Will You Earn More with a Doctor of Occupational Therapy? Maybe, Maybe Not.
March 10, 2021
In the occupational therapy field, a doctorate can open doors that would be otherwise closed, but those opportunities may not deliver bigger paychecks.
There can be no question that occupational therapists (OTs or OTRs—the "r" stands for "registered") play an essential role in the health professions. When injuries and illnesses rob people of their capacity for self-care or individuals with disabilities or delays seek more independence, OTs are there to help them learn or relearn the kinds of routine, everyday activities most of us take for granted.
Occupational therapists are among only people in the world who understand how complex seemingly straightforward activities can be. You might not realize it, but even preparing a bowl of cereal or putting away laundry involves numerous motor processes, sensory input processing skills, bilateral coordination, and motor planning.
OTs know how challenging simple daily tasks can be for people with neurological or physical differences thanks to their rigorous training. The entry-level education to become an occupational therapist is a two-year master's degree. The Master of Occupational Therapy (MOT) isn't the terminal degree in the field, however. Some OTs pursue the Doctor of Occupational Therapy degree(OTD)—either as their entry-level credential or as a post-professional credential.
You don't need an OTD to work in clinical roles in occupational therapy, though there's a chance you might need one in the future. The Accreditation Council for Occupational Therapy Education (ACOTE) has recommended that all entry-level occupational therapy programs transition to the doctoral level, but has never gone as far as mandating that the OTD become the entry-level degree for the field.
There are good reasons to pursue an OTD, but salary may not be one of them. Occupational therapy jobs pay well—about $85,000 annually as of 2019—and are relatively stable, but that's irrespective of highest level of education achieved.
In this article, we look at the factors that impact Doctor of Occupational Therapy salaries and cover:
- What is a Doctorate in Occupational Therapy, and who pursues this degree?
- How much do occupational therapists usually earn?
- Do I need an OTD to become an occupational therapist?
- Which schools have the best Doctorate in Occupational Therapy programs?
- Will earning an Occupational Therapy Doctorate help me make more money than an MOT?
- What else can an occupational therapist do to earn a higher salary?
What is a Doctorate in Occupational Therapy, and who pursues this degree?
The Doctor of Occupational Therapy is a practice-oriented professional doctorate designed for clinical OTs. There are two types of OTD programs:
- Entry-level Doctor of Occupational programs for students coming out of bachelor's degree programs with no professional experience in occupational therapy
- Post-professional programs for OTs who have graduated from an MOT program, passed the American Occupational Therapy Association (AOTA) National Board for Certification in Occupational Therapy (NBCOT) exams (information about the NBCOT certification examination is available online), and worked as licensed occupational therapists for three or more years
Until fairly recently, most Doctor of Occupational Therapy programs were designed for OTs who already meet licensure requirements. However, the number of online and on-campus entry-level OTD programs is growing. There are around 40 entry-level AOTA-accredited OTD degree programs in the United States. The list of post-professional OTD programs recognized by AOTA is quite a bit longer. You can check the accreditation status of any program at the ACOTE website.
Both OTD pathways include core classes in:
- Advanced clinical methods
- Program development
- Patient assessment
- Healthcare administration
- Applied research
Some programs require students to complete a three-credit-hour capstone course or write a thesis. Students in both types of program complete a minimum of 24 weeks of full-time supervised Level II fieldwork—ideally in a variety of clinical settings.
The big difference between these two academic programs can be found in the scope of the material covered. Entry-level doctorate programs cover a broad range of topics primarily focused on issues related to clinical practices, while post-professional programs usually focus on leadership, assessment, and innovation.
At the University of Pittsburgh, for example, students in the three-year, nine-term entry-level OTD program take courses like:
- Activity/Context Adaptation Theory and OT Practice
- Advanced Concepts in Clinical Reasoning
- Advanced Concepts in Health Policy and Advocacy
- Biomechanical Theory and Practice
- Body Functions and Structures: Anatomy
- Clinical Conditions
- Critical Appraisal of Evidence
- Developmental Theory and Practice
- Foundations of Occupation
- Human Performance Analysis
- Leadership Development
- Management of Occupational Therapy Practice
- Neurobehavioral Science
- Neurorehabilitation Theory and Practice
- Principles of Assessment
- Productive Aging Theory and Practice
- Occupational Therapy and the Health System
- Psychosocial/Cognitive Theory and Practice
- Therapeutic Approaches
Meanwhile, the core courses in the school's online post-professional Doctor of Clinical Science in Occupational Therapy program look quite different. Students in that doctoral program follow an OTD curriculum that includes courses in:
- Advanced Assessment
- Advocacy for Implementation
- Conceptualizing and Assessing Quality Improvement
- Evidence Analysis and Synthesis
- Evidence-Based Protocols and Practice Guidelines
- Evidence of Interpretation for Implementation
- Foundations in Implementation
- Implementation Evidence
- The Business of Implementation
- Theories of Change
Earning an OTD can help launch a career in occupational therapy (much like an MOT) or open up new career paths in teaching, research, and leadership positions in clinical settings. From a compensation standpoint, entry-level Doctor of Occupational Therapy salaries are very similar to MOT salaries, while earning a post-professional doctorate in occupational therapy may result in a salary increase (when it leads to a change in responsibilities).
How much do occupational therapists usually earn?
The average salary of freshly minted OTs (those with five or fewer years work experience) is about $64,000, while the median income calculated across all levels of experience is about $85,000, according to the US Bureau of Labor Statistics.
Neither of these figures tells a complete story, however, because these averages don't take education into account. Consequently, they're not particularly useful when it comes to determining the value of a doctorate.
Salaries for occupational therapists also vary significantly by location. In New York (and particularly in and around NYC), OTs tend to earn over $100,000. In North Carolina, OTs earn closer to $74,000. Again, that's irrespective of education.
Practice setting also plays a role in the earning potential of OTs. There are occupational therapists in hospitals, outpatient clinics, schools, home health agencies, research facilities, and rehabilitation centers. OTs who provide in-home care tend to earn the most, while those who work in schools typically earn the least.
It's unclear what role education plays in salary. It's not unusual for OTs to start at the same point on the pay scale, whether they graduate from a master's-level OT program or earn an entry-level Doctor of Occupational Therapy. The OTD holder may be able to advance through clinical positions more quickly because their education included coursework related to advanced clinical topics, management, and program development. There are also higher-paying administrative roles, research positions, and program development jobs that are only open to OTD holders. On the other hand, the MOT holder has joined the workforce one year sooner, gaining valuable clinical experience, and may carry less student loan debt.
Do I need an OTD to become an occupational therapist?
The quick answer to this question is not yet. While ACOTE has delayed making the clinical doctorate for OTs the mandatory entry-level degree for licensure in this field, AOTA has been kicking around the idea for about two decades. In 2018, the organization nearly mandated that all MOT programs become OTD programs by 2027. However, a year later, it decided to table the mandate and continue to support dual entry-level degree pathways.
Aspiring OTs shouldn't rule out the possibility that an OTD mandate will eventually go into effect. Licensed occupational therapy practitioners with master's degrees would still be legally able to work. Still, a time might come when doctorate holders have more doors open to them and can earn more in clinical roles because they've been able to specialize in areas like gerontology, program development, pediatric occupational therapy, or administration.
Which schools have the best Doctorate in Occupational Therapy programs?
According to US News and World Report, the best occupational therapy programs can be found at:
- Boston University
- Boston University College of Health and Rehabilitation Sciences
- Colorado State University - Fort Collins College of Health and Human Sciences
- Thomas Jefferson University Jefferson College of Rehabilitation Sciences
- Tufts University Graduate School of Arts and Sciences
- University of Illinois at Chicago College of Applied Health Sciences
- University of Pittsburgh School of Health and Rehabilitation Sciences
- University of Southern California Chan Division of Occupational Science and Occupational Therapy
- Washington University in St Louis School of Medicine
All of these schools have either entry-level or post-professional OTD programs accredited by ACOTE.
Will earning an Occupational Therapy Doctorate help me make more money than an MOT?
You might earn more with a doctorate of occupational therapy, provided you graduate from a post-professional program. In general, however, entry-level Doctor of Occupational Therapy degrees are treated like an MOT by those in charge of hiring. Whether you have an OTD or an MOT, your professional experience will likely impact your salary more than the degree on your resume. Even AOTA, in its own materials, states outright that "preliminary informal surveys of entry-level doctoral graduates indicate that the doctoral degree does not guarantee advanced salaries."
AOTA also wrote in the same report that "many entry-level doctoral graduates are able to pursue and fill unique positions due to their advanced education." These positions, which can include roles in academia, administration, and scientific research, are often only open to doctorate holders and may pay more.
What else can an occupational therapist do to earn a higher salary?
Given how many factors contribute to an occupational therapist's earning potential, there are many things occupational therapists can do to make more money beyond getting an advanced degree. For instance, an OT might look for work in one of the states that tend to pay occupational therapists more, or in major metro areas where salaries are often higher. They might also apply for roles with home health agencies or travel OT positions, which usually pay more. Non-clinical roles are some of the highest-paying, so transitioning into administration can lead to a bigger paycheck.
Occupational therapists who find per diem employment sometimes command a higher hourly rate than occupational therapists in full-time positions, though be aware that per diem positions don't come with PTO, health insurance, or other benefits. Other OTs boost their earning potential by specializing in a particular field of occupational therapy.
Another way to earn more, regardless of highest education achieved, is to pursue nationally recognized certifications or professional development training related to certain patient populations or specific therapies. There are many salary-boosting certifications OTs can pursue, including:
- Aquatic Therapeutic Exercise Certification (ATRIC)
- Basic DIR Floortime Certification
- Certified Aging in Place Specialist (CAPS) credential
- Certified Industrial Ergonomic Evaluator (CIEE) credential
- Certified Stroke Rehabilitation Specialist (CSRS) credential
- Certified Driver Rehabilitation Specialist (CDRS) credential
- Certified Neuro Specialist (CNS) credential
- Seating and Mobility Specialist (ATP/SMS) credential
- Assistive Technology Professional (ATP) certification
- Certified Hippotherapy Clinical Specialist (HPSC) credential
Finally, just keep working hard. According to the AOTA Salary and Workforce Survey, occupational therapists typically earn about $59,000 right out of school, but after just six years in the field, that jumps to $69,000. At some point in your career in occupational therapy, your degree will become the least interesting thing on your resume. Your earning potential will hinge not on your education but on the quality of care you're capable of delivering to your patients.
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