Occupational Therapist

What occupational therapists make

The national median is $100,330 a year, and the bottom tenth earn $71,690 or less. School district jobs come with a school calendar.

The bottom quarter

This covers everyone in the job, not only beginners, because the survey publishes no separate starting figure. Home health work is often paid per visit, with the driving unpaid.

The top quarter

The survey does not say who they are. One common route up is travel work: 13-week contracts in places short of staff, with a housing stipend on top of the hourly rate. It is also a fast way to burn out.

What it costs to get there

Roughly $85,000 to $165,000 in all. Fill out the FAFSA (Free Application for Federal Student Aid) every year. Graduate students cannot get a Pell Grant, so the master's is usually paid for with federal loans. If you work for a nonprofit hospital, a public school district or a government clinic, the Public Service Loan Forgiveness program can cancel what is left after ten years of qualifying payments.

What comes with the job

• Health insurance and a retirement plan

  Hospitals and school districts both offer them. Per-visit home health contracts often do not.

• Continuing education money

  Most employers pay for the courses your license renewal requires.

• School holidays

  District therapists follow the school calendar, including summer.

• Federal jobs

  Veterans Affairs hospitals employ occupational therapists, with federal pay scales and a pension.

• Loan repayment in shortage areas

  Rural hospitals and some state programs pay down student loans in exchange for a few years of service.

The path to becoming an occupational therapist, step by step

Four years of undergraduate, then a graduate degree. There is no shortcut, and no way in with a bachelor's alone.

1. 1

   High school

   Grades 11 and 12

   Biology, anatomy if it is offered, psychology and statistics. Get volunteer hours in a clinic or a special education classroom.

2. 2

   Bachelor's degree

   4 years

   Any major is allowed. Kinesiology, psychology and biology are the common ones because they cover the prerequisite courses.

3. 3

   Master's or doctorate in occupational therapy

   2 to 3 years

   At a program accredited by ACOTE (the Accreditation Council for Occupational Therapy Education). The master's is the shorter and more common entry route.

4. 4

   Level 2 fieldwork

   About 6 months

   Two full-time placements, about 24 weeks total, working with real patients under a supervising therapist. Unpaid.

5. 5

   Exam and license

   Final months

   Pass the national certification exam from NBCOT (the National Board for Certification in Occupational Therapy), then apply to your state board for a license.

High school courses that help you become an occupational therapist

• Biology and anatomy

  Muscles, joints and nerves are the daily vocabulary.

• Psychology

  Half of this job is getting a discouraged person to try one more time.

• Statistics

  You read research and score standardized tests constantly.

• Art, shop or anything hands-on

  Therapists build splints, adapt tools and rig up solutions out of foam and velcro.

Time and money, at a glance

Licensed in every state

You need a state license to practice occupational therapy anywhere in the United States, and all fifty states plus the District of Columbia issue one. Every state builds its license on the same two things: a degree from a program accredited by ACOTE (the Accreditation Council for Occupational Therapy Education) and a passing score on the national exam from NBCOT (the National Board for Certification in Occupational Therapy). That shared standard is why moving states is mostly paperwork rather than retraining. Many states have joined an occupational therapy licensure compact, but it is not yet issuing practice privileges, so for now you still apply to each state's board.

Where people study

• In-state public universities

  Almost every state has at least one accredited program, and in-state tuition is by far the cheapest way in.

• Large private programs

  Schools like the University of Southern California run big research-heavy programs with a doctorate option and a matching price.

• Combined bachelor's and master's tracks

  Some schools admit you out of high school and move you straight into the graduate years without reapplying, which saves a year.

• Programs with rural fieldwork sites

  Worth seeking out. Rural placements often turn into job offers and loan repayment.

Specialties that change the work

• Certified Hand Therapist

  A separate exam you can sit after several years of practice and thousands of hours treating hands and arms.

• Pediatrics

  Handwriting, feeding, sensory processing, play. A large area of the profession.

• Driving rehabilitation

  Deciding whether a stroke survivor or an older driver can safely keep driving. A short list of people are qualified to do it.

• Low vision

  Teaching people with failing eyesight how to cook, read and get around again.

• Assistive technology

  Switches, eye-gaze computers, mounted controls for people who cannot use their hands.

Nice-to-haves

• Volunteer hours before you apply

  Most graduate programs want documented hours with a licensed therapist, and some want them in more than one setting.

• A second language

  Spanish especially. You are explaining home exercises to families, not just patients.

• A driver's license and a reliable car

  School and home health therapists drive between sites all day.

• Patience with slow progress

  Gains are measured in inches. If you need fast wins, this is the wrong job.

The assistant route

There is a shorter way into the same rooms. An occupational therapy assistant needs a two-year associate degree from an accredited program and a national exam, and has a national median of $72,300 a year (2025). Assistants deliver treatment that a therapist has planned. Plenty of people work as an assistant, discover they like it, and either stay or use tuition help from the employer to go back for the master's.

What an occupational therapist does day to day

In a hospital, six to eight patients before lunch. Getting a woman three days after a hip replacement out of bed and into a shower safely. Teaching a man who had a stroke to put on a shirt with one working arm. Fitting a splint and cutting it down until it stops rubbing. In a school, you pull four children out of class for half an hour each, work on handwriting, scissors and sitting still, then sit in a meeting with parents and teachers. Everywhere, documentation: every minute you bill has to be written up before you go home.

The honest pros and cons of being an occupational therapist

Work life

Similar paths

• Physical TherapistGet people moving again after injury, surgery or stroke. Seven years of school for a job that exists in every town.
• Speech-Language PathologistYou help people talk, be understood and swallow safely, from toddlers to stroke patients. A master's degree is the price of entry.
• Recreation TherapistYou use activity as treatment: getting someone back to cooking, gardening or shooting hoops after their life changed.

The job was invented for wounded soldiers

Occupational therapy grew out of the First World War, when women called reconstruction aides were sent to army hospitals to get injured soldiers using their hands again through weaving, woodwork and typing. The professional association was founded in 1917.

It is not physical therapy

People mix them up constantly. A physical therapist works on the movement itself: strength, balance, walking. An occupational therapist works on the task you want the movement for: buttoning a shirt, making toast, getting into a car. The two often treat the same patient on the same day.

Schools have to provide it by law

The Individuals with Disabilities Education Act requires public school districts to provide occupational therapy to students who need it to access their education. That single law is why so many occupational therapists work in schools.

Half your tools you will make yourself

There is no catalog item for most problems. Therapists cut down splints, build up spoon handles with foam, bolt a knob onto a steering wheel and tape a pencil grip into shape. Being handy is a real professional skill here.