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 exactly 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 to others. For instance, I interviewed at one school that thought I didn’t have a good understanding of OT because I mentioned a strong interest in research! 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 is required to meet 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.
Degree Paths and Entry-Level Standards
There are currently three different degree paths to becoming an occupational therapist: the combined bachelor’s/master’s (BS/MS), the entry-level master’s (typically MS, though there are MA programs), and the entry-level doctorate (OTD). Which pathway is right for you?
Currently, the BS/MS degree takes the least amount of time at roughly 5 years total. The MS and the OTD tend to take closer to 6.5 years total (2.5 years for the master’s or OTD curriculum in addition to a 4-year bachelor’s degree).
Since 2007, newly-graduating occupational therapists have been required to obtain a master’s degree. In 2027, the new entry-level standard will be a doctorate. Individuals who obtained their bachelor’s before 2007 were “grandfathered in,” meaning that you may often find older OTs practicing with a bachelor’s degree. AOTA currently states that the same will happen for those who have obtained a master’s degree before 2027. However, many master’s programs are beginning to make the switch to OTD now. This does not have a large impact on time to degree completion, because current master’s programs often have the same amount of credit hours as typical professional doctorate degrees.
To sum it up: At this point in time, whether you get the BS/MS, MS, or OTD will not impact your ability to practice and is completely up to you.
Bachelor’s Degree Coursework
Husson University offers an example of what BS/MS program would look like. Most general education requirements are taken within the first two years of school, and the credit load is pretty high if students choose not to take courses in the summer. The BS/MS is a very efficient route, as it should typically include all of your master’s prerequisites into your bachelor’s degree. It is a great option for driven individuals that already know exactly what they want to do.
However, some students may want more freedom in the courses they choose to take. Others may be intimidated by the idea of taking challenging courses like Anatomy and Physiology with an 18-credit course load during freshman year. It’s best to speak to an advisor about concerns like these.
The third, fourth, and fifth year of BS/MS programs cover much of the same material as the first, second, and third years of an entry-level MS program.
Master’s Degree Coursework
Students can pursue an entry-level MS 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. 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.
The first year of our curriculum focused on establishing a strong 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! The purpose of this was to improve students’ abilities to work together effectively, because most OT settings require working closely with other health professionals. The first year was definitely 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 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 summer. We began taking population-specific courses, 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.
Our second year continued to focus on specific populations and different diagnoses. This was when we really got into different sorts of assessments, and continued learning basic skills to prepare us for Level 2 fieldwork. Courses included pediatrics, assistive technology, and physical rehabilitation. Certain 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 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 coursework related to leadership, organizational structures, and community practice, which would continue through the summer and into the fall.
The beginning of fall term was spent finishing our last class. The last three months of fall term were dedicated to our second Level 2 fieldwork.
Most of our coursework was set, 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 very specific electives that were typically taken during the summers and semesters where there was no Level 2 fieldwork.
Doctoral Degree Coursework
The main difference between the master’s program and the OTD is the 16+ week doctoral experiential component required by the OTD. 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 largely self-directed and meant to encourage students to consider how they can bring positive change to OT practice.
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.
To some extent, your life will revolve around OT 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 classmates most of the time. You may have moved a considerable distance to attend your program, and your friends and family may not be able 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 end up making lifelong friends from their cohorts, while others find it hard to make any meaningful connections. It is important for students to be aware of their overall mental wellness during this period of change, and to feel comfortable reaching to personal contacts, faculty, and the university for support.
When I entered my OT program, the professors wisely warned my cohort against working too much outside of 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, but 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 kind of 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 was able to develop strategies to finish my thesis on time, finish my run, and keep my dog happy, but I would recommend making things easier on yourself by planning ahead 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 that have many outside life demands, some programs have a large online component, offer a part-time option, and/or 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!