable with different populations, develop a professional demeanor, and respectfully learn from a supervisor.

Our courses continued through the summer. We began taking population-specific classes, like mental health, and learning about different diagnoses. We started learning expected skills for our Level 2 fieldwork, like documentation, taking blood pressure manually, and manual muscle testing. Students who wanted to take additional electives had time to do so.

Year 2

Our second year continued to focus on specific populations and different diagnoses. This year, we got into various assessments and continued learning basic skills to prepare us for Level 2 fieldwork. Courses included pediatrics, assistive technology, and physical rehabilitation. Specific courses continued, such as our research project and seminar. We had the option of completing our second Level 1 fieldwork during the summer before fall classes started or once per week throughout the fall semester.

Our first Level 2 fieldwork began in the second half of the year. This fieldwork was where we finally got to apply our skills and have hands-on patient contact. We spent the first three months of the year at our fieldwork sites and, apart from online assignments related to fieldwork, did not have any coursework.

We returned from fieldwork and transitioned into leadership, organizational structures, and community practice coursework, which would continue through the summer and into the fall.

Year 3

We spent the beginning of the fall term finishing our last class. The last three months of the fall term were dedicated to our second Level 2 fieldwork.


Most of our coursework was fixed, but there was still some room for us to explore opportunities that were interesting to us. For instance, I was one of two students in my cohort who chose to complete a thesis, so throughout the program, I had to fit writing and data collection into my schedule (even during fieldwork!). I also took electives that sounded interesting to me or that I thought would help me have a broader knowledge base. Other students decided to pursue certificates in areas like autism or assistive technology, which required particular electives typically taken during the summers and semesters where there was no Level 2 fieldwork.

The OTD also requires a 16+ week doctoral experiential component. Belmont University has a helpful overview describing the goals of the DEC, as well as examples of previous projects and where the DEC fits into the curriculum. There are endless options for a DEC, but it’s much like a thesis or capstone project in that it is mainly self-directed and meant to encourage students to consider how they can bring positive change to OT practice.

Extra-Curricular Opportunities

As an OT student, there are opportunities to get involved in student organizations like SOTA and PTE. You can also present research at state, national, and international conferences and are encouraged to participate in political advocacy events like Hill Day. In addition, there may be opportunities to volunteer with underserved populations in your area—and if your school doesn’t hand these opportunities to you, find them yourself! These are great opportunities to network with the OT community and potential community partners.

Life Balance

To some extent, your life will revolve around occupational therapy school. Some semesters require intense periods of studying and rote memorization, while others are heavier on reading, writing, and reflection upon experiences. While it was typically not hard to find free time to go to the gym, watch a favorite show, or do other self-care activities, a graduate program can make you feel somewhat insulated from the rest of the world. Programs are typically small—often 24-36 classmates, though some programs are different—so you’ll be surrounded by the same handful of classmates most of the time. You may have moved a considerable distance to attend your program, and your friends and family may be unable to relate when you talk about your program. Some programs may have a lot of diversity in their student population in terms of factors like age, ethnicity, sexuality, or gender, while other programs may have very little. Some students make lifelong friends in their cohorts, while others find it hard to make meaningful connections. It is crucial for students to be aware of their overall mental wellness during this period of change and to feel comfortable reaching out to personal contacts, faculty, and the university for support.

When I entered my OT program, the professors warned my cohort against working too much outside school. Ultimately, whether or not you can work while going to graduate school depends on you. In my cohort, almost no one held a full-time job. Still, many of us worked part-time in labs on campus, in local hospitals, in retail or food service, or in the community as babysitters, personal care assistants, or dog walkers.

However, during fieldwork holding any job can be tricky. During my last Level 2, I worked around 8 hours per week as a personal care assistant during the weekend and two weekdays before fieldwork—on those days, I would work with my client from 7 AM to about 8:30 AM, then leave for my fieldwork which went from 9 AM to 5 or 6 PM. I also had to finish my thesis, take care of my dog, and stay in shape for the half-marathon I had committed to running months ago. Some days, I felt pretty rushed and disorganized. I developed strategies to finish my thesis on time, finish my run, and keep my dog happy. Still, I would recommend making things easier on yourself by planning to limit your responsibilities during fieldwork.

However, some conflicts with OT school are a natural part of life. What if you have children? Others who depend on you for financial support? A sick parent or spouse? Physical or mental health concerns of your own? Everyone’s situation is different. My best advice is to respect your limits and to communicate clearly and frequently with the program faculty. (For students with many outside life demands, some programs have a significant online component, offer a part-time option, and have flexible fieldwork options.)

If there’s one thing that’s especially great about OT school, it’s that our whole profession is about helping others succeed, and your program will want that for you! I’ve never been in a more supportive academic environment, and I hope your experience is the same. Good luck on your journey to becoming an OT!

Are you considering Occupational Therapy school? HSPA offers a free “How To Get Into Occupational Therapy School” admissions guide to help you on your journey. Topics covered include:

  • Prerequisite coursework
  • GRE resources
  • OTCAS application details
  • School-specific information
  • Interview preparation suggestions

Download “How To Get Into Occupational Therapy School” today!