Other OT-Related Information Reality check time. In many cases a career in OT is not worth it.

[prodigiousflame]

At one point several years back, I was trying to pursue a career in OT. I would venture on this forum everyday, trying to see what my chances were in getting into a school, and arguing with any OT who would speak poorly about the rehab industry. I didn't know what else to do other than OT--and I didn't need some jaded OT to ruin my buzz. Little did I know I would become one of those OT's one day who I used to argue with. Some of you are so focused on getting your hours in, finishing your prereqs, compiling your applications, that you're not exactly taking into consideration the future and reality of this field. Shadowing hours are not forever. School is not forever. Practicals and studying for the NBCOT is not forever. One day you WILL graduate and will have an actual CAREER in OT and so it's imperative to consider life AFTER school aka the real world.

Today I walked into my SNF job where we risk our lives working with COVID patients, during a **** show year without having received hazard pay even, and were told we're all receiving a pay cut due to pending Medicare cuts. When i graduated with all my student loans I was told I was entering a "secure" career---schools love making the pitch that there will be an explosion of baby boomers and your job is secure for years to come!! People will always need OT blah blah blah. These are all sale pitches to get you to fill their seats.

Without you as their students they don't have a job. Notice how tuition is only rising without considering industry needs and changes, saturation in parts of the country, and inflation. I ask everyone to please do your diligent research--stop relying on schools ESPECIALLY for profit/private schools, TOP 10 CAREER articles that have no idea what they're talking about, and glossy marketing materials filled with models who are posing as smile-y therapists who are "making a difference!" because in many settings you are just fulfilling the bottom line and I'll be honest, you won't be making much of a difference. Don't ask a 60 year old OT if they love their career and if they regret it. That 60 year old probably only has a Bachelor's degree, no student loans or very minimal loans, experienced many of the OT "golden years", and is about to retire anyway. Ask the stressed out 28 year old, who just graduated from an expensive OT school, with a ton of student loans, is realizing their day to day work experience is a lot different than what was taught in their textbook, who has recently experienced all the industry/reimbursement changes and is trying to keep their head above water. Tell them the price you are paying to go to OT school and ask them very honestly if they would recommend you proceed.

I had only one professor who was honest enough to explain that health reimbursement changes can affect whether or not you'll have a job. Yes people like to state that healthcare goes through cyclical changes and that OT will be in a good place again in relation to insurance etc., however therapy was seen as the revenue maker in facilities and now it's not. I graduated 4 years ago and have worked in 4 different settings. When I first started out, I was working full time in a SNF. I quit and became per diem because there was so many per diem hours available and I was making GREAT money with all the freedom I wanted. PDPM happened, that changed, and many of my hours were cut. Less per diems were needed in general. Therapists were now seeing patients in groups and doing concurrent treatment leaving less hours to go around for all therapists. This is EXHAUSTING. Your schedule goes from 6-8 patients to now 12+ in a full day. It is very hard mobilizing, motivating and grouping physically and mentally disabled patients all day, getting all you minutes in, all your documentation in, and dodging the many things in your day that will mess with your productivity (family visits, diaper changes, nurse treatments/administering medication). The onslaught of my career after PDPM continued with PDGM in HH (less visits overall allocated for rehab), COVID, and now MEDICARE cuts. Medicare HATES US. I can't stress this enough. I am always hearing about future impending Medicare cuts and getting letters in my email from AOTA with a template to send to congress begging them not to cut our services and reimbursement.

For those of you who are thinking you are safe because you want to do peds or work in a hospital--sure you might have better luck due to having more insurance options for reimbursement however when people are tired of getting **** on in SNF or HH, or there's less jobs and hours to go around, they will look to other settings which impacts every other available setting left.

As I've mentioned earlier I have been able to see my friends move up in their careers and have compared their career trajectory to mine. I have friends who have graduated with what some would consider "pointless" degrees. History, anthropology, etc. They have a Bachelor's, do not have student loans or anywhere NEAR the debt I have, and did not have years of lost income. They have surpassed me in income READ: WITHOUT A MASTERS DEGREE (OT really never needed to become a Masters), fatter retirement accounts, have mortgages, have had promotions/raises, holidays off etc. And even if they had NONE of that--they not tied to their career. They are free to start over and do whatever they like because they do not have a ball and chain debt load that follows them through life, and a very VERY specific degree that has a VERY specific skillset that may not smoothly segway into a different career option. They might not have known what they wanted to do in the beginning of their career, but through different experiences and exposure within their careers, they have carved out areas they were interested in and did side boot camps (UX design), or taken specific courses to immerse themselves more deeply in that area of interest. Because of their promotions they do not need to get a second and third and fourth job the way therapists do in order to make more money. Their hours don't get cut during the day if a patient discharges so they consistently get their full day of work.

We also live in a different time than when I started attending school several years ago. Nowadays there are alternative ways of making money, of making a living. There are more routes to financial freedom which does not include going to some expensive school for a career that you have to pay for for the rest of your working life which is an old school and outdated way of thinking.

Now you can get a joe shmo type job, use a program like YNAB to monitor how you spend every dollar, join the FIRE community, spend your money wisely and retire early.
Or you can continue working a joe shmoe job and join a community like BiggerPockets and invest your money into real estate and watch your passive income grow and stop selling your time for money. It's not easy but people do it everyday. Oh and btw getting into OT school and getting through OT school is not easy either. There's a whole world full of digital nomads, content creators, people who are able to make an income online, who can be mobile and work anywhere in the world and not be stuck at a facility. Hell at this point I even envy those who are making money through OnlyFans or have figured out how to sell a product through IG--I'm not saying sell your ass online but these individuals are not answering to a boss, don't have an income ceiling and aren't cutting a check to FedLoan services every month. Or pay for a 10K~ tech bootcamp and invest in a career that has a potential for high growth vs pay cuts and constant looming threats from insurance companies that dictate our pay. With the pay cut I received today and ones I will most definitely receive in the future I realized I would've been better off managing a taco or burger joint as my choice to go into OT was a very poor ROI in comparison. My point is we live in a time where you have options and I think the younger generation gets this more than anyone, and you don't have to pigeonhole yourself and then later feel trapped.


Now there are therapists who may disagree with me. They may say they have zero regrets going into this field. All the stars have aligned and they may feel like they're making a difference everyday, they aren't bothered or affected by any changes happening in our field, they found an awesome company and team to work for, they are not being buried by student loans, and that the hard work was all worth it. And that's completely valid and those therapists DO indeed exist. But I just ask you to consider all angles before making such a life altering commitment and not just let this thread get buried under the "HOW SHOULD I GET ALL MY SHADOWING HOURS" threads. This is my opinion but after working for a few years in schools, adult daycare, snf and home health and comparing my circumstances with friends who work in various other industries here are my 2 cents about whether or not you should consider OT plus things you may not have considered due to tunnel vision on the preliminary steps of getting into OT school



Things you may not have considered:

-the availability of jobs in your area
-the variety of OT jobs in your area. For example, in school we are told there are sooooo many settings. How many mental health jobs are there actually in your area?? I've seen 4 crop up in the past 4 years. Pay attention to facts--not a sales pitch meant to keep schools in business.
-when you don't want to work in a SNF or a peds outpatient setting what is the actual likelihood of working in an "emerging setting". Is there enough funding in that "emerging setting" to carve out a job with benefits for a Masters level clinician? Ever considered why "emerging settings" STAY "emerging settings"? Hint: not enough resources and advocacy to prove our value to hire on an OT
-the ease in which you can explore different settings
-having enough AUTHENTIC desire to work in a specific setting like schools in order to outweigh the BS (litigation, high caseloads that affect quality of treatment delivery, families)
-how you will physically fare as you age. Doing a MAX transfer as a fresh 25 year old is different than doing these consistently when you have a bad/weak back, knee, hip etc. Will you wanna chase a high energy kid around a sensory gym or be on the floor rolling around in your older years? Will you want to be doing manual therapy day in and day out in a hand therapy clinic?
-think into the future. When you tire and are experiencing burnout from the emotional and physical load of direct patient care (very frequently happens especially due to undesirable industry changes that places the pressure and burden on the therapist to make up for any loss of revenue to the facility) what will your options be as an OT? Do you have aspirations of being a DOR? Non clinical jobs are not plentiful. Positions like utilization review are highly sought after however there are not enough to meet the demand and mostly go to nurses. In fact nurses have much more non clinical job options as they progress in their careers.
-how student loans can chip away at you and affect the milestones you want to achieve in life. If you have a plan, great. But know that there are many older professionals who regret taking out high student loans because when they were young and figured they could pay them off they didn't consider the ridiculous federal loan interest rates. Many people have paid off their original loan but now because of interest their loans have double and triple exploded. Hint: loans are a scam. In many cases school is a scam.
-that people CHANGE. If people evolve and change over time what makes you think your career interest will stay the same? You may like OT now however it is very possible you will have a change of heart, but because of your loan debt you feel stuck in the mud.
-the ease of getting a hospital job if you have no desire to work in a SNF or in pediatrics and you don't have acute experience
-feeling like an OT salesman trying to sell your value to patients who have never heard of an OT ie. "oh is that a person who helps me get a job?" "arm exercises??" ::mockingly waves their arms around to show they can do AROM independently:: "Bathroom?" "Oh no I can do all that, please fetch the PT so I can walk and get out of this hell hole".
-other careers that "help people" that may have a better return on investment
-that you can still help people without taking that so literally when looking at potential careers


People who probably should not bother considering what's currently happening in our field:

-people who have GENERIC reasons for entering OT ie. I don't know what else to do, I want to "help people" (plenty of careers help people), healthcare seems like a stable job, I like to see people get better, I don't want to sit in a chair at a desk all day, I have a pointless Bachelor's degree that I can't make money with, I'm tired of being an accountant and OT sounds like a "nice change", I don't want to take "XYZ" science class in order to get a nursing or pharmacy or preferred degree, I couldn't get into that other career I really wanted so OT is what was left. Some of these reasons are OK but they shouldn't be your ONLY reasons.
-if your only choice is a super super expensive OT school because in the last several years getting into an OT school is insanely competitive (I blame the BS top 10 career articles) so now you'll be left with an 80K tuition which will sky rocket because you have to take out more loans for living expenses and have a 6% interest rate etc.
-you couldn't get into a cheaper in state school but don't want to "waste a year" sprucing up your application so you're accepting admission into that super pricey school that will make you go into indentured servitude trying to pay it off. Note: one year is nothing in comparison to a lifetime of paying off debt.
-you're choosing OT as a substitute for a career in psychology because OT involves "mental health". We've done a poor job advocating ourselves in that area and in many states there are very few mental health OT jobs so yeah you might use MH as one aspect of your treatment but it's not the same as being a psychotherapist or psychologist. Note this does not apply to people in the UK or Australia as they play a bigger role in MH.
-You think OT will mainly be about helping people recover so they can participate in their occupations of interests. Insurance doesn't care about all your patient's holistic and varied interests. They don't care that they used to be a skydiving instructor and post stroke can't be a skydiving instructor no more. ADL's and MOSTLY ADL's are our bread and butter so make sure you are interested in performing ADL's and exercise day in and day out. Similarly in the school setting, many interventions are based on meeting "sensory" needs and handwriting legibility.



People who may have better outcomes if they choose to go into this field:

-you have a sugardaddy who will pay for schooling
-you have a wealthy family who will pay for schooling
-you have lots of money saved up through a previous career, or have scored scholarships, or are certain you will have a financially stable situation (will live at home rent free for awhile), so you can quickly pay off said loans
-you have a partner who has a great paying job. You can even get on their health insurance and work here and there for fun money, or if you lose your job or side per diem gig you know your partner will be there to fill in the gaps. You may be able to live on their income while you quickly pay off your loans
-you are going to a cheap OT school and will have very little debt so if you ever choose to do something else it will not be such a big deal
-you are highly entrepreneurial and plan to network, market yourself and start a business endeavor using your skills as an OT
-you know yourself to be an absolute workhorse, and have no problems working 6-7 days a week, multiple therapy jobs, travel jobs, and sacrificing parts of your life in order to meet financial goals and pay off loans
-you will have debt but you know you want to work in pediatrics in a school setting and are confident in the PSLF program as a way to have your loans forgiven in 10 years with mounting debt that grows everyday because you're only paying the monthly minimum
-you have very specific and authentic reasons for wanting to be an OT, enough to outweigh any other possibilities or negativities about the field and the state of healthcare
-you have deeply personal experiences regarding OT and are genuinely passionate about OT and cannot see yourself doing anything else having explored many other careers that may have similar traits
-you want to be an OT with every fiber of your being or have a very strong "like" for it. You have shadowed every setting, have been able to envision yourself in that therapists position and can imagine doing what they do day in and day out including the grunt work and not just convincing yourself you like it because you don't want to start over and look for another career you would actually resonate with more (because that takes time and you're already 23 and want a career so you're not left out in your group of friends who already have careers)

Note: even having passion isn't enough to guarantee satisfaction in this career due to issues from immediate jobs (high caseload, high productivity, unreasonable expectations), and from the industry (medicare changes, reimbursement cuts, pay cuts, no pay increase in 10 years yet a growing student loan debt can feel like a slap in the face). Many OT's who were once passionate now regret it due to the reasons I've listed but having a strong passion can certainly improve job satisfaction outcomes overall. The person who responded to my post missed my point completely. You can like OT as a subject matter but be beaten down by actual circumstances and expectations in your job and the overarching industry.


Now I'm not trying to convince EVERYONE not to enter this field and be an alarmist and fear monger. I don't want everyone to panic, run for the hills, or worry they've made the wrong choice. I haven't covered more information including the quality of the jobs I've had because this post is already too long. Even in a bleak job climate there are still some pros.. there are patients who will make you feel very rewarded, your paychecks will be decent considering how cheap the cost of living is in your area, depending on availability you can try out different settings to switch things up. There are genuinely people who love OT so much they're willing to sacrifice a lot for it, don't really care about what I've said above, or they have advantages that others don't. I just don't want some people to think OT is the ONLY CHOICE to living a happy, financially comfortable life, especially when the return on investment is becoming poorer and poorer as the years pass by. This post goes especially for the fence sitters, the people who are considering more than one option and feel they would be happy in other careers, people who aren't fully convinced and their gut is telling them to keep looking, who shadowed therapists and weren't really "feeling it" all the way, who only have a super expensive school as an option, or who have a lot at stake. Just think it through so you won't regret it because the field is not exactly on an upward trend and the flashy marketers are not telling you everything.

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[prodigiousflame]

Thats awesome for you Amy but that sentiment might mean more if you were actually working in the field and experiencing some of what therapists are going through today--just liking the subject matter isn't everything when you're undergoing real systemic issues that are affecting your job, income and quality of life. Not to mention I already stated in my post my reasons for not going into OT may not apply to everyone--but for many it does and this is for them. No need to defend your position if you feel like it's irrelevant for you. Either way good luck!

 

[beestrng]

Thats awesome for you Amy but that sentiment might mean more if you were actually working in the field and experiencing some of what therapists are going through today--just liking the subject matter isn't everything when you're undergoing real systemic issues that are affecting your job, income and quality of life. Not to mention I already stated in my post my reasons for not going into OT may not apply to everyone--but for many it does and this is for them. No need to defend your position if you feel like it's irrelevant for you. Either way good luck!

I like your post G. I remember when we were applying for admission. Haha. I wish I had a sugar daddy, but I'm just an ugly dude.

 

[OT&me]

This is all great information (despite creating an enormous amount of anxiety for me because I truly do feel passionate about OT but understand that it is a finicky field that often gets overlooked and underpaid, especially in terms of how much I am thinking about shelling out for graduate school). Are there fields that you would recommend for people who are "OT-minded?" Do you feel that the same hesitations exist for PT? I tend to oscillate between PT and OT but I would assume that the same complaints occur under PT. I get extremely frustrated thinking about paying for a doctorate degree but not being compensated for one. Do you see any future where OTs are more appreciated and better compensated? In my mind, OT needs to build a niche for itself (which I would love to be more focused on neuroscience and psychology), but it is clear that it does not have that yet. Not sure what your thoughts are on any of this. Thanks for the detailed post!

 

[OTMentalHealth96]

This post made me think a lot. I'm currently an RBT for an ABA company and have been deciding between ABA and OT. I may not agree with all the behavioral principles, but I do like how in that field there seems to be growth towards supervisory/administrative roles (ex: RBT ---> BCBA ----> Clinical Director) and you aren't doing direct care for years and years. In OT, it seems as though this is the case and as you mentioned, it may get more difficult as you get older. The only other options I see if you want to change is teaching OT students, but not everyone wants to do that.

Not to mention, many ABA companies provide tuition reimbursement, so the cost of going to school would be significantly less.

This isn't the first time I heard an OT say the cost of going to OT school is not worth the reality of how much you make. I follow many OT's on instagram who talk about their debt A LOT. Not sure I want to live that way. :/

 

[Skeletonia]

I recommend anyone who will need to take out over $20k in loans to check out a return on investment calculator such as this (all the way at the bottom of the page): Is grad school worth it?

I calculated all sorts of potential outcomes. You can never account for everything, life happens, but don't assume you will make $75k straight out of school or that your OT salary will keep up with inflation. It also includes the salary you will forfeit when you attend school, assuming you had a previous full time job.

I have worked in several other fields prior to this and had very little undergraduate debt that I paid off years ago. I would absolutely not have gone to grad school if I had to take out more than $20k in loans. If I was younger, I think even up to $50-60k is very doable.

 

[prodigiousflame]

Thanks everyone for you thoughts. Skeletonia--I agree about figuring out a roi before taking out loans, wish I had that mentality back when I was applying for schools.

OTMentalHealth-I'm so glad you're thinking things through and looking at other options that are fulfilling but also not financially crippling. If you're an RBT and enjoy the work and working with that population, then it's definitely worth looking into, especially if there's opportunity for upward mobility. That's fantastic that there's ABA companies that offer tuition reimbursement! I did my school setting orientation with a behaviorist awhile back, and he was on a path to pursuing his BCBA. He mentioned that they make similar salary to OT's but did not seem to be stressing about having to take out large student loans to pay for it the way we do.


Hi OT&me, I'm glad my post resonated. I do feel that PT's and what they do is overall more understood by the general population however the schooling is longer and as you know very expensive! And they also have the same issues with Medicare cuts although in certain settings like in HH they may qualify to receive more visits (see below from AOTA page)

as of January 22, 2020, AOTA has received 330 survey responses with the following clear trends:

• 76% report a mandated reduction in the number of occupational therapy visits;
• 35% report changes to occupational therapy practice patterns, including HHAs refusing to fulfill physician referrals for OT and/or shifting OT visits to PT colleagues, agencies telling beneficiaries that they do not need OT in home health and can wait until outpatient, and only allowing OT to complete an evaluation after the initial 30 days of care;
• 33% report occupational therapists have been laid off or had service level reduced; and
• 28% report occupational therapy assistants have been laid off or had service level reduced.

I think pediatrics has its own set of stressors that are different than in adult settings, but if you really enjoy that population I didn't feel like my job or hours were on the chopping block in that setting (well until Covid). In schools for example you get a lot of referrals to eval a student even if the reason isn't always exactly appropriate. I do feel that people are happy in the less common settings like in a psych setting helping patients with IADL's, or at the VA where there's good benefits, but those jobs aren't really the majority that's out there. In terms of being compensated well, I think one would have to think outside the box a little or work in a high cost of living town or in a rural area. When I say think outside the box I mean maybe open up your own pediatric clinic, or find a niche area and market your service to clients. For example, my former classmate was a LMT and learned lymphedema treatment prior to attending OT school, and then after receiving her Masters in OT she networked through an OT at a hospital and through her was sent private clients where she is getting cash pay as an OT lymphedema therapist (she still works her other OT jobs as well). You say you're interested in neuroscience and psychology. I'm not sure if you've looked into school psychology? They do perform a lot of assessments and probably another field you'd wanna apply for in state tuition. If you join the alternative careers for rehab professionals group on FB there are people who are trying to leverage their OT skills (creativity, problem solving) into other careers. I've seen people even transition into health tech like Health Informatics. It might even be worth talking to a career counselor about it. Either way I hope it works out for you and glad you're not taking this decision lightly.

 

[deleted517237]

*sigh*
I totally get all of your frustration. I got the same pay cut as you did last week, been working in a SNF for 5yrs. We had no covid cases in our facility up until the end of October...since then we have gotten 150+ cases among staff/residents, 18 deaths, and just exhaustion working daily with covid + patients. We finally got back down to 0 active cases last week, then BAM: pay cut. Just a horrible feeling. Like you, I have always been a big proponent of the field and hate to scare prospective students, but I think those wanting to work in the SNF/LTC setting should know what's going on. They pay is good, the work conditions are pretty good/flexible, coworkers/patients are amazing, but my company (nationwide contract therapy company) has not given any type of pay raise in the last 8 years, and actually decreased pay 8 yrs ago by 3%. I really don't regret going into OT and I have paid back 2/3 of my 90k student loans, but what's happened in the last year just sucks.

 

[Confusedandlostone]

Not going to argue with you there. I resinated with you when you said " the stressed out 28 year old new grad" with student loans LOL.
I busted my ass to get to where I am now, but I would be lying to everyone when I say that the future of this field isn't scary. Looming medicare cuts and PDPM/PDGM, as well as new grads popping out every year are making the field unstable.

One thing to take note of though: job outlook is incredibly area dependent. I've worked full time at a SNF and literally just quit at the beginning of the month because I hated it. So the jobs are out there, but are they jobs that you will enjoy? Seems as if most full time openings are money hungry SNFs or home health agencies where documentation will pile up to your eyeball everyday.

 

[prodigiousflame]

Not going to argue with you there. I resinated with you when you said " the stressed out 28 year old new grad" with student loans LOL.
I busted my ass to get to where I am now, but I would be lying to everyone when I say that the future of this field isn't scary. Looming medicare cuts and PDPM/PDGM, as well as new grads popping out every year are making the field unstable.

One thing to take note of though: job outlook is incredibly area dependent. I've worked full time at a SNF and literally just quit at the beginning of the month because I hated it. So the jobs are out there, but are they jobs that you will enjoy? Seems as if most full time openings are money hungry SNFs or home health agencies where documentation will pile up to your eyeball everyday.

Thank you for bringing up such a great point as that is a major selling point to recruit OT students. That there are a plethora of settings to work in as an OT so if you tire of one you just conveniently hop into another. It's very important for people to do their research beforehand and see what the majority of jobs are in their area. I live in one of the most populated cities in the country, and in my area there is mostly SNFS, SCHOOLS, and HOME HEALTH. So be sure to like one of these available settings before applying to OT school.

 

[Evie]

After working at a SNF/LTC for the last 6 months, I felt every word of this. My loans aren’t outrageous for a newer grad, but it’s enough for me to lose sleep as I try to find my way out of this rural hell hole.

 

[prodigiousflame]

currently reading a long running thread about all the rehab companies who are just recently enforcing employee pay cuts

 

[prodigiousflame]

I applied to OT school and currently waiting on the admission decision. I’ve been reading about the cons of OT as a career including this post. I am concerned and nervous from all that I’ve read.

One of the points that is frequently mentioned is the average accrued debt of an OT student which the salary of the profession does not justify.

In my case, If I do get accepted, I will have tuition assistance which will pay for almost 90% of my tuition as my mom is an employee at one of the school hospital. Very lucky to be in this position.

With that in mind, I would like to know if going to OT school would be worth it considering my unique case regarding tuition assistance?
(Besides that, I’m also worried about finding employment/insurance cuts, etc.) I would like to know other’s insight on this. Thank you!

Hi olil,
I'm not sure what setting you're shooting for but most insurance cuts are happening in LTC/SNF. I would do research to see how saturated of an area you're in but otherwise you sound like you have a great setup especially if you're sure OT is what you wanna do. Even if you were to transition out of OT one day at least you would have more freedom to do so and no major debt hanging over your head.

 

[OTadventures]

Hi! Appreciate the thoughts shared here, especially from @prodigiousflame. We as prospective OT students are wearing rose-colored glasses, and the reality check, though it stings, is appreciated.

Since this is related to the topic of how debt affects future life as an OT, I thought I'd share this post I found on Reddit. It's definitely helpful to hear from people who are working OTs, because I think they do have a perspective on loans/debt/price of school that we might not have right now as aspiring OT students.

*Reddit and the "Occupational Therapy New Grad and Students" group have been valuable to me in getting advice from people a little further along in their OT journeys

Reddit: Choose: Your career or your family?

"Yes, OT can be a wonderful career. But I bet your family and relationships are more wonderful. Go to the cheapest program you can, and if the cheapest program has you paying in the six figures, don't go. Most of you do not have the financial support or personal wealth for this to make sense."

Would love to hear thoughts if anyone cares to chime in. How much are you considering the effects of student loan debt on your future family & relationships as you choose your OT program?

Edit: linked Facebook group

 

[heyitsolil]

At one point several years back, I was trying to pursue a career in OT. I would venture on this forum everyday, trying to see what my chances were in getting into a school, and arguing with any OT who would speak poorly about the rehab industry. I didn't know what else to do other than OT--and I didn't need some jaded OT to ruin my buzz. Little did I know I would become one of those OT's one day who I used to argue with. Some of you are so focused on getting your hours in, finishing your prereqs, compiling your applications, that you're not exactly taking into consideration the future and reality of this field. Shadowing hours are not forever. School is not forever. Practicals and studying for the NBCOT is not forever. One day you WILL graduate and will have an actual CAREER in OT and so it's imperative to consider life AFTER school aka the real world.

Today I walked into my SNF job where we risk our lives working with COVID patients, during a **** show year without having received hazard pay even, and were told we're all receiving a pay cut due to pending Medicare cuts. When i graduated with all my student loans I was told I was entering a "secure" career---schools love making the pitch that there will be an explosion of baby boomers and your job is secure for years to come!! People will always need OT blah blah blah. These are all sale pitches to get you to fill their seats.

Without you as their students they don't have a job. Notice how tuition is only rising without considering industry needs and changes, saturation in parts of the country, and inflation. I ask everyone to please do your diligent research--stop relying on schools ESPECIALLY for profit/private schools, TOP 10 CAREER articles that have no idea what they're talking about, and glossy marketing materials filled with models who are posing as smile-y therapists who are "making a difference!" because in many settings you are just fulfilling the bottom line and I'll be honest, you won't be making much of a difference. Don't ask a 60 year old OT if they love their career and if they regret it. That 60 year old probably only has a Bachelor's degree, no student loans or very minimal loans, experienced many of the OT "golden years", and is about to retire anyway. Ask the stressed out 28 year old, who just graduated from an expensive OT school, with a ton of student loans, is realizing their day to day work experience is a lot different than what was taught in their textbook, who has recently experienced all the industry/reimbursement changes and is trying to keep their head above water. Tell them the price you are paying to go to OT school and ask them very honestly if they would recommend you proceed.

I had only one professor who was honest enough to explain that health reimbursement changes can affect whether or not you'll have a job. Yes people like to state that healthcare goes through cyclical changes and that OT will be in a good place again in relation to insurance etc., however therapy was seen as the revenue maker in facilities and now it's not. I graduated 4 years ago and have worked in 4 different settings. When I first started out, I was working full time in a SNF. I quit and became per diem because there was so many per diem hours available and I was making GREAT money with all the freedom I wanted. PDPM happened, that changed, and many of my hours were cut. Less per diems were needed in general. Therapists were now seeing patients in groups and doing concurrent treatment leaving less hours to go around for all therapists. This is EXHAUSTING. Your schedule goes from 6-8 patients to now 12+ in a full day. It is very hard mobilizing, motivating and grouping physically and mentally disabled patients all day, getting all you minutes in, all your documentation in, and dodging the many things in your day that will mess with your productivity (family visits, diaper changes, nurse treatments/administering medication). The onslaught of my career after PDPM continued with PDGM in HH (less visits overall allocated for rehab), COVID, and now MEDICARE cuts. Medicare HATES US. I can't stress this enough. I am always hearing about future impending Medicare cuts and getting letters in my email from AOTA with a template to send to congress begging them not to cut our services and reimbursement.

For those of you who are thinking you are safe because you want to do peds or work in a hospital--sure you might have better luck due to having more insurance options for reimbursement however when people are tired of getting **** on in SNF or HH, or there's less jobs and hours to go around, they will look to other settings which impacts every other available setting left.

As I've mentioned earlier I have been able to see my friends move up in their careers and have compared their career trajectory to mine. I have friends who have graduated with what some would consider "pointless" degrees. History, anthropology, etc. They have a Bachelor's, do not have student loans or anywhere NEAR the debt I have, and did not have years of lost income. They have surpassed me in income READ: WITHOUT A MASTERS DEGREE (OT really never needed to become a Masters), fatter retirement accounts, have mortgages, have had promotions/raises, holidays off etc. And even if they had NONE of that--they not tied to their career. They are free to start over and do whatever they like because they do not have a ball and chain debt load that follows them through life, and a very VERY specific degree that has a VERY specific skillset that may not smoothly segway into a different career option. They might not have known what they wanted to do in the beginning of their career, but through different experiences and exposure within their careers, they have carved out areas they were interested in and did side boot camps (UX design), or taken specific courses to immerse themselves more deeply in that area of interest. Because of their promotions they do not need to get a second and third and fourth job the way therapists do in order to make more money. Their hours don't get cut during the day if a patient discharges so they consistently get their full day of work.

We also live in a different time than when I started attending school several years ago. Nowadays there are alternative ways of making money, of making a living. There are more routes to financial freedom which does not include going to some expensive school for a career that you have to pay for for the rest of your working life which is an old school and outdated way of thinking.

Now you can get a joe shmo type job, use a program like YNAB to monitor how you spend every dollar, join the FIRE community, spend your money wisely and retire early.
Or you can continue working a joe shmoe job and join a community like BiggerPockets and invest your money into real estate and watch your passive income grow and stop selling your time for money. It's not easy but people do it everyday. Oh and btw getting into OT school and getting through OT school is not easy either. There's a whole world full of digital nomads, content creators, people who are able to make an income online, who can be mobile and work anywhere in the world and not be stuck at a facility. Hell at this point I even envy those who are making money through OnlyFans or have figured out how to sell a product through IG--I'm not saying sell your ass online but these individuals are not answering to a boss, don't have an income ceiling and aren't cutting a check to FedLoan services every month. Or pay for a 10K~ tech bootcamp and invest in a career that has a potential for high growth vs pay cuts and constant looming threats from insurance companies that dictate our pay. With the pay cut I received today and ones I will most definitely receive in the future I realized I would've been better off managing a taco or burger joint as my choice to go into OT was a very poor ROI in comparison. My point is we live in a time where you have options and I think the younger generation gets this more than anyone, and you don't have to pigeonhole yourself and then later feel trapped.


Now there are therapists who may disagree with me. They may say they have zero regrets going into this field. All the stars have aligned and they may feel like they're making a difference everyday, they aren't bothered or affected by any changes happening in our field, they found an awesome company and team to work for, they are not being buried by student loans, and that the hard work was all worth it. And that's completely valid and those therapists DO indeed exist. But I just ask you to consider all angles before making such a life altering commitment and not just let this thread get buried under the "HOW SHOULD I GET ALL MY SHADOWING HOURS" threads. This is my opinion but after working for a few years in schools, adult daycare, snf and home health and comparing my circumstances with friends who work in various other industries here are my 2 cents about whether or not you should consider OT plus things you may not have considered due to tunnel vision on the preliminary steps of getting into OT school



Things you may not have considered:

-the availability of jobs in your area
-the variety of OT jobs in your area. For example, in school we are told there are sooooo many settings. How many mental health jobs are there actually in your area?? I've seen 4 crop up in the past 4 years. Pay attention to facts--not a sales pitch meant to keep schools in business.
-when you don't want to work in a SNF or a peds outpatient setting what is the actual likelihood of working in an "emerging setting". Is there enough funding in that "emerging setting" to carve out a job with benefits for a Masters level clinician? Ever considered why "emerging settings" STAY "emerging settings"? Hint: not enough resources and advocacy to prove our value to hire on an OT
-the ease in which you can explore different settings
-having enough AUTHENTIC desire to work in a specific setting like schools in order to outweigh the BS (litigation, high caseloads that affect quality of treatment delivery, families)
-how you will physically fare as you age. Doing a MAX transfer as a fresh 25 year old is different than doing these consistently when you have a bad/weak back, knee, hip etc. Will you wanna chase a high energy kid around a sensory gym or be on the floor rolling around in your older years? Will you want to be doing manual therapy day in and day out in a hand therapy clinic?
-think into the future. When you tire and are experiencing burnout from the emotional and physical load of direct patient care (very frequently happens especially due to undesirable industry changes that places the pressure and burden on the therapist to make up for any loss of revenue to the facility) what will your options be as an OT? Do you have aspirations of being a DOR? Non clinical jobs are not plentiful. Positions like utilization review are highly sought after however there are not enough to meet the demand and mostly go to nurses. In fact nurses have much more non clinical job options as they progress in their careers.
-how student loans can chip away at you and affect the milestones you want to achieve in life. If you have a plan, great. But know that there are many older professionals who regret taking out high student loans because when they were young and figured they could pay them off they didn't consider the ridiculous federal loan interest rates. Many people have paid off their original loan but now because of interest their loans have double and triple exploded. Hint: loans are a scam. In many cases school is a scam.
-that people CHANGE. If people evolve and change over time what makes you think your career interest will stay the same? You may like OT now however it is very possible you will have a change of heart, but because of your loan debt you feel stuck in the mud.
-the ease of getting a hospital job if you have no desire to work in a SNF or in pediatrics and you don't have acute experience
-feeling like an OT salesman trying to sell your value to patients who have never heard of an OT ie. "oh is that a person who helps me get a job?" "arm exercises??" ::mockingly waves their arms around to show they can do AROM independently:: "Bathroom?" "Oh no I can do all that, please fetch the PT so I can walk and get out of this hell hole".
-other careers that "help people" that may have a better return on investment
-that you can still help people without taking that so literally when looking at potential careers


People who probably should not bother considering what's currently happening in our field:

-people who have GENERIC reasons for entering OT ie. I don't know what else to do, I want to "help people" (plenty of careers help people), healthcare seems like a stable job, I like to see people get better, I don't want to sit in a chair at a desk all day, I have a pointless Bachelor's degree that I can't make money with, I'm tired of being an accountant and OT sounds like a "nice change", I don't want to take "XYZ" science class in order to get a nursing or pharmacy or preferred degree, I couldn't get into that other career I really wanted so OT is what was left. Some of these reasons are OK but they shouldn't be your ONLY reasons.
-if your only choice is a super super expensive OT school because in the last several years getting into an OT school is insanely competitive (I blame the BS top 10 career articles) so now you'll be left with an 80K tuition which will sky rocket because you have to take out more loans for living expenses and have a 6% interest rate etc.
-you couldn't get into a cheaper in state school but don't want to "waste a year" sprucing up your application so you're accepting admission into that super pricey school that will make you go into indentured servitude trying to pay it off. Note: one year is nothing in comparison to a lifetime of paying off debt.
-you're choosing OT as a substitute for a career in psychology because OT involves "mental health". We've done a poor job advocating ourselves in that area and in many states there are very few mental health OT jobs so yeah you might use MH as one aspect of your treatment but it's not the same as being a psychotherapist or psychologist. Note this does not apply to people in the UK or Australia as they play a bigger role in MH.
-You think OT will mainly be about helping people recover so they can participate in their occupations of interests. Insurance doesn't care about all your patient's holistic and varied interests. They don't care that they used to be a skydiving instructor and post stroke can't be a skydiving instructor no more. ADL's and MOSTLY ADL's are our bread and butter so make sure you are interested in performing ADL's and exercise day in and day out. Similarly in the school setting, many interventions are based on meeting "sensory" needs and handwriting legibility.



People who may have better outcomes if they choose to go into this field:

-you have a sugardaddy who will pay for schooling
-you have a wealthy family who will pay for schooling
-you have lots of money saved up through a previous career, or have scored scholarships, or are certain you will have a financially stable situation (will live at home rent free for awhile), so you can quickly pay off said loans
-you have a partner who has a great paying job. You can even get on their health insurance and work here and there for fun money, or if you lose your job or side per diem gig you know your partner will be there to fill in the gaps. You may be able to live on their income while you quickly pay off your loans
-you are going to a cheap OT school and will have very little debt so if you ever choose to do something else it will not be such a big deal
-you are highly entrepreneurial and plan to network, market yourself and start a business endeavor using your skills as an OT
-you know yourself to be an absolute workhorse, and have no problems working 6-7 days a week, multiple therapy jobs, travel jobs, and sacrificing parts of your life in order to meet financial goals and pay off loans
-you will have debt but you know you want to work in pediatrics in a school setting and are confident in the PSLF program as a way to have your loans forgiven in 10 years with mounting debt that grows everyday because you're only paying the monthly minimum
-you have very specific and authentic reasons for wanting to be an OT, enough to outweigh any other possibilities or negativities about the field and the state of healthcare
-you have deeply personal experiences regarding OT and are genuinely passionate about OT and cannot see yourself doing anything else having explored many other careers that may have similar traits
-you want to be an OT with every fiber of your being or have a very strong "like" for it. You have shadowed every setting, have been able to envision yourself in that therapists position and can imagine doing what they do day in and day out including the grunt work and not just convincing yourself you like it because you don't want to start over and look for another career you would actually resonate with more (because that takes time and you're already 23 and want a career so you're not left out in your group of friends who already have careers)

Note: even having passion isn't enough to guarantee satisfaction in this career due to issues from immediate jobs (high caseload, high productivity, unreasonable expectations), and from the industry (medicare changes, reimbursement cuts, pay cuts, no pay increase in 10 years yet a growing student loan debt can feel like a slap in the face). Many OT's who were once passionate now regret it due to the reasons I've listed but having a strong passion can certainly improve job satisfaction outcomes overall. The person who responded to my post missed my point completely. You can like OT as a subject matter but be beaten down by actual circumstances and expectations in your job and the overarching industry.


Now I'm not trying to convince EVERYONE not to enter this field and be an alarmist and fear monger. I don't want everyone to panic, run for the hills, or worry they've made the wrong choice. I haven't covered more information including the quality of the jobs I've had because this post is already too long. Even in a bleak job climate there are still some pros.. there are patients who will make you feel very rewarded, your paychecks will be decent considering how cheap the cost of living is in your area, depending on availability you can try out different settings to switch things up. There are genuinely people who love OT so much they're willing to sacrifice a lot for it, don't really care about what I've said above, or they have advantages that others don't. I just don't want some people to think OT is the ONLY CHOICE to living a happy, financially comfortable life, especially when the return on investment is becoming poorer and poorer as the years pass by. This post goes especially for the fence sitters, the people who are considering more than one option and feel they would be happy in other careers, people who aren't fully convinced and their gut is telling them to keep looking, who shadowed therapists and weren't really "feeling it" all the way, who only have a super expensive school as an option, or who have a lot at stake. Just think it through so you won't regret it because the field is not exactly on an upward trend and the flashy marketers are not telling you everything.

I was also wondering if these issues also apply to the Physical Therapy profession?

 

[OTish20]

Hi @prodigiousflame I really appreciate this post. It's great to get a realistic perspective of the field and think beyond just hitting a certain number of volunteering hours and other application stuffers. I do have a question for you as someone who is out working in the world. Realistically, how important is the prestige/name of the school you go to and is it worth it to go to a more expensive school with a Medical Center (and possibly an OTD program) versus a small school that doesn't (and is a Master's)? Does it make any impact on the jobs you get or anything of the sort? I'd really appreciate your insight!

 

[prodigiousflame]

I was also wondering if these issues also apply to the Physical Therapy profession?

There are some similarities in the PT profession. High tuition, lack of raises, medicare cuts, poor debt/income ratio and complaints of feeling like an assembly line worker in outpatient etc. However I do believe they get a little more respect in the medical community and from patients due to more acknowledgement and awareness about what PT is (less elevator speeches needed for PT). Above I posted that in HH OT's have been seeing a greater hit to allocated visits after the PDGM changes. Also in my own experience I noticed that in certain niche settings such as pelvic therapy or lymphedema therapy that there are a greater number of PT's working overall. I tried to get into lymphedema at one point and the clinic I was applying for told me they only hired PT's. This is not to say that OT's cannot be pelvic therapists or lymphedema therapists and many are--just sharing that PT's have gained greater ground in those areas and that there needs to be more advocacy and awareness that OT's are just as qualified.

 

[prodigiousflame]

Hi @prodigiousflame I really appreciate this post. It's great to get a realistic perspective of the field and think beyond just hitting a certain number of volunteering hours and other application stuffers. I do have a question for you as someone who is out working in the world. Realistically, how important is the prestige/name of the school you go to and is it worth it to go to a more expensive school with a Medical Center (and possibly an OTD program) versus a small school that doesn't (and is a Master's)? Does it make any impact on the jobs you get or anything of the sort? I'd really appreciate your insight!

I'm glad to hear it. I cannot stress this enough. It really does not matter where you go for OT. The most important thing is to pass your NBCOT exam and get your license. This is not law or business where going to a top law school or going to a school like USC for networking will help significantly with job prospects. Also people have mixed reviews on what difference their OTD actually made for them. If for whatever reason you wanted to get an OTD later down the line they have post professional online OTD programs that are affordable. Someone from one of my fb groups mentioned University of South Dakota and only paying 12-13k for it.

I got my first job from INDEED and so did many of my classmates, or they had a great level 2 experience and got a job at that clinic after graduating. I mean I suppose there's special cases where it might give you a leg up if you wanted to become a professor at that specific certain university but my school recruited OT's who had graduated from other schools. So again--go to that small school if it's cheaper; you will thank yourself at the end. For others who only got into expensive schools--if OT is your absolute passion and you are willing to make some long term sacrifices then I get it. You're in a tough spot, OT school is very competitive, and you're doing what you can to make your dreams a reality. But for those who have a choice I really want to make it clear that you and that student who went to an expensive OT school will get the same job. I want to add that when I started working I networked through my job and found out about other OT job opportunities through other therapists ie. my coworkers would tell me about a per diem opportunity that had opened up at their other job. However no one ever cared about what school I went to.

 

[heyitsolil]

There are some similarities in the PT profession. High tuition, lack of raises, medicare cuts, poor debt/income ratio and complaints of feeling like an assembly line worker in outpatient etc. However I do believe they get a little more respect in the medical community and from patients due to more acknowledgement and awareness about what PT is (less elevator speeches needed for PT). Above I posted that in HH OT's have been seeing a greater hit to allocated visits after the PDGM changes. Also in my own experience I noticed that in certain niche settings such as pelvic therapy or lymphedema therapy that there are a greater number of PT's working overall. I tried to get into lymphedema at one point and the clinic I was applying for told me they only hired PT's. This is not to say that OT's cannot be pelvic therapists or lymphedema therapists and many are--just sharing that PT's have gained greater ground in those areas and that there needs to be more advocacy and awareness that OT's are just as qualified.

Echoing with what you said, I’ve definitely only heard of PT’s doing pelvic therapy. Since you tried applying for those positions, does that mean OT’s can do those kind of therapies as well? Like is pelvic therapy something both PT and OT students will learn in their degree or is it like some kind of certification that either PTs/OTs can get at any time in their profession? Have not been in OT school, so I don’t know what we can do/not do in terms of therapy. Thanks for the insight!

And yeah, I agree with the need for advocacy and awareness... when I was in undergrad, 95% of students in my Kinesiology major wanted to pursue PT and when I ask some people why not OT, many of them say because they “don’t want to do do dirty work,” which is sad knowing that many people see OT as like something below PT, rather than something that supplements it. :/

 

[prodigiousflame]

Echoing with what you said, I’ve definitely only heard of PT’s doing pelvic therapy. Since you tried applying for those positions, does that mean OT’s can do those kind of therapies as well? Like is pelvic therapy something both PT and OT students will learn in their degree or is it like some kind of certification that either PTs/OTs can get at any time in their profession? Have not been in OT school, so I don’t know what we can do/not do in terms of therapy. Thanks for the insight!

And yeah, I agree with the need for advocacy and awareness... when I was in undergrad, 95% of students in my Kinesiology major wanted to pursue PT and when I ask some people why not OT, many of them say because they “don’t want to do do dirty work,” which is sad knowing that many people see OT as like something below PT, rather than something that supplements it. :/

Hi so yes technically OT can do pelvic therapy or lymphedema management but it usually requires some sort of training outside OT school because you're not normally given in depth information on it in school. Klose training is a popular certification course for lymphedema but it's expensive so it would be ideal if an employer paid for it (if they have a need for it where you work). Herman & Wallace is the popular training program for pelvic therapy.

 

[OTish20]

I'm glad to hear it. I cannot stress this enough. It really does not matter where you go for OT. The most important thing is to pass your NBCOT exam and get your license. This is not law or business where going to a top law school or going to a school like USC for networking will help significantly with job prospects. Also people have mixed reviews on what difference their OTD actually made for them. If for whatever reason you wanted to get an OTD later down the line they have post professional online OTD programs that are affordable. Someone from one of my fb groups mentioned University of South Dakota and only paying 12-13k for it.

I got my first job from INDEED and so did many of my classmates, or they had a great level 2 experience and got a job at that clinic after graduating. I mean I suppose there's special cases where it might give you a leg up if you wanted to become a professor at that specific certain university but my school recruited OT's who had graduated from other schools. So again--go to that small school if it's cheaper; you will thank yourself at the end. For others who only got into expensive schools--if OT is your absolute passion and you are willing to make some long term sacrifices then I get it. You're in a tough spot, OT school is very competitive, and you're doing what you can to make your dreams a reality. But for those who have a choice I really want to make it clear that you and that student who went to an expensive OT school will get the same job. I want to add that when I started working I networked through my job and found out about other OT job opportunities through other therapists ie. my coworkers would tell me about a per diem opportunity that had opened up at their other job. However no one ever cared about what school I went to.

Thanks for your response, I really, really appreciate it. The first place I got an acceptance from is a local, modestly-priced (~70k) Master's program and I'm quite happy about it. I do see myself maybe going into research or teaching in the future, but I'm more than happy to pursue a post-professional OTD program if/when that time comes, I have ample experience under my belt, and am not drowning in debt. Especially with the fact that soon, all programs will become OTDs, I'm hoping there will be more post-professional program options for someone like me. I also hope that going to my small/relatively unknown school won't hurt my chances should I decide to pursue that.

The only advantage I see to going to a larger, more well-known school is that maybe they'll have better and/or more varied fieldwork placements options, but maybe that isn't even true.

 

[prodigiousflame]

Ah gotcha. Thank you! That’s interesting to know. So you were basically turned down just cuz you’re not a PT even though you have the knowledge...?

Also, out of topic, I got waitlisted for USC OT (was looking forward to tuition assistance).
Do you have any advice moving forward (this is a sign for you to run/hope for the best)? LOL! JK, I would appreciate any advice/tips!

I forgot why I was turned down I think they said something about only hiring PT's and not having a documentation system setup for OT's (whatever that means). I would try and spruce up your apps and apply to cheaper schools if you can

 

[heyitsolil]

Thanks for your response, I really, really appreciate it. The first place I got an acceptance from is a local, modestly-priced (~70k) Master's program and I'm quite happy about it. I do see myself maybe going into research or teaching in the future, but I'm more than happy to pursue a post-professional OTD program if/when that time comes, I have ample experience under my belt, and am not drowning in debt. Especially with the fact that soon, all programs will become OTDs, I'm hoping there will be more post-professional program options for someone like me. I also hope that going to my small/relatively unknown school won't hurt my chances should I decide to pursue that.

The only advantage I see to going to a larger, more well-known school is that maybe they'll have better and/or more varied fieldwork placements options, but maybe that isn't even true.

Do you think there would be employers in the future who would be willing to foot the bill for their employee’s continued higher education like paying for their doctorate if they only graduated w/ a Master’s?
....Or is this like almost impossible and most employers don’t care/wanna spend $$$ on their employees?

 

[OTish20]

Do you think there would be employers in the future who would be willing to foot the bill for their employee’s continued higher education like paying for their doctorate if they only graduated w/ a Master’s?
....Or is this like almost impossible and most employers don’t care/wanna spend $$$ on their employees?

I have no clue! I guess it's possible but I kinda don't see it going that direction. The fact that there are practicing OTs whose highest level of education is a Bachelor's tells me employers probably won't care as long as you are certified and qualified and such if that makes sense. But anyway, I'm just a future OT student, not a practicing OT so I can't really speak to the direction I see the industry heading!

 

[chaseyourdreams_93]

THANK U FOR WRITING THIS!! I WISH IT COULD BE ON EVERY FORUM. Please please everyone should read this because I think a lot of ppl are delusional about the OT field. Are the some people who are doing well? yes a select few but for majority of new grad OTs things are very rough. Also I would like to add that race is a factor. This may be controversial but OT is not diverse and it seems a certain ppl of a particular group rise to the top a lot faster and get those dreams jobs. My advice, go into a field where you can see people like you. I feel you will have a better chance when you do.

Every single point mentioned is accurate and I could have not have said it myself. OT and also PT is very hard on the body overtime it wears the body and there are not many options to do something non-clinical in the field. Yes there are new sites and new businesses with people giving ideas on what to do after clinical work but we want to see the non-clinical jobs on internet job sites.

Lastly, I would like to add that the BURNOUT I have seen in this field is ABSOLUTELY scary. I have seen certain therapists so burned out they have so much hate and disdain for anything and one around them. They hate and resent other people in another fields within their facility, they become very rude to other coworkers and they overall look very miserable. Burnout is a scary thing to see from what I have observed. I dont want to be in their position so I am packing my bags and making another career move. It is also absolutely ridiculous that therapists are not receiving covid rates. There was a PA jobs I saw online offering 112$ an hour for a full time position..I think it was a traveler position. Why is it that when I look on job sites its all rubbish jobs. With shady A S companies, no bonus pay and disturbingly LOW salaries and hourly rates. Are we a joke to these facilities? because it seems that we are the facilities' biggest joke. Has it always been this way for decades....someone let me know..some Dr's I have met are not even too sure of our positions. Glad I woke up when I did. Thank goodness.

 

[deleted939094]

Thanks for your response, I really, really appreciate it. The first place I got an acceptance from is a local, modestly-priced (~70k) Master's program and I'm quite happy about it. I do see myself maybe going into research or teaching in the future, but I'm more than happy to pursue a post-professional OTD program if/when that time comes, I have ample experience under my belt, and am not drowning in debt. Especially with the fact that soon, all programs will become OTDs, I'm hoping there will be more post-professional program options for someone like me. I also hope that going to my small/relatively unknown school won't hurt my chances should I decide to pursue that.

The only advantage I see to going to a larger, more well-known school is that maybe they'll have better and/or more varied fieldwork placements options, but maybe that isn't even true.

Unless something dramatic changes, if you're interested in research and teaching at a university, you will need to get a PhD. Until the OTD becomes the entry level degree for practitioners, there is no practical reason to go OTD over MOT.

 

[OTish20]

Unless something dramatic changes, if you're interested in research and teaching at a university, you will need to get a PhD. Until the OTD becomes the entry level degree for practitioners, there is no practical reason to go OTD over MOT.

Does going to a more well-known school (and probably more expensive/OTD program) with possibly more/better fieldwork opportunities give you an advantage, though? I always figured that you would land your first job probably in one of the settings that you did your fieldwork in.

 

[deleted939094]

Does going to a more well-known school (and probably more expensive/OTD program) with possibly more/better fieldwork opportunities give you an advantage, though? I always figured that you would land your first job probably in one of the settings that you did your fieldwork in.

This is just my perspective based on my experiences and those of my 50ish fellow students. Very few people were hired by their level II sites but nothing about our experience as new grads has been standard (I see you COVID-19). You can never be sure you will get your dream placement for fieldwork, and part of what I got out of fieldwork was the opportunity to try out some settings I thought I would enjoy but, in at least one case, didn't. If you have a very specific interest in OT, consider that you may have to work in another setting for a year or two before you can get hired in your chosen niche. In my experience applying for jobs, my 2+ years of experience in activities and personal care of senior citizens seems to impress employers more than my academic credentials. They want to know if I passed the NBCOT and if my license is current. Because I went to an inexpensive but still top 10 program, I don't really know if there is a prestige factor I benefitted from. If you do decide to go to a lower cost program and you're worried about impressing employers or getting a job in a niche field, consider setting aside some money for some additional paid training or certifications. I guarantee that will make you stand out to employers.

 

[OTish20]

This is just my perspective based on my experiences and those of my 50ish fellow students. Very few people were hired by their level II sites but nothing about our experience as new grads has been standard (I see you COVID-19). You can never be sure you will get your dream placement for fieldwork, and part of what I got out of fieldwork was the opportunity to try out some settings I thought I would enjoy but, in at least one case, didn't. If you have a very specific interest in OT, consider that you may have to work in another setting for a year or two before you can get hired in your chosen niche. In my experience applying for jobs, my 2+ years of experience in activities and personal care of senior citizens seems to impress employers more than my academic credentials. They want to know if I passed the NBCOT and if my license is current. Because I went to an inexpensive but still top 10 program, I don't really know if there is a prestige factor I benefitted from. If you do decide to go to a lower cost program and you're worried about impressing employers or getting a job in a niche field, consider setting aside some money for some additional paid training or certifications. I guarantee that will make you stand out to employers.

I don't expect to get my dream placement for fieldwork, but I want to be sure that I'm getting decent experience that will set me up to be in settings that I want down the road if that makes sense. I'm fully aware that I will need to work my way up to my "dream" job, though! The paid trainings and certifications are an awesome idea and something I haven't heard much about (other than CHT). What other kind of extra trainings/certifications exist? Right now, the program I got into is ranked almost 200 lol so I am a little nervous at that putting me at any sort of disadvantage

 

[deleted939094]

I didn't mean to suggest that you think you will get your dream job right away, although you might! Try not to take the great news that you got accepted to OT school and find a reason to get down on yourself. If your program has a poor NBCOT pass rate (less than 80%), pause and decide if you are willing and able to do the work required after graduation to prepare for the test. Otherwise, onward and upward. If you get great clinical experience and mediocre preparation for the NBCOT, you will be the envy of someone who gets mediocre clinicals and great test prep (and vice versa). If you are feeling tremendously nervous about your decision to do OT at all, I recommend you really delve into your finances and future implications of debt and market saturation, and then see what jobs you can get without going back to school that may satisfy what you hope to satisfy with OT as a career. If OT still seems like a good option (it is for me!) GO FOR IT!

Some other certifications: (shamelessly copied and pasted from otpotential.com)

Assistive Technology Professional (ATP)

Seating and Mobility Specialist (ATP/SMS)

Aquatic Therapeutic Exercise Certification (ATRIC)

Basic DIRFloortime Certification

Neuro-Developmental Treatment Certification (C/NDT)

Certified Autism Specialist (CAS)

Certified Aging in Place Specialist (CAPS)

Certified Brain Injury Specialist (CBIS)

Certified Diabetes Educator (CDE)

Certified Hand Therapist (CHT)

Certified Industrial Ergonomic Evaluator (CIEE)

Certified Industrial Rehabilitation Specialist (CIRS)

Certified Kinesio Taping Practitioner (CKTP)

Certified Living in Place Professional (CLIPP)

Certified Lymphedema Therapist (CLT)

Certified Low Vision Therapist (CLVT)

Certified Neuro Specialist (CNS)

Certified Psychiatric Rehabilitation Practitioner (CPRP)

Certified Driver Rehabilitation Specialist (CDRS)

Certified Stroke Rehabilitation Specialist (CSRS)

Certified Hippotherapy Clinical Specialist (HPSC)

Lee Silverman Voice Treatment- BIG (LSVT BIG)

Physical Agent Modalities (PAM) Certification

SAEBO Certified Therapist

Sensory Integration and the Sensory Integration Praxis Test (SIPT)

 

[OTish20]

I didn't mean to suggest that you think you will get your dream job right away, although you might! Try not to take the great news that you got accepted to OT school and find a reason to get down on yourself. If your program has a poor NBCOT pass rate (less than 80%), pause and decide if you are willing and able to do the work required after graduation to prepare for the test. Otherwise, onward and upward. If you get great clinical experience and mediocre preparation for the NBCOT, you will be the envy of someone who gets mediocre clinicals and great test prep (and vice versa). If you are feeling tremendously nervous about your decision to do OT at all, I recommend you really delve into your finances and future implications of debt and market saturation, and then see what jobs you can get without going back to school that may satisfy what you hope to satisfy with OT as a career. If OT still seems like a good option (it is for me!) GO FOR IT!

Some other certifications: (shamelessly copied and pasted from otpotential.com)

Assistive Technology Professional (ATP)

Seating and Mobility Specialist (ATP/SMS)

Aquatic Therapeutic Exercise Certification (ATRIC)

Basic DIRFloortime Certification

Neuro-Developmental Treatment Certification (C/NDT)

Certified Autism Specialist (CAS)

Certified Aging in Place Specialist (CAPS)

Certified Brain Injury Specialist (CBIS)

Certified Diabetes Educator (CDE)

Certified Hand Therapist (CHT)

Certified Industrial Ergonomic Evaluator (CIEE)

Certified Industrial Rehabilitation Specialist (CIRS)

Certified Kinesio Taping Practitioner (CKTP)

Certified Living in Place Professional (CLIPP)

Certified Lymphedema Therapist (CLT)

Certified Low Vision Therapist (CLVT)

Certified Neuro Specialist (CNS)

Certified Psychiatric Rehabilitation Practitioner (CPRP)

Certified Driver Rehabilitation Specialist (CDRS)

Certified Stroke Rehabilitation Specialist (CSRS)

Certified Hippotherapy Clinical Specialist (HPSC)

Lee Silverman Voice Treatment- BIG (LSVT BIG)

Physical Agent Modalities (PAM) Certification

SAEBO Certified Therapist

Sensory Integration and the Sensory Integration Praxis Test (SIPT)

Despite it's low ranking, it has graduated 3 cohorts with pass rates of 100%, 100%, and most recently 96%. I really appreciate your advice!! I'm not feeling particularly nervous about whether I want to attend OT school or not, I'm excited to learn everything I can!! Thank you so much for this list!! I will check out otpotential myself too! What's your favorite part about being an OT?

 

[deleted939094]

That's awesome! You should feel really great about the program you got into and never look back! I love helping people regain function and celebrate where they are in life. I also love to learn and feel great about the many different directions we can go in our OT careers.

 

[OTish20]

That's awesome! You should feel really great about the program you got into and never look back! I love helping people regain function and celebrate where they are in life. I also love to learn and feel great about the many different directions we can go in our OT careers.

Thank you!! And that's wonderful, I'm glad you found your spot in the field

 

[prodigiousflame]

Does going to a more well-known school (and probably more expensive/OTD program) with possibly more/better fieldwork opportunities give you an advantage, though? I always figured that you would land your first job probably in one of the settings that you did your fieldwork in.

I just wanted to add that when I was attending my program it was barely even accredited at that time and not well known at all. Our class had no issues securing fieldwork sites and some of the sites we did our level 2's at (mine included) were well sought out sites. I think some of the success possibly has to do with your fieldwork coordinator and how aggressive they are about reaching out and connecting with FW sites. Very few of my classmates stayed at their level 2 sites due to moving away, or wanting to work in a different setting than where they did their level 2, or there weren't job openings available.

 

[OTish20]

I just wanted to add that when I was attending my program it was barely even accredited at that time and not well known at all. Our class had no issues securing fieldwork sites and some of the sites we did our level 2's at (mine included) were well sought out sites. I think some of the success possibly has to do with your fieldwork coordinator and how aggressive they are about reaching out and connecting with FW sites. Very few of my classmates stayed at their level 2 sites due to moving away, or wanting to work in a different setting than where they did their level 2, or there weren't job openings available.

I'm assuming, though, that the setting in which you do your fieldwork provides you some "leg up" in terms of experience if you wanted to continue working in that setting? Or are you viewed as more of a blank slate once you graduate?

 

[prodigiousflame]

I'm assuming, though, that the setting in which you do your fieldwork provides you some "leg up" in terms of experience if you wanted to continue working in that setting? Or are you viewed as more of a blank slate once you graduate?

yes certain settings like hands or hospital might appreciate if you have a level 2 in one of these settings however in my case my class's ability to get the sites they wanted or to get into a more desirable setting was not dependent on whether or not my school had prestige/expensive/well established. There are other ways to land the job you want whether or not you do a level 2 in that setting (and as long as you're not in a super saturated area). For example my friend from a lower cohort did her Level 2 at a SNF and a MH site that works with sex trafficking victims. She was still able to get a job in acute rehab after graduating and through travel OT is now working at a very well known prestigious hospital as an acute rehab therapist. She is very passionate about that setting which I believe comes through to employers and she also did a cont education course called Neuro Infrah which expanded her neuro skills. I believe that certification helped her in terms of her resume and at work as patients on other therapists' caseloads witness her treatments and will seek her out to be their therapist. I just wouldn't go to an expensive school based on the idea that you might get better sites that way or that you can land a great job that way. I also want to add that I live near a very expensive and well established OT school that has graduated well known OT researchers and a couple of the settings I did my Level 1 or 2 in said they didn't love taking their students as they found they didn't have necessary "practical" skills so it can go either way.

 

[OTish20]

yes certain settings like hands or hospital might appreciate if you have a level 2 in one of these settings however in my case my class's ability to get the sites they wanted or to get into a more desirable setting was not dependent on whether or not my school had prestige/expensive/well established. There are other ways to land the job you want whether or not you do a level 2 in that setting (and as long as you're not in a super saturated area). For example my friend from a lower cohort did her Level 2 at a SNF and a MH site that works with sex trafficking victims. She was still able to get a job in acute rehab after graduating and through travel OT is now working at a very well known prestigious hospital as an acute rehab therapist. She is very passionate about that setting which I believe comes through to employers and she also did a cont education course called Neuro Infrah which expanded her neuro skills. I believe that certification helped her in terms of her resume and at work as patients on other therapists' caseloads witness her treatments and will seek her out to be their therapist. I just wouldn't go to an expensive school based on the idea that you might get better sites that way or that you can land a great job that way. I also want to add that I live near a very expensive and well established OT school that has graduated well known OT researchers and a couple of the settings I did my Level 1 or 2 in said they didn't love taking their students as they found they didn't have necessary "practical" skills so it can go either way.

This is all really helpful info and context to have, thank you!

 

[sourpatch22]

I’m in my last semester of OT school, and for sure this is something I worry about. I’m an older student, and I definitely have some concerns about getting a job, debt, etc.

That being said, many of the complaints I hear about OT seems to be true of most professions, particularly the ones that used to be considered solidly middle-class. What are these mythical career paths where you can make 6-figures, have a good work-life balance, enjoy your day to day job, all with just a bachelors?? I’m sure some exist, but from what I’ve seen, they definitely aren’t a breeze to come by! I think it’s easy to think the grass is greener elsewhere, when really the grass is patchy and sad everywhere.

From a casual survey of my friend group, there are basically 4 career paths after college.

1) go straight to med/law school, work your butt off to get a super high paying job (harder for doctors), have a zillion dollars in debt, and work like 100hrs/week. Constant stress and little time to actually enjoy your wealth.

2) find a decent white collar job making 40-60k, work there a few years, realize there is zero way to advance without getting another degree or getting super lucky, go back to school, take on more debt, and maybe make it to low 6-figures

3) bounce from job to job for years and never even make it to the 60k range

4) be born with a trust fund and do whatever you want.

Basically every career’s subreddit is full of posts about burnout, poor outlooks, stagnating pay, etc. Any profession that isn’t like that... give it 5 years. Everyone decides that’s the magic job, which leads to over saturation, and so on.

Personally, I wanted a job that was interesting enough and had the potential of decent pay, reasonable hours, and wasn’t easily outsourced or automated. Debt sucks for sure, but even if with monthly payments I should be able to take home more than I ever could in the office job I had before grad school. Not trying to be a Debbie Downer!

 

[prodigiousflame]

Hi Sourpatch,

I hear you on that because I had the exact same thoughts as you when I chose OT and I think it's partly that we've been brainwashed by society and institutions that we have to get a higher level of education to make something of ourselves. But OT/PT school has become so expensive that it's almost become a liability vs an opportunity for upward mobility. I thought I would never make a decent wage unless I went to graduate school and now realizing with inflation, reimbursement thats dictated by insurance, and pay that doesn't match our rising costs of tuition or cost of living, that the jokes on me. From my own survey of friends..all of them are making more than 40k either close to six figures or six figures without killing themselves or going back to school for a Master's, can freelance for extra money if needed, they've been in their respective careers for longer than 5 years, some are able to work remotely as digital nomads, maybe did not start out with a "passion" job but through work experience they were exposed to areas of interest that they honed skills in by doing certifications etc. and now they're doing things that are more closely aligned with what they like and have all surpassed me in income. They've received a Bachelor's degree in what's considered "useless" areas like history and anthropology and now are doing marketing, ux design (15k bootcamp investment to make a six figure income), cyber security, recruiting, etc. These are all high paid jobs without needing a professional degree.

Even if my friends were only making 50k at a job they've had since college (they're making higher wages now), they are ahead of the person who just spent years of lost income in grad school, and are coming out with 100K+ of loans. Once you're actually out in the field working and you're paying taxes and making your monthly loan payment you'll realize you're making as much or maybe even a little less than Cubicle Joe whose making a "mediocre" salary. Cubicle Joe however has been investing in his 401k/dividend stocks/etc since he's been in the workforce and has some disposable income left over for other luxuries. Not to mention Joe actually gets promotions and raises which as I said above--in certain settings OT's very rarely ever get raises so even if he starts out making less than us he'll end up making more while we stay at a stagnant wage for years.

Graduate students with heavy student loan debt have to work for YEARS before they're where Cubicle Joe is at now. Quickly paying off their loans means 10-15 years of high monthly loan payments which may mean delaying milestones such as having kids, buying a house, taking trips etc. The other option is to have more disposable income and go on IBR and make lower monthly payments but then your overall loan payment will balloon to 200-300k+ towards the end of your loan term and in twenty years you are taxed on the amount forgiven (50k+) right around retirement age. For those who know they want to work in a hospital or school setting try to get on PSLF. Now if OT's were making what they were worth, if we were getting raises, if our pay was increasing w inflation, COL, and w the demands of the field, then I wouldn't be here complaining. But when schools are regularly charging a six figure amount of tuition and average pay is 65k--THATS A PROBLEM and thats not worth it and I want people to deprogram themselves from limited thinking that it's grad school or BUST. Not to mention OT DIDNT EVEN NEED TO BE A MASTERS DEGREE just like nursing doesn't require a Master's. If research is the issue then tack on an evidence based research course and call it a day. OT is a career you learn by DOING--another example of the profession of OT being a money grab.

Like I said in original posts this mostly applies to people who are taking on an insane debt load to go to OT school. This doesn't apply to someone who is going to a fairly cheap school, has saved up and is paying for their tuition out of pocket, who have financial help from a spouse or family. This also might not apply to people who have a MAJOR passion for OT, have diligently researched every other career route, and cannot see themselves doing anything else in this world and are willing to subject themselves to pretty much anything and everything for the field. There are those who are entrepreneurial minded who may figure out a cash pay business, do travel OT or are cool working 50-60 hours a week for years w/ multiple OT gigs to quickly pay off their loans. I just want people to know there are other professions or careers in which you can help people without sacrificing so much for it especially when things aren't the way they were even a few years ago.

 

[deleted939094]

I’m in my last semester of OT school, and for sure this is something I worry about. I’m an older student, and I definitely have some concerns about getting a job, debt, etc.

That being said, many of the complaints I hear about OT seems to be true of most professions, particularly the ones that used to be considered solidly middle-class. What are these mythical career paths where you can make 6-figures, have a good work-life balance, enjoy your day to day job, all with just a bachelors?? I’m sure some exist, but from what I’ve seen, they definitely aren’t a breeze to come by! I think it’s easy to think the grass is greener elsewhere, when really the grass is patchy and sad everywhere.

From a casual survey of my friend group, there are basically 4 career paths after college.

1) go straight to med/law school, work your butt off to get a super high paying job (harder for doctors), have a zillion dollars in debt, and work like 100hrs/week. Constant stress and little time to actually enjoy your wealth.

2) find a decent white collar job making 40-60k, work there a few years, realize there is zero way to advance without getting another degree or getting super lucky, go back to school, take on more debt, and maybe make it to low 6-figures

3) bounce from job to job for years and never even make it to the 60k range

4) be born with a trust fund and do whatever you want.

Basically every career’s subreddit is full of posts about burnout, poor outlooks, stagnating pay, etc. Any profession that isn’t like that... give it 5 years. Everyone decides that’s the magic job, which leads to over saturation, and so on.

Personally, I wanted a job that was interesting enough and had the potential of decent pay, reasonable hours, and wasn’t easily outsourced or automated. Debt sucks for sure, but even if with monthly payments I should be able to take home more than I ever could in the office job I had before grad school. Not trying to be a Debbie Downer!

I think prodigiousflame hit the nail on the head. OTs who are not drowning in debt AND have a passion for OT AND aren't shouldering the full responsibility to raise a family on their own tend to be happier and more satisfied than those who have big loans. I am one of the LUCKY/savvy/highly disciplined (read: obsessively frugal) ones who has no debt and got a great job in my desired setting in my desired location with benefits and a good starting pay rate. I am happy with my choice of career. I'm not sure I will be as happy in 10 years when I'm making 10-15% more than I'm making now, which is pretty much the cap on this type of position in my area.

It would be a mistake to dismiss "negativity" about OT out of hand, especially when it is largely negativity about overburdening oneself with education debt to earn a degree with moderate earning potential and its fair share of volatility. This is not a problem entirely unique to OT. I don't think it's dumb to become an OT or a lawyer or a journalist or teacher but I do think it's a mistake to do any of these with some blind loyalty to the "more degrees at more prestigious and expensive schools equals success" model.

 

[CHIOTR]

I’m in my last semester of OT school, and for sure this is something I worry about. I’m an older student, and I definitely have some concerns about getting a job, debt, etc.

That being said, many of the complaints I hear about OT seems to be true of most professions, particularly the ones that used to be considered solidly middle-class. What are these mythical career paths where you can make 6-figures, have a good work-life balance, enjoy your day to day job, all with just a bachelors?? I’m sure some exist, but from what I’ve seen, they definitely aren’t a breeze to come by! I think it’s easy to think the grass is greener elsewhere, when really the grass is patchy and sad everywhere.

From a casual survey of my friend group, there are basically 4 career paths after college.

1) go straight to med/law school, work your butt off to get a super high paying job (harder for doctors), have a zillion dollars in debt, and work like 100hrs/week. Constant stress and little time to actually enjoy your wealth.

2) find a decent white collar job making 40-60k, work there a few years, realize there is zero way to advance without getting another degree or getting super lucky, go back to school, take on more debt, and maybe make it to low 6-figures

3) bounce from job to job for years and never even make it to the 60k range

4) be born with a trust fund and do whatever you want.

Basically every career’s subreddit is full of posts about burnout, poor outlooks, stagnating pay, etc. Any profession that isn’t like that... give it 5 years. Everyone decides that’s the magic job, which leads to over saturation, and so on.

Personally, I wanted a job that was interesting enough and had the potential of decent pay, reasonable hours, and wasn’t easily outsourced or automated. Debt sucks for sure, but even if with monthly payments I should be able to take home more than I ever could in the office job I had before grad school. Not trying to be a Debbie Downer!

I don't think you're wrong here... and I tell myself that every day when I feel like I would rather downsize every aspect of my life than face the turmoil in therapy for decades to come.

That being said, there are some unique ways that make our jobs emotionally difficult, and these aren't the obvious ones like being an emotional sponge for your patients. With productivity expectations, it's almost impossible to have any "down" time. And if you do, it is likely fraud.

For example, my husband has a white collar, well degreed office job. If he's tired of working on a project for awhile, he can stand up, move around, talk to co-workers, laugh at a youtube video, scroll facebook, whatever. When he started working from home due to COVID, he realized he can do what used to take 8 hours in about 5 hours, because he's not doing any of the extraneous socialization or goofing off inherent in his work environment.

If I want to watch a youtube video or chat with a co-worker about The Bachelor I'm either unproductive and in trouble, or doing it when I should be focusing on a patient and billing that time in a way that is ethically questionable if I'm not focused on providing skill at all times- not a nustep, but my skilled assessment and what I can do a tech can't.

And it's easy to rail against the rehab companies for the productivity issues, the "money hungriness," the push for group and concurrent therapy... But the reality is that reimbursement is garbage, so if we want the pay we deserve, they have to find ways to make that money. Average reimbursement in my area for a patient is 70-75 dollars a day per patient from the SNF to the therapy company. Out of that vast sum of money, OT, PT, and SLP have to be paid. The wiggle room comes that we get that rate on days the patients don't have therapy too (frequently people are seen 5x a week). But it's TIGHT.

I work for a company that is ethical. I have worked for those that are not, and it's night and day. But even being ethical we have to find ways to earn our keep. If the whole team was 70% productive for a day, we would cost more than we are reimbursed.

None of this is even getting into the aforementioned PDGM horribleness. That's another situation where it's god awful, but the numbers aren't always there financially to do more, because nursing, therapy, and supplies come out of a lump sum payment, that for some diagnoses is not very high.

Don't get me wrong, I'm not defending most companies- they're garbage, despite the fact that there are a very few good ones. That being said, I know the numbers are insanely tight because we have been completely devalued in terms of reimbursement.

I don't know... I know all jobs suck. But there is something particularly soul sucking about having the knowledge and desire to help, and being limited constantly by financial considerations. I work with a new grad OTR who is WONDERFUL and energetic and creative. She always tells me "this patient would really benefit from XYZ." And I have to tell her she's right, but nobody is going to pay for that positioning device, or this home mod, or a particular style of wheelchair. It's not just the rehab companies. It's the SNFs, the government, the families and patients who legitimately can't afford it. So we have all this potential to do so much good, and nothing can ever get done in the system we operate in. So people who could go home with caregivers if they had AM and PM aides and home mods waste away in SNFs because our system is broken. And that's why so many of us are broken.