Occupational Therapy Education Overview
Becoming an occupational therapist requires at minimum a master’s degree from an ACOTE-accredited program, followed by passing the NBCOT certification exam and obtaining state licensure. OT assistants enter through an associate’s degree program. Both paths require supervised fieldwork that cannot be completed fully online.
Occupational therapy draws people who want to help others regain independence after illness, injury, or disability. Before you get there, you need to understand what the educational path looks like. The degree you pursue determines the role you’ll fill, and the difference between an OT assistant and a practicing occupational therapist depends on the program you complete. Understanding which path fits your goals is the first step.
OT Education at a Glance
The table below shows the two primary practice roles and the degrees that lead to them.
| Degree | Role | Minimum Entry | Typical Timeline |
|---|---|---|---|
| Associate’s | OT Assistant (COTA) | High school diploma | 2 years total |
| Master’s (MOT/MSOT) | Occupational Therapist (OTR) | Bachelor’s degree | Typically 2-3 years (graduate) |
| Doctorate (OTD) | Occupational Therapist (OTR) | Bachelor’s degree | Typically 3 or more years (graduate) |
The OTA Pathway: Associate’s Degree
If you want to work directly with patients as an occupational therapy assistant, an associate’s degree from an accredited program is the entry point. OT assistants work under the supervision of a licensed OT, helping patients carry out treatment plans and build skills for daily living.
OTA programs typically take two years to complete and combine classroom instruction with supervised fieldwork. You’ll study anatomy, therapeutic interventions, and patient communication before moving into hands-on clinical hours. Accreditation by the Accreditation Council for Occupational Therapy Education (ACOTE) is required for a program to qualify you to sit for the national certification exam. After graduation, OTAs must pass the National Board for Certification in Occupational Therapy (NBCOT) exam to earn the Certified Occupational Therapy Assistant (COTA) credential and apply for licensure in their state.
The OT Pathway: Master’s and Doctoral Degrees
To practice as a licensed occupational therapist, a master’s degree in occupational therapy is the minimum requirement in all U.S. states. A bachelor’s degree in OT alone is no longer standard for entry-level practice. The field transitioned away from that years ago, and today’s programs are designed around graduate-level entry.
Master’s Degree (MOT or MSOT)
Most people entering the OT field pursue a Master of Occupational Therapy (MOT) or a Master of Science in Occupational Therapy (MSOT). Both prepare you for licensure and full independent practice. Programs typically take two to two and a half years after completing an undergraduate degree.
Your undergraduate major doesn’t have to be in OT or health sciences. Programs commonly accept students from biology, psychology, kinesiology, or liberal arts backgrounds, as long as prerequisite coursework in subjects like anatomy and statistics is completed. Prerequisites vary by program, so check directly with the programs you’re considering. After finishing a master’s program and its required fieldwork hours, graduates must pass the NBCOT exam to earn the Occupational Therapist Registered (OTR) credential and become eligible for state licensure.
Doctoral Degree (OTD)
The Occupational Therapy Doctorate (OTD) is increasingly common as an entry-level path, though a master’s degree remains sufficient for practice. The OTD includes additional coursework in leadership, research, policy, and program development, along with a doctoral capstone project. Some students choose this path from the start. Others return for it after working as OTs who want to move into administration, clinical specialization, or academic roles. Both the master’s and doctoral paths require ACOTE accreditation and NBCOT certification.
Fieldwork: Where Classroom Learning Becomes Practice
OT and OTA programs are not offered in fully online formats due to required fieldwork. Accreditation standards require significant hands-on clinical experience, and ACOTE-accredited programs build this into the curriculum.
There are two levels. Level I fieldwork is observation-based, introducing students to clinical environments and patient populations across different settings. Level II fieldwork is more intensive: students work directly with patients under licensed supervision to develop real competency before entering the workforce. Doctoral students also complete a 14-week capstone experience.
Fieldwork placement matters when you’re evaluating programs. Ask where students are typically placed, how the program supports students who need placements in specific geographic areas, and whether clinical sites align with the populations you want to work with.
Choosing an ACOTE-Accredited Program
ACOTE accredits both OT and OTA programs at the associate’s, master’s, and doctoral levels. Graduating from an ACOTE-accredited program is required for NBCOT certification eligibility. Without that certification, you can’t obtain state licensure. ACOTE accreditation is required, not optional, and is the baseline standard to verify before evaluating any program.
Once you’ve confirmed a program holds ACOTE accreditation, look at program format, fieldwork placement support, NBCOT exam pass rates, and whether the curriculum aligns with the specialty area you’re considering, such as pediatrics, geriatrics, or mental health. Specializations are typically pursued after earning your degree, but program culture and clinical affiliations can shape where you develop expertise.
Salary and Career Outlook
According to the Bureau of Labor Statistics, occupational therapists earned a median annual salary of $98,340 as of May 2024. OT assistants earned a median of $68,340 during the same period. These are national estimates and vary by location, experience, and setting. The BLS also projects strong demand ahead: employment of occupational therapists is expected to grow 14 percent from 2024 to 2034, with approximately 10,200 job openings projected each year. OT assistant employment is projected to grow 18 percent over the same period. To learn more about what occupational therapists do day to day, visit our OT career overview.
Frequently Asked Questions
What degree do I need to become an occupational therapist?
A master’s degree in occupational therapy from an ACOTE-accredited program is the minimum requirement in all U.S. states. Some students pursue an Occupational Therapy Doctorate (OTD) instead. A bachelor’s degree alone does not qualify you for licensure as an OT.
What’s the difference between an OT and an OTA?
An occupational therapist (OT) holds a master’s or doctoral degree and carries full clinical responsibility for patient care. An occupational therapy assistant (OTA) holds an associate’s degree and works under the supervision of a licensed OT to carry out treatment plans.
What is ACOTE accreditation, and why does it matter?
ACOTE is the Accreditation Council for Occupational Therapy Education, the body that accredits OT and OTA programs in the United States. Graduating from an ACOTE-accredited program is required to sit for the NBCOT certification exam, which is, in turn, required for state licensure.
Do OT programs require fieldwork?
Yes. Both OT and OTA programs require supervised fieldwork as part of the curriculum. ACOTE standards mandate Level I and Level II fieldwork experiences. OT and OTA programs are not offered in fully online formats because of this requirement.
How long does it take to become an occupational therapist?
Most people spend about six to seven years in school: four years of undergraduate study followed by two to three years in a master’s program. Doctoral programs typically add another year to the graduate portion. OTA programs take about two years total.
Key Takeaways
- A master’s degree is the minimum for OT practice: a bachelor’s degree in OT is no longer sufficient for licensure as an occupational therapist in any U.S. state.
- OTA entry requires an associate’s degree: OTAs work under the supervision of a licensed OT to carry out treatment plans.
- ACOTE accreditation is required: programs must be accredited by the Accreditation Council for Occupational Therapy Education for graduates to sit for the NBCOT certification exam.
- Fieldwork is built into every program: hands-on clinical hours are part of ACOTE accreditation standards, and fully online OT programs do not exist.
- The OTD is increasingly common: while a master’s degree remains the standard entry point, doctoral programs are available and better suited for those pursuing leadership or specialized practice roles.
Ready to explore your options? Browse ACOTE-accredited occupational therapy programs and compare degree pathways by state.
2024 US Bureau of Labor Statistics salary figures for Occupational Therapists and Occupational Therapy Assistants reflect national data and not school-specific information. Conditions in your area may vary. Data accessed April 2026.