Choosing a career in occupational therapy or physical therapy can be a big and confusing decision. They seem so similar, yet so different? There are a lot of really important considerations to keep in mind before jumping down the road to becoming either an OT or PT.
The biggest difference between occupational therapy and physical therapy is that occupational therapy focuses on increasing independence in daily activities, while physical therapy focuses on the mechanics of how the body moves. As for your path to becoming an OT or PT, therapy school for PTs is currently more extensive and will require a doctorate, while OT will require a Master’s.
There’s actually a lot more to dive into here. If you’re serious about becoming an OT or PT, keep reading to learn about how your education and career will differ depending on which one you choose.
1. The Education You’ll Need for OT vs. PT
To become a physical therapist, you’ll need to get your Doctorate. To become an occupational therapist, you’ll need to get your master’s.
The education requirements for occupational therapy will be changing on July, 1 2027. After this date, anyone who wants to become an OT is going to be required to get a doctorate, just like PT (source).
When changes have happened like this in the past, everyone who got their education before the date the change was implemented was grandfathered in.
This is why you’ll see OTs who have their bachelor’s degrees working in the field–they got their education and started working before a master’s is required. It’s likely this grandfathering rule will apply to the switch between the master’s and doctorate, but it’s a good thing to talk to any programs you may be considering.
For now, before 2027, you’ll spend less time and money on an advanced degree to become an OT than a PT, but only by a tiny bit. In general, a master’s in occupational therapy will take you between 2-3 years. My particular OT program was 2 years of classes and 6 months of fieldwork experience. This structure and timeframe can vary depending on your program.
A doctorate in PT generally takes 3 years. Many programs intermix classes with fieldwork experience, but you’ll need to refer to individual programs to find a structure you’re happy with. Once you’re done with your DPT program, you have the option to do a residency or fellowships.These aren’t required, but are meant to help new PTs specialize in areas they’re interested in. These can add an additional 6-36 months depending on the one you choose (source).
After getting your initial certification in OT or PT, you’ll need to maintain your registration and license on a yearly or bi-yearly basis depending on your state. Everytime you move to a new state, you’ll need to fill out the forms to get a license in that new state. You’ll also need to do a certain amount of continuing education, which is also determined by the state you’re working in.
I know this sounds like a lot to maintain but, when you work in a field like healthcare, it’s important that you’re always learning and staying up to date on the newest treatment methods. Even though licensing and continuing education requirements can be time consuming, they can be important for you to stay sharp as an OT or PT.
As you can see, there aren’t huge differences between the time it will take to become an OT and a PT. While a year seems like a big difference, it really isn’t when you consider the timespan of your whole career. If you think you’ll be happier as a PT, you shouldn’t choose the OT path just because the education might be shorter.
2. Your Day-to-Day Work Responsibilities
Physical therapy focuses on body mechanics and occupational therapy focuses on helping individuals master and achieve independence with daily activities.
In my head, I like to think that PTs help with the “what” and OTs help with the “why.” For example, a physical therapist may help someone walk down the hall, while an OT may help someone get to the dining room for dinner. The goal is the same, to get down the hall, but the PT is focused on the mechanics of walking, while the OT is focused on the activity of arriving to dinner.
While it may look the same from the surface, both are helping someone walk down the hall, the goals behind them are different, which is key. An OT may decide that the best way to get to dinner is with a walker or wheelchair, while the PT will only want to walk, regardless of whether they make it to the dining room or not.
OTs and PTs work very closely together. In a lot of settings, they work with the same patients and need to have compatible goals. Because of that, the nuances between the jobs can get blurred. It’s more complicated than simply saying that PTs work on body mechanics and OTs work on activities.
To keep us focused on the bigger picture though, remember that each career takes a very different focus and approach to working with people (mechanics vs. daily activities). Even if the lines blur down the line as you start working, it’s important you resonate with the core of either PT or OT when choosing which path to take.
I personally chose OT because I liked the “activity-based” approach. I wanted to help people problem solve the activities they need to do everyday. Helping a child develop sensory strategies to sit through class, celebrating someone who learned how to use adaptive equipment to put on their pants after an accident, doing art with a patient undergoing cancer treatment. Those are all things that have been meaningful for me to help with as an OT.
Seeing PTs work, I couldn’t imagine getting as much satisfaction out of helping someone heal their hamstring as I did through my own activity-based work. It was necessary and important work, but it doesn’t excite me in the same way it did others, others who are more suited to be PTs.
I was also drawn to OT because I liked art. It was so neat to me that I could use art to help people heal and achieve their goals. OT may be a great place for you as well if you have an artistic side and want to incorporate it into your profession. I had an entire class in grad school about using art with my clients. Especially if you end up in a mental health setting, you’ll use arts and games a lot.
While general, here are other signs you may be pulled to one or the other:
Physical Therapy Interest Cues
Physical Therapy Work Examples
Occupational Therapy Interest Cues
Occupational Therapy Work Examples
Hand therapy is an important realm of OT to highlight. Hand therapy involves any rehab relating to the hands, whether it be from an accident or injury. Many people get confused because hand therapy seems like it should fall in the PT category. Yes, this is a very “body mechanics” type of field, but there’s a general rule that OTs deal with the arms and the hands. This is why a lot of OTs work on handwriting with kids.
I worked in hand therapy for a bit and absolutely loved the merge between the OT and PT concepts. It’s a complex subject that has a very intensive and difficult specialization process, so it can be a long road to become skilled at it. If the mechanics of the hands and arms interest you though, it’s worth looking into.
3. The Settings You’ll Be Working In as an OT vs. PT
OTs and PTs often work in similar settings. These fields go together like peanut butter and jelly, so most places have a staff that consists of both OTs and PTs that work together a lot. If you’re interested in either OT or PT, you’ll find opportunities to work in:
While the following settings will have a mix of both OTs and PTs here are setting where you’ll most likely find one or the other.
4. Your Salary as an OT vs. PT
Salaries are pretty similar between OTs and PTs. Where they differ a ton is between states and settings. Traditionally, hospitals pay more, while schools pay less (accounting for the summer vacation). States with high costs of living like California pay more, while other states pay less.
The salaries can swing a lot depending on where you live and where you work, so it’s worth Googling the average salary for an OT or PT in your state.
5. Career Outlook for OT and PT
Occupational therapy and physical therapy are not careers that are going to die out anytime soon. In fact, they’re projected to explode in the next 10 years.
There could be multiple reasons for this. The Baby Boomer generation is large and they’re all getting older. As they get older, they’ll need OTs and PTs to help them. Also, OT is becoming a more established profession. As the awareness of it has grown, so has the need for it.
Healthcare is one of the few professions where there is a guarantee for need. No matter the state of the economy or the world in general, healthcare will always be a necessity. This is a great thing for anyone looking for a stable career they can retire with.
6. Your Job Description as an OT vs. PT
We all know that job descriptions aren’t always the most accurate or helpful, but they do give a great sense of what a job fundamentally is about. The job description for a chef and an account executive, for example, will be very different.
The same is true for OT and PT. If you’re struggling to decide between one path and the other, read through some job listings. Which one leaves you more excited? Which one involves skills that you would want to learn?
Be sure to look at job descriptions across different settings, since an OT in a school will differ a lot from an OT in a hospital, for example. Is there a certain setting that you kept getting drawn to?
Listen to your gut as you’re reading through these descriptions. At the end of the day, OT and PT are labors of love. They’ll both be a lot of work and take a lot of perseverance. If you have a genuine interest and passion for the profession, this will help you throughout your career path and ultimately make it a better decision. Your gut knows a lot about what you need, so don’t ignore it.
7. Shadow an OT or a PT
Most OT and PT programs will require you to shadow an OT or a PT for a certain amount of time before applying. This is a GREAT requirement. There’s nothing that will show you the realities of the job more than working with someone who is in the thick of it.
Even if you’re not working towards applying to a program yet, reach out to OTs and PTs in your area and see if you can shadow them for a bit. Be sure to ask people in different types of settings so you get a great overview of all of your options.
Some people will even let you help with tasks that don’t require professional training. This will help you see if you actually enjoy working with kids, being in a hospital, focusing on body mechanics, and more. Get as much hands on experience as you can and see where your interests lie.
When shadowing, become Sherlock Holmes. Don’t be afraid to ask as many questions as you can think of about the day-to-day experience of the job.
Here are some questions to get you started:
Think about what you would hope to get out of your career and ask questions that will give you some insight into whether OT or PT can give you that.
Becoming an OT or a PT can both be really rewarding paths to choose. In both cases, you’ll be helping people, which is ultimately why most of us decide we’re interested in healthcare to begin with.
As you can see though, the differences between the two are important. Take some time to understand what you really want in your future career and what would be the most fulfilling. Reach out to friends and family who know you well and seek their advice. Talk with professionals in the industry and understand what they do on a daily basis. But, at the end of the day, listen to your gut. This is your life, your career, and your future happiness.
Diana is a registered occupational therapist who specializes in sensory processing disorders and autism.