What is Occupational Therapy School Like? Difficult? FAQs

If you are considering a career in occupational therapy, then this post will help you get an idea of what OT school is like. I’ll be talking about becoming an OTR, or occupational therapist, as opposed to an occupational therapy assistant – as this was my personal experience.


My OT program spanned 2.5 years before I graduated and was eligible to take the board exam.
In general, an OT program consists of 4 major components – classroom lectures, labs, fieldwork (also known as clinicals), and lastly a capstone research project (which is similar to a thesis).

OT program is divided into 3 major categories – mental health, pediatrics, and adults, which mean students graduate as generalist occupational therapists and can go into any of those 3 fields. They can later specialize and do something more specific such as hand therapy. Besides these 3 major client populations, students will learn the history, fundamentals, and professional matters related to becoming an occupational therapist.


One thing you should know is that in the beginning, a lot of your education will be on theory. You will learn a lot of different theories of practice based on each of the categories – mental health, pediatrics, and adults physical disabilities. One thing students may often get frustrated by is why there is so much theory and not so much hands-on learning on specific skills as they would like. As occupational therapy can be thought of as a profession where science meets creativity, theory is important to provide a strong foundation for when you practice as an occupational therapist.

Case Study

For example, when I was in OT school, COVID-19 was non-existent. However, with my education of a lot of these theories, I can apply these theories to provide the best 1:1 intervention with a COVID-19 survivor. And when I look at the research that is out there, I can use my critical thinking skills to separate fact from fiction. This is what makes an occupational therapist different rather than say an aide or a therapist, in terms of application when it comes to working with clients in their scope of practice.

Group Work

Another thing you should know is that there will be a lot of group work. You will likely form small groups to research topics to provide your class lectures, form small groups in labs to practice with each other and role play (this was one of my favorite student experiences), get into groups for projects that may culminate say a semester of what you learned, researching together as a group, and lastly the capstone, in which you work together with a small group to come up with a research question, conduct research, analyze the data, write a manuscript, and give an in-person presentation to the class and faculty. While all of this may seem overwhelming, don’t worry, your professors will provide support on each step of the way based on the knowledge you build as a student.


Here are some frequently asked questions that often get asked regarding OT school.

Is OT school hard?
I would say, yes it has it’s challenges, but what was hard was not say the exams, or labs. For me, it was writing assignments and the final manuscript. Of course, writing is a skill, and one challenge is that in OT school, you learn to write like an OT which means being clear and concise. I got pretty good marks, because I knew I would use what I learn in school one day possibly, so I studied really hard.

Do you need to get all A’s?
Not necessarily, you just need to do well enough so that you are not in danger of failing. This is all based on your work ethic, but I feel like many OTs tend to be overachievers. Don’t worry about just the grades, but enjoy your time with your peers, have fun outside of school, and build a relationship with friends and professors.

Do students drop out?
In my class, only 2 students dropped out, likely due to non-academic reasons. The rest of us did really well and in fact, all passed our board exam.

Can you work during OT school?
Definitely, at least part time. Nowadays, you can easily find gig work with things like Uber or doordash if you need a quick buck. A popular option is babysitting with websites like care.com. If you don’t desperately need to work,

I always recommend building your skills in ways that you can use it to complement being an occupational therapist, say photography, coding, web design, business, marketing, that kind of thing. It was thanks to these skills that help me to start OT Dude without much consulting with other professionals and I learned a lot of these things on my own for free, just right here on youtube or from reading books. If you are into entrepreneurial things like starting an Etsy shop, I would say do your research first and don’t rush into it because you don’t want to get in trouble with things like copyright law or taxes.

Can I have a child during OT school?
I would wait if possible, because while school can be quite accommodating, with your fieldwork, it may not be as accommodating. Every student will get a unique fieldwork placement. Also, you likely will have a strict attendance policy for fieldwork so you can’t miss too many days or you may either need to do it again or fail the program altogether. So plan ahead and keep your professors in the loop, but don’t expect much when it comes to changing schedules around to accommodate childcare too often.

Is OT school worth the tuition?
This depends on your situation and how much you can afford. Yes, I am aware that many students will need to take out loans which are really big numbers that may take years to pay off. However, the OT job market is growing and there are many settings that you can go into. If you work, say per diem, you may earn a higher per hour salary, also called a differential. There is also loan forgiveness and scholarships. Yes, some students may not get a job right away, and this may be due to the location, and with COVID-19, many places have stopped hiring altogether temporarily.

I recommend you look at your expenses, how much you have saved up, how much OTs earn in your area, how long it takes to pay back, and your spending habits, and big life expenses coming up like car, house, getting married. In general, if you need to take out a loan that takes a lifetime to pay off, then I would advise against it and try to get into a less expensive school. This goes for any major and profession.

Should I do OT or some other profession like PT, speech, child psychology, etc.?
This, of course depends on many factors. What drew me to the profession was how OTs can work in many settings and populations alongside nurses, doctors, therapists, and other allied health professionals. OTs get to use their creativity while helping others. Reflect and ask yourself why you want to go into healthcare.

What is great about OT is you get a lot of autonomy, stress is manageable, the work is rewarding – yes even fun, and it never gets boring, for me anyways. You get to be “hands on” 1 on 1 with a lot of clients and while the paperwork is not the most fun, it is much less time consuming than nursing and the responsibility is less “life or death”.

Jeff is a licensed occupational therapist and lead content creator for OT Dude. He covers all things occupational therapy as well as other topics including healthcare, wellness, mental health, technology, science, sociology, and philosophy. Buy me a Coffee on Venmo.