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Overseas Occupational Therapy Career

Occupational Therapist Jobs and
Career in United States

All the states in the United States require successful completion of NBCOT's occupational therapy certification examination. In other words, you can practice or work in the United States only if you pass the Board Examination.

The National Board for Certification in Occupational Therapy (NBCOT) certifies that both US and internationally educated occupational therapists meet its criteria for Occupational Therapist Registered (OTR) Exam. NBCOT does not certify internationally educated candidates for Certified Occupational Therapy Assistant Exam (COTA).

Passing the NBCOT certification examination does NOT automatically entitle you to work in America. You must first meet all the requirements of the state regulatory entity in order to legally practice occupational therapy.

Eligibility Requirements

To become eligible to take the OTR certification examination, internationally-educated occupational therapists must meet NBCOT eligibility requirements and undergo prescreening based on the status of their occupational therapy educational programs. NBCOT eligibility requirements include:

(1) Education: Graduation (a bachelor's degree, diploma, or certificate) from an acceptable entry-level occupational therapy program.
(2) Supervised Experience: A certain number of  hours of fieldwork or practical experience.
(3) English Language Proficiency: Passage of three tests of English language proficiency, including the Test of English as a Foreign Language (TOEFL), Test of Written English (TWE), and Test of Spoken English (TSE).

The English language requirements do not apply to graduates of educational programs in Australia, Canada (excluding Quebec Province), Ireland, New Zealand and United Kingdom.

Application Review

After all required documents and payments have been received, your application will be reviewed to determine if you meet the standards for eligibility to take the Examination. You will be sent a letter with the results of the review (approval, denial, request for additional documentation).

If approved, you will be eligible to apply for the certification examination either online or with a paper application. The certification examination will be on-demand, year long testing.  Upon approval to take the certification examination, a candidate will receive a letter authorizing them to apply for the certification examination.

Upon approval to take the Examination, the NBCOT can provide you with a Nonimmigrant Visa Letter for immigration and/or employment, which states your professional education equivalency to that of a U.S. educated occupational therapist, and approval to apply for the certification examination.

Upon successful completion of the examination, you may request an application to obtain a Visa Credential Verification Certificate, which is required by INS interim regulations for occupational therapists seeking permanent work-related visas.

State Regulatory Boards

Prior to working in the US as an occupational therapist, it is essential that you meet the requirements of the state regulatory board in the state in which you wish to work. Most, but not all states, have laws governing the employment qualifications of occupational therapists. Most, but not all of these state boards, will allow you to work in the state if you have been certified as an OTR by the NBCOT. However, it is essential that you receive a license or permit from the state board before you start to work in that state. Each state in the United States has a regulatory board and a professional association that provides resources regarding practice and continuing education.


Employers require occupational therapy practitioners to meet state regulatory requirements. The first step in this process is becoming certified by NBCOT by meeting their requirements and passing necessary exams. Therapists must also meet the regulatory requirements of a state of jurisdiction in order to practice.

Inquiries concerning employment must be made directly to the prospective employer. Employment contracts will vary among states and institutions; thus, salaries, position levels, benefits, etc. are negotiable between you and your prospective employers.

In the following pages, you will find brief information useful to overseas occupational therapists that want to work in the United States, Canada, the United Kingdom, Republic of Ireland, Australia and New Zealand.

The complete details can be found in 'Your Complete Guide to Overseas Occupational Therapy Career.'

It is a downloadable eBook. It is not available in paper format.

Information for overseas Occupational Therapists:

Looking for a bright, prosperous overseas career but don't know where, when and how to begin?
How to go to and work in the United States, United Kingdom, Australia, Canada, Ireland and New Zealand?
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