I'll post a response that I hope will be realistic as well as encouraging. I think that the field of occupational therapy is always changing like any other field but that the field is actually going back to its roots of being focused on actual occupation and reconnecting people to occupation. Originally when the field started, it was based on the arts and crafts movement which used those mediums as a way for people to become rebalanced in their routines of work, leisure, self-care etc. Perspectives on care were very holistic, taking the entire person into account. In the 1950s, however, OT became very reductionistic and exclusively based on just science--essentially treating the symptoms alone. Today, OT is reshifting back toward that original paradigm of looking at the whole person. It's a balance of looking at the whole person and using practice techniques that are evidence-based, i.e. reliable/valid based on a sizable research base. There is a lot more focus on prevention of decline (I work at a company with a 70/30 model where 70% of our care is on prevention of further decline in seniors and the other 30% is rehabilitative). That is the major difference with PT--OT is a discipline that looks at the whole person; it doesn't just break down the person into organic parts. While OTs offer exercise and strengthening like a PT would, we also offer applied retraining in areas like ADLs, cognitive testing, environmental adaptation and many other areas which reflects our broad scope of practice.
My point is that OT is both an art and a science--OT programs, no matter how competitive, are going to reflect that. Science, of course, is a major part of the foundation but as I said before, the focus is on application and how to use it in a real life context. Also, part of learning OT is the theory and understanding the entire person. AOTA has come out with a practice framework that a lot of programs use for completing case study papers and if you take a look at it, you'll see that it is no only very thorough but comprehensive in covering the aspects of a person in relation to their occupational profile.
http://www.cde.state.co.us/cdesped/download/pdf/OT_PracticeFrameworkDomainProcess.pdf
I think that people may get competitive in OT school but I'd stay away from them, they are merely insecure about their own abilities. What worked for us in OT school was to work together--we formed study groups and helped each other out. A lot of program faculty encourage students to work together especially as it mimics the therapy teams that exist in a real-life work situation. For those of us who come from a non-science background, I would say not to underestimate your skills either. English and psychology majors tend to do well in OT because of the critical thinking and analytical skills that these majors hone. Again, it isn't all just science. When a patient walks into the clinic, I'm not just looking at decreased ROM, a diagnosis or diminished muscle strength, I'm looking at the entire person--what is the person's affect and motivation levels? Why does the patient believe he/she is receiving therapy? What kinds of things are they now unable to do? How does that affect them, i.e. more burden of care on family/caregivers, depression, etc? A big thing is how you interact with patients--that can't be taught with scientific principles. As simple as it sounds, that is really how you can connect with patients and having a whole person approach is helpful for that by including family etc.
So, if you're ready to work hard but are passionate about caring for the entire person therapeutically, you will find that you are adequately challenged but also enjoy OT school. And no matter what the economy demands make out there for competition, a good OT program will teach you how to be an OT that uses a combination of both science and art. Hope that helps.
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