Why Work Internationally
Working as an occupational therapist in another country can be a unique opportunity to experience and immerse yourself in another culture. The healthcare system of other countries may also vary in similarity in how clients and patients receive occupational therapy services from birth onwards. Furthermore, if you love to travel, working as an occupational therapist in another country allows you to earn some money to fund your travel expenses.
You do not necessarily need to commit to spending an extensive time working as an occupational therapist in another country if you are not ready. For example, a fellow coworker has volunteered his time several trips abroad to third world countries helping poor children overcome their barriers to participation in their occupations. He worked alongside other occupational therapists, doctors, physical therapists, and other healthcare professionals doing what he loves. As he was quite experienced with wheelchairs, he helped modify oversized wheelchairs to better suit their pediatric users.
One potential downside to this depending on your current employer and your employee policy is potentially having to take personal time off for the trip (unpaid). Of course, you would also be responsible for travel expenses such as airfare, food, transportation costs. Ask your manager if there are any such opportunities for a way to volunteer abroad for a short period such as a week or a month.
If you already have a country in mind, check out this list compiled by occupational therapists and published by the WFOT with some information to start.
The most important considerations for choosing the country to work in is safety. Is there a lot of crime in general such as theft or cultural biases against you? Is there a war going on? With the pandemic, is travel restricted between your country and the one you want to work in? What if you get ‘stuck’ broad? Will that be okay? A great place to look is the US Travel Advisory page as this could change at any time.
Whether you are a male or female, this is still important to consider. For example, some more patriarchal countries may view working females differently than here in the United States. The same could be said if you are a male, as traditionally, most OTs are female in the occupational therapy profession.
Native Spoken Language(s)
“You will need to understand local terminology and translated professional language. Specific terms related to occupational therapy may differ across countries.” – WFOT
Whether you speak the country’s native language or not may be a reason to consider that country. If you speak the native language, then great! You will likely be just fine. Don’t forget you will have to read and write to some degree for documentation.
If you are less familiar, this can be an opportunity to improve or learn in another language. Do not discount an opportunity to work abroad because you do not speak or can read and write that language. With modern technology, there are much less barriers to this – for example, using Google Translate at your fingertips with a smartphone. Just as you may work with a non-english speaker here in the US, you may also use a live translator service to translate into English for you abroad as well. Check with your potential employer if they offer this service either in a phone or video format.
- At the very minimum, you should be able to read and write enough for documentation and to provide occupational therapy services for your clients.
Main Spoken Language(s) by Country
- Argentina: Spanish
- Australia: English
- Austria: German
- Bangladesh: Bangla
- Belgium: Dutch, French, German
- Bermuda: English
- Bulgaria: Bulgarian
- Canada: English, French
- Colombia: Spanish
- Cyprus: Greek
- Czech Republic: Czech
- Denmark: Danish, English
- Estonia: Estonian
- Faroe Islands: Faroese, Danish
- Finland: Finnish, Swedish
- Franch: French
- Georgia: Georgian
- Germany: German
- Greece: Greek
- Hong Kong: Cantonese, English, Mandarin
- India: Hindi, English
- Ireland: English, Irish
- Israel: Hebrew
- Italy: Italian
- Japan: Japanese
- Jordan: Arabic
- Kenya: English
- Korea: Korean
- Latvia: Latvian
- Luxembourg: Luxemburgish
- Macau: Cantonese, Portuguese, English, Mandarin
- Madagascar: Malagasy, French
- Malawi: English, Chichewa
- Mexico: Spanish
- Namibia: English, Namibian
- Netherlands: Dutch
- New Zealand: English, Maori, New Zealand Sign Language
- Nigeria: English, Hausa, Ibo, Yoruba
- Norway: Norwegian
- Pakistan: Urdu, English
- Panama: Spanish
- Peru: Spanish
- Philippines: Filipino, English
- Portugal: Portuguese, English
- Romania: Romanian
- Singapore: English, Mandarin, Malay, Tamil
- Slovenia: Slovene
- South Africa: English, Afrikaans, Isindebele, Isixhosa, Isizulu, Sesotho sa Leboa, Sesotho, Setswana, SiSwati, Tshivenda, Xitsonga
- Sweden: Swedish
- Switzerland: German, French, Italian
- Taiwan: Mandarin
- Tanzania: English, Swahili
- United Kingdom: English
- Venezuela: Spanish
- Zimbabwe: English
Depending on the country, some may require that you have working visas. If you are planning to bring family members, there may be specific restrictions on the number of family members that you can bring. If your family members decide to stay, they may not be able to if there are requirements that they leave when your employment contract ends. Look into how long these visas can last and how long they can be extended. Some visas are easier to obtain than others and with COVID-19, some may be closed entirely.
Some countries highly recommend or even insist that you have professional indemnity insurance coverage. It may also be optional. Liability insurance is another good idea to cover your practice.
Compare your current health and other medical insurance with the new one to cover the needs of you and your family. Look into enrollment periods, cost of services, and coverage networks. Don’t forget to research dental, vision, and medications coverage. Some OT associations may include incentives or discounts for other insurances.
If you are considering starting a private practice, you are more on your own, but you may potentially have a larger selection of insurance providers. Also look into sliding scale and private pay as well, depending on your contract and expected annual salary.
Many credit cards offer some benefits such as insurance for car rentals, waived foreign transaction fees, and more. Take a look at your current credit cards to see what they offer or consider opening a new one. I recommend researching on Nerdwallet.
As vaccinations may take a long time to get or be in a shortage, it is recommended that you complete all of the vaccinations well ahead of time. Veterans and military members may have vaccinations already covered, depending on your specific circumstance and prior service, e.g., COVID-19 vaccine.
Pro Tip: take a picture for digital records as well in case you lose or have your proof of vaccinations stolen.
Don’t forget your US passport if you plan to travel back home such as for the holidays or even for emergencies if you have family and friends in the US. If you never had a passport, applying for the passport is very straightforward: fill out an online application, print it out, bring some proof(s) of who you are, schedule an appointment, bring or take a picture, pay, and wait for it to come in the mail. I had a positive experience with this at the USPS for my son, even during the pandemic. Waiting for it to come is the variable you cannot control. It can take a month or more to arrive but can be expedited for an extra cost.
Pro Tip: Take a picture of your passport (and its number) and consider storing it on the cloud in case you lose it. You will likely be able to go to the US embassy with the digital image to get back to the states.
Cost of Living
- Is the cost of living similar, less, or more than here in the US?
- How does the dollar (USD) compare to the other currency?
- Do OTs do well abroad compared to the US?
- How much is the rent?
- Do you know someone you can stay with to save money?
- How much is food?
- How much is transportation? Is it public, private, or can you walk or even bike to work? Is any of it subsidized by the government or employer?
- Entertainment or leisure?
Pay and Taxes
- How will you be paid?
- How often will you be paid?
- How will taxes look like?
- When are taxes due?
- What will you have to report?
- Will you have to continue to pay taxes to the US?
- Do you have dual citizenship?
These answers can be found with a CPA in the country you wish to work in. A good place to start is a Google Search for general information first. Keep in mind that everyone’s situation is unique. Do your due diligence because you do not want to increase the chances that you will be audited by the IRS or other government agencies.
Coaching and Mentoring
Can an occupational therapist or assistant coach and mentor you? This is a plus as it can help you acclimate to the new country and on the job much faster. It is an even more important consideration if you will likely be working alone (e.g., home health OT) and not have easy access to other OTs to ask questions. Also consider just connecting virtually online via social media.
How is the professional OT community like in this country? Most have websites with information on how to connect similar to AOTA here in the US. Connecting with professional or local organizations can be tremendously helpful to provide you with information, insight, and resources to improve your OT practice abroad. Again, social media is another tool you can use as you are likely to not know anyone in the OT work. Be sure that social media platform is allowed and not banned in the said country though. Not all countries may be Facebook friendly, for example.
Internet Access and Telecommunications
Will you have easy access to the internet for documentation, research, communication, and staying connected? If you are going to be providing telehealth, you will definitely want to look into this or you will be working at a Cafe more than you may like. Internet speed is important for this as video calls can be somewhat bandwidth-intensive.
Besides internet access, don’t forget to look into cell phone use. A good investment is an unlocked phone that you can use to insert a SIM and start using right away abroad. Dual sim phone are even better. Otherwise, you can find a second hand one such as on ebay or purchase a cheaper ‘throwaway’ phone abroad, you may just be carrying two phones.
Thankfully Wifi is more universal, but is the place you will be staying or working even have wifi? Again, consider other countries’ restrictions and what they may ban. There are workarounds for this such as VPNs, but look into this more as you may be potentially breaking local laws.
We all know that work-life balance is important. Is the culture in the country you are looking to work in have more of a work culture? How are genders viewed in terms of working or not and/or how often do they work?
A major factor that will affect your work-life balance is the contract and its working hours, sick pay, and holiday pay.
Also look into if you can pick up an extra job, e.g., per-diem abroad if you wish to earn more money or if the schedule is more spaced out.
You do not necessarily need to quit your job here in the US. Ask if you can cut down on hours to part-time or per diem to work remotely when you are abroad. Of course they may not be possible for some positions such as acute care, home health, or SNF, but may be more possible with other jobs – especially if you are currently providing telehealth already. This may potentially complicate your taxes a bit, but you will maintain your relationship and job here in the US (in case things don’t work out abroad) and also increase your overall combined salary.
- Will family come with you?
- Do you have children?
- Are you in a relationship?
- Are you married or engaged?
- What will you do if a family member falls ill in the US while you are working abroad?
- Do you currently take care of a family member?
- Do you have family abroad who can help you make a smooth transition?
Perhaps the most difficult question is how long you wish to work abroad. Is it 1 year? 5? Permanent? Of course, there are many factors that can affect this and it is hard to even plan out because you have not started and don’t know how the culture is like, how your boss is like, etc.
I recommend setting short and long-term goals and reevaluating them as time passes to see if you are meeting them. Are you overworked? Underpaid? Bored? Or the opposite and doing quite well for yourself? Again, consider keeping your current job and working remotely or at least not ‘burning bridges’ with your employer and ending on good terms in case you wish to work your current job in the future.
Maintaining US OT Certifications
I highly recommend that you maintain your certifications for your OTR/L in case you decide to come back and practice in the US or if things don’t work out. Don’t let your NBCOT expire or your licensure expire with the state. Sure, this can be an added expense as you are also required to take continuing education, but getting relicensed and recertified is more work, stress, and money. Another good question to ask the NBCOT and state is whether working abroad counts as con-ed.
National Associations and Registration Requirements
Another resource when you are serious and more committed to working abroad are the websites and contacts for the local associations – the equivalent of AOTA abroad. Some countries have websites for their boards (similar to the boards for the state you work for in the US, e.g., California Board of Occupational Therapy) as well.
Each specific country has its own registration requirements for practice. Some require registration with the country’s national organization and/or state similar to OTR/L here in the US. (R = Registered = NBCOT. L= Licensed = One of the 50 states in America.)
Here are some links or contacts to the National Associations by country:
- Argentina – http://www.terapia-ocupacional.org.ar
- Australia – www.otaus.com.au
- Austria – www.ergotherapie.at
- Bangladesh – http://bota-bd.org
- Belgium – www.ergobel.be
- Bermuda – Bota.firstname.lastname@example.org (unverified)
- Bulgaria – http://abet-bg.org
- Canada – www.caot.ca
- Colombia – www.tocolombia.org
- Cyprus – email@example.com (unverified)
- Czech Republic – www.ergoterapie.cz
- Denmark – www.etf.dk
- Estonia – www.tegevusteraapia.ee
- Faroe Islands – www.etf.fo
- Finland – www.toimintaterapeuttiliitto.fi
- France – www.anfe.fr
- Georgia – firstname.lastname@example.org (unverified)
- Germany – www.dve.info
- Greece – www.ergotherapists.gr
- Hong Kong – http://www.hkota.org.hk/general_information.html
- India – www.aiota.org
- Ireland – www.aoti.ie
- Israel – email@example.com
- Italy – www.aioto.i
- Japan – http://www.jaot.or.jp
- Jordan – +962 7 9604 0296
- Kenya – www.kaota.co.ke
- Korea – www.kaot.org
- Latvia – http://ergoterapija.lv
- Luxembourg – http:/www.aled.lu
- Macau – http://www.mota.org.mo
- Madagascar – firstname.lastname@example.org , email@example.com (unverified)
- Malawi – www.otamalawi.com
- Mexico – http://www.apto.org.mx
- Namibia – www.naotnam.org
- Netherlands – www.ergotherapie.nl
- New Zealand – www.nzaot.com
- Nigeria – www.naot.org.ng
- Norway – http://www.ergoterapeutene.org
- Pakistan – firstname.lastname@example.org (unverified)
- Panama – email@example.com (unverified)
- Peru – http://www.aptop-pe.com
- Philippines – www.otap.org.ph
- Portugal – www.ap-to.pt
- Romania – www.terapieocupationala.ro
- Singapore – www.saot.org.sg
- Slovenia – www.dts.si
- South Afirca – www.otasa.org.za
- Sweden – http://www.fsa.se/Om-forbundet/Other-languages/English/Professional-issues/ (unverified)
- Switzerland – www.ergotherapie.ch
- Taiwan – http://www.ot-roc.org.tw
- Tanzania – firstname.lastname@example.org (unverified)
- Trinidad & Tobago – www.ttota.com
- United Kingdom – www.baot.org.uk
- Venezuela – email@example.com (unverified)
- Zimbabwe – firstname.lastname@example.org (unverified)
Another place to look is Facebook groups which may contain links to specific websites, e-mail addresses, phone numbers, or physical addresses. Try googling for a specific country plus the keywords ‘national occupational therapy association’.
Working abroad can be a great opportunity to experience OT in the local culture. Whether it is your native ethnicity, a country you always wanted to visit and travel to, helping the disadvantaged and underserved, being an OT entrepreneur, or all of the above, working abroad is not as difficult as it seems. The key is to be organized, research the things in this guide, and to allow time to complete requirements. If you can, try to find an actual OT who works in the country you wish to work in to guide and mentor you in the process. I highly recommend that you check out the link below by the WFOT to get started.
WFOT Position Statement “Recruiting Occupational Therapists from International Communities” available at www.wfot.org > Resource Centre > Position Statements