A Doctor of Occupational Therapy (OTD) is a clinical doctorate that prepares graduates to practice as licensed occupational therapists while also training them in leadership, research, and health policy. It is not a medical doctor (MD) degree. The OTD is increasingly becoming the standard entry-level degree for the profession, replacing the master’s degree that was previously the norm.
What the Degree Covers
An OTD program is a full-time, three-year graduate program. At the University of Missouri, for example, students complete 105 credit hours in a cohort model, meaning everyone moves through the curriculum together on the same timeline. The coursework covers clinical practice skills like patient evaluation and treatment planning, but it goes well beyond that. Students also study healthcare policy, program development, administration, evidence-based research methods, and advocacy.
Clinical training is a major component. Programs typically include 24 weeks of Level II fieldwork, where students work hands-on at clinical sites across the country. On top of that, OTD students complete a 14-week doctoral capstone experience, an extended placement focused on a specific area of interest. Students at some programs can choose from more than 300 fieldwork sites nationwide.
The capstone project is what most clearly separates the OTD from a master’s in occupational therapy. It’s an independent research study and presentation on an OT topic of the student’s choice, designed to strengthen critical thinking and research skills through collaboration with a mentor. This project gives graduates experience in applied scholarship and clinical innovation before they ever enter the workforce.
How It Differs From a Master’s Degree
Both the OTD and the Master of Occupational Therapy (MOT) qualify graduates to sit for the same national licensing exam and practice as occupational therapists. The clinical foundation is essentially the same. Where they diverge is depth: the OTD typically includes two additional trimesters of study focused on leadership, advocacy, and policymaking.
An MOT prepares you for direct clinical practice. An OTD does that too, but it also builds skills for shaping programs, influencing health systems, and mentoring the next generation of therapists. If your long-term goals include leadership, academia, policy work, or eventually pursuing a PhD, the OTD provides a more direct path. For someone planning to focus entirely on patient care, both degrees lead to the same license and the same clinical role.
Licensure and Certification
After graduating from an accredited OTD program, you must pass the national certification exam administered by the National Board for Certification in Occupational Therapy (NBCOT). To be eligible, you need to have graduated from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). Passing this exam earns the OTR (Occupational Therapist Registered) credential, which is required for state licensure in all 50 states.
Once licensed, occupational therapists can pursue advanced specialty certifications through the American Occupational Therapy Association. Three board certifications are currently available: gerontology, pediatrics, and physical rehabilitation. These certifications signal expertise in a specific population or practice area and can open doors to advanced clinical and leadership roles.
Where OTD Graduates Work
Most occupational therapists work in clinical settings: hospitals, rehabilitation centers, outpatient clinics, schools, skilled nursing facilities, and home health. The OTD doesn’t change the core of what you do in these roles. You still help people recover function, adapt to disabilities, and participate in the daily activities that matter to them.
What the OTD does expand is the range of non-clinical careers available to you. Graduates work as consultants in ergonomics, assistive technology, home and workplace modifications, and driver rehabilitation. Others move into education, teaching at universities or running continuing education programs. Some become clinical leads, program coordinators, or rehabilitation managers, positions where they shape care models and influence patient outcomes across entire organizations. Entrepreneurial paths are common too, from private practice to product development to health media.
Many leadership, research, and academic roles now favor or require the OTD specifically because of its advanced coursework in policy, innovation, and program development.
Salary and Job Growth
Occupational therapists earned a median salary of $98,340 per year as of May 2024, according to the Bureau of Labor Statistics. Employment is projected to grow 14% from 2024 to 2034, which is much faster than average for all occupations. An aging population and growing recognition of occupational therapy’s role in mental health, pediatrics, and chronic disease management are driving that demand.
Salary varies by setting and specialization. OTs in leadership, consulting, or academic roles may earn more or less than those in direct clinical practice, depending on the employer and geographic area. The OTD itself doesn’t automatically guarantee a higher salary than a master’s degree for the same clinical position, but it does position you for the types of roles that tend to come with higher compensation over time.
Is the OTD Becoming Required?
The occupational therapy profession has been moving toward the doctoral level for years. Many newer programs offer only the OTD, and some that previously offered master’s degrees have transitioned. That said, the MOT remains a valid entry-level degree, and therapists who hold a master’s are not required to go back and earn a doctorate. Both degrees lead to the same OTR credential and the same scope of clinical practice. The OTD simply adds preparation for roles that extend beyond the treatment room.