To become an occupational therapist in the US, you typically earn a bachelor's degree, then a master's degree in occupational therapy, which usually takes 2 to 3 years and includes supervised fieldwork. After that you pass a qualifying exam and get your state licence. All states require occupational therapists to be licensed.
The welcome surprise is that your bachelor's degree doesn't need to be in a particular subject. What matters is that you've covered the prerequisite courses.
Figures here come from the US Bureau of Labor Statistics (BLS) Occupational Outlook Handbook, read on 26 October 2026, with exam context from NBCOT, the national certifying body. It's a careers guide, not therapy advice.
Occupational therapy in numbers
| Measure | BLS figure |
|---|---|
| Median pay (May 2025) | $100,330 a year |
| Lowest 10 in every 100 earned less than | $71,690 |
| Highest 10 in every 100 earned more than | $131,950 |
| Jobs in 2025 | 169,600 |
| Projected growth 2025 to 2035 | 15%, much faster than average |
| Openings each year | About 10,000 on average |
Pay figures are as of October 2026. A projected 15% rise puts occupational therapy among the faster-growing healthcare careers.
Your route to becoming an OT
- Earn a bachelor's degree. BLS says it may not need to be in a particular subject.
- Cover the prerequisites. Master's programs frequently want coursework in biology, psychology and other sciences.
- Get some experience. Some programs require applicants to have volunteered or worked in an occupational therapy setting.
- Complete an accredited master's in occupational therapy, usually 2 to 3 years, with courses such as kinesiology, neuroscience and anatomy plus supervised fieldwork.
- Pass the qualifying exam. You need a degree from an accredited program that includes fieldwork to sit it.
- Get your state licence and keep it current with continuing education.
The title that comes with passing
Here's a detail many applicants don't know until late in the process. BLS says therapists must pass the qualifying exam to use the title Occupational Therapist Registered, or OTR. So the exam isn't just a licensing step; it's what gives you the professional title you'll put after your name. NBCOT, which runs it, publishes the exam's content domains and the share of questions in each, so you can build your study plan around them.
Some schools also offer dual-degree programs where you earn the bachelor's and master's together, which can cut the total time if you know early that this is your path.
Where OTs work and what they earn
Therapy offices employ the most occupational therapists, at 28% of jobs, with hospitals close behind at about 26 in every 100. Schools account for about 13 in every 100.
| Setting | Median pay, May 2025 |
|---|---|
| Home healthcare services | $106,300 |
| Nursing care facilities (skilled nursing facilities) | $105,850 |
| Hospitals; state, local and private | $102,820 |
| Offices of physical, occupational and speech therapists, and audiologists | $97,940 |
| Educational services | $87,300 |
Those are BLS medians as of October 2026. School-based roles paid the least of the five settings, so if pay is your priority, home health and skilled nursing facilities are where to look.
The physical side of the job
People often picture OT as gentle, desk-adjacent work. BLS says otherwise: occupational therapists have one of the highest rates of injuries and illnesses of all occupations, because they may lift and move clients or heavy equipment. You'll spend a lot of time on your feet, and good lifting technique is part of the job.
Most OTs work full time, part-time work is common, and some work nights or weekends to fit clients' schedules. Some travel to clients' homes, and others work in schools. Some employers also ask for CPR or basic life support certification, so it's worth getting that done before you apply.
How long it takes, start to finish
| Stage | Typical time (BLS) |
|---|---|
| Bachelor's degree, any subject | About 4 years |
| Master's in occupational therapy, with fieldwork | 2 to 3 years |
| Qualifying exam and state licence | After graduation |
That puts most people at six to seven years. A dual-degree program that combines the bachelor's and master's can shorten it, and choosing your undergraduate courses with the prerequisites in mind avoids an extra semester later.
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Choosing a master's program
Check accreditation first, because you can only sit the qualifying exam with a degree from an accredited program that includes fieldwork. Then compare where the fieldwork happens, since that's your first real taste of hospitals, schools or home health. Ask whether the program wants volunteer or work experience in an OT setting before you apply, because some do and some don't, and that can change your timeline by months.
Skills that make a good OT
- Patience, since progress with clients can be slow.
- Communication, to explain plans to clients and families.
- Creativity in adapting activities and environments.
- Compassion for clients' needs and concerns.
If you later run a private practice, it pays to think about the business side early. These ways to improve an occupational therapy practice and our look at the best EHR systems for therapists are good starting points.
My verdict
Occupational therapy is a well-paid, fast-growing career that you can reach from almost any bachelor's degree, as long as you pick up the science prerequisites and some real OT experience along the way. Plan for 2 to 3 years of master's study with fieldwork, then the exam that earns you the OTR title. And go in knowing it's physically demanding: BLS ranks it among the occupations with the highest injury rates.
Frequently asked questions
How long does it take to become an occupational therapist?
Usually a 4-year bachelor's degree plus a master's in occupational therapy that BLS says takes 2 to 3 years, so about six to seven years in total.
What bachelor's degree do you need for occupational therapy?
BLS says it may not need to be in a particular subject, but master's programs frequently require coursework in biology, psychology and other sciences.
What does OTR stand for?
Occupational Therapist Registered. BLS says therapists must pass the qualifying exam to use the title.
How much do occupational therapists make?
BLS reports a median of $100,330 a year in May 2025, as of October 2026.
Is occupational therapy a growing field?
Yes. BLS projects 15% growth from 2025 to 2035, much faster than average, with about 10,000 openings a year.
Do occupational therapists need experience before applying?
Some programs require applicants to have volunteered or worked in an occupational therapy setting, so check each program's rules.
