Is Occupational Therapy Really a “Top Job of 2014”?

Occupational Therapy Top Job 2014 recently came out with its top jobs of 2014. (See the article here.) This year “occupational therapist” is ranked #9. So, we’re awesome, right? Hey, it’s hard not to pat yourself on the back for your career choice when you see how cool you are. However, when you look at their criteria for ranking jobs, how does OT truly measure up? Let’s take a gander into some of the factors they looked at.

Before we dive in, I should establish that yes, I do love my field. Have I ever had a second thought about my career choice? Ooooh yeah baby. And dare I say, who hasn’t? They didn’t get that phrase “the grass is always greener…” from people that were always content with what was in front of them. Regardless, there are a few things I get to say from my position that others might not. So here I go.

From my research, there appear to be 4 “key factors” in’s rating of jobs. I’ll break them down for you.


I suppose this means work environment. Now, I’m only taking pediatric occupational therapy into consideration here, so don’t jump on me in regards to other settings.

For the most part, if you are working in an adorable little private therapy gym as an outpatient or inpatient therapist, you’ve got it great! Aside from sweating your face off when you are in an A/C battle with the speech therapists in your office, it’s a pretty comfortable environment. I can even get over the fact that I lift a few heavy kids and a bunch of 25 pound swings over my head about 50 times a day. So yeah, it’s pretty cushy.

What about therapists that work in the homes of children? I have been in some pretty scary environments doing this job.
I had moments when I had to accept the fact that my car may or may not still be outside the house when I was done with the session. I had people attempt to siphon gas from my car. I got to the point where I really tried to stop freaking out when giant bugs or spiders crawled across the room, or even when I would stand up to find actual grease stains on my scrubs from kneeling on the carpet. Or what about the poop on the floor? I’ll say that again. Poop. On the floor. Maybe those Career Cast rankers want to ride along on some of those adventures.

Also, don’t forget to fill any of these previously mentioned environments with children that might have severe behavioral issues (including but not limited to: spitting, kicking, pinching, scratching, and punching) I might spend an hour session with someone literally screaming in my ear for 60 minutes. Not to mention siblings that might not be properly supervised tearing apart the room.
But on the flip side, sometimes I have little kids cracking me up with their adorable-ness, or just saying sweet things like, “I love playing here!” Now thats pretty darn amazing. Maybe that tips the scales a little… or a lot.


This has to be a pretty big factor here, and I can’t blame anyone for looking at this aspect of a career closely. We all gotta pay our bills (and those nasty student loans). But the average salary they posted for an occupational therapist was $75,400. Where can I sign up for that job in my field?

Ok, since they are including all practice settings of occupational therapy, there are some people here that are weighing down the average. Typically, a pediatric OT makes about 30% or so less than in other settings. (I just guestimated that number, don’t hold me to it.) However, yes, you can make some pretty good money as a therapist. I even turned down (TURNED DOWN!) a job as a new grad in a nursing home for $80,000. I almost salivated at the offer. But why turn it down? For the most part, those jobs that pay really well come with their own price. Either the setting isn’t the greatest (This was a nursing home that was not well taken care of, and it showed), or the location itself isn’t the greatest. Anyone up for a pit stop in rural South Dakota? (No offense to SD, of course.)

So yes, even as a pediatric therapist I do feel like I make a decent salary. However, when I’m getting kicked or scratched on a sometimes daily basis, it might not quite feel like enough.


The job outlook for our profession is great. I usually get a call or email at least once a day from a recruiter looking to fill open positions. However, these jobs are pretty much never near where I actually want to work. If you have no commitments and want to travel around, you could very easily do that. Plus if it came down the the worst possible scenario, I know I could move somewhere and easily find a job.

Compare that outlook to my husband who spent 7 months unsuccessfully looking for a job in his field. Now that’s scary. But remember what I mentioned before, those jobs with the nicest paychecks usually have some sort of catch to them.

You also have to consider that with all the “great outlook” and “top job” postings that OT has received in the media, there has been a huge outpouring of new graduates. They are freaking everywhere! While the need continues to rise for OT services, I can’t help but feel that the tables will eventually turn. I’ve already had my look at a few very heavily saturated markets that were extremely difficult to get a job in. So yes there is availability, but it depends on your flexibility.


Oh goodness. Who was it that said occupational therapy was low stress? Let me at ‘em. Now I know stress has a lot of different meanings, and for this article, they mentioned different types including high risk situations and tough deadlines. I don’t know about my fellow OTs, but this job can be incredibly stressful at times.

I’ve got kids that are screaming, parents with various demands and requests that I need to juggle, a high productivity expectation from my boss that just never seems to happen, as well as deadlines for paperwork that influence insurance coverage and essentially if treatment will be continued. I am scheduled with back to back sessions without a break to even go to the bathroom, and yet I need to write several 4 page narrative evaluations so that parents can understand what in the world OT actually is, and hopefully so insurance might actually pay for it.

There is emotional stress for challenging patient and family situations, as well as physical stress of lifting, assisting, or transferring children all day. If you don’t leave completely exhausted at the end of the day, you probably did something wrong.
Am I saying that my job is as stressful as say, some wall street trader? No. All I’m saying is that there are a lot of hidden stressors that people take for granted or overlook.

And yes it is fair to say that among all of this stress, there is a lot of fun to be had. We play, we are creative, and we try to help people change their lives. It can be incredible, but you can’t avoid the whole package.

So what can I say? This job does have its incredible satisfactions of goals achieved. My colleague and I were talking one day, and we decided that there seems to be just enough of those little “wins” throughout the week to get you through. Even when someone just isn’t making progress, or if a parent doesn’t really care about services, there might be that one child that does something amazing that you taught them, and you just can’t beat that.

All venting aside, OT is absolutely a great career. Our world isn’t always rainbows and roses though.  It’s sweat, occasional tears, and a whole lot of heart. I’d say we deserve to hang out on that top job list.


About TheAnonymousOT

Pediatric Occupational Therapist
This entry was posted in Insider Information, Lessons Learned, Occupational Therapy and tagged . Bookmark the permalink.

22 Responses to Is Occupational Therapy Really a “Top Job of 2014”?

  1. Sue Meyerson says:

    Great post! I always look forward to reading your blog…it usually makes my whole day!

  2. Very well said! I have worked in a variety of settings, acute care, rehab, TBI, school and clnic based. $$ is not as great as it sounds. School loans payments the size of a mortgage payment! Paperwork requirements are huge. Traveling between sites [home to school; between schools; school to home] is often a nightmare. The unsanitary homes, ugh! I have bought Chux to use on the floor or furniture. [Mouse in my bag from one home] Being robbed 3 times! All my testing and tools were taken! Big holes in the back of my brand new car! Why does someone need my goni? An OH YES trying to get a minute to use the bathroom between sessions. I think that “Top Job” comments are flooding the system with occupational therapists. Some of whom are going into the field for the money that they think they will earn. As for now, I only take private cases that I choose and I am working on something else. I love being an occupational therapist. When I chose this as my career, I felt that the core of OT fit me, what I do, my life experience, all of which contribute to your treatment of clients. I read OT books, I live OT social media. Even in my other work, I think and act in OT mode. OT is my “Top Job” because of who I am. It is clearly not for everyone.

  3. Kati says:

    I’m a recent graduate and you’re right about the job outlook and pay. I live in a rural area of Puerto Rico and it’s true that there are job offers, but none seems a very good option to me. I think my first job will be with early intervention visiting kids’ homes so wish me luck! I hope that being able to help families will make up for all the bad stuff.

  4. Although I am a PT, I can relate completely to all your sentiments. Years ago when I first came out of school, the market was amazing. There were jobs everywhere with great packages. Pediatric jobs have always paid less but you have to consider we also work less hours and no holidays which for me is worth any cut in pay. Which brings me to a huge bonus about a career as an OT, PT and speech therapist – excellent career for working mothers. There are many opportunities to work part time which is great if you have kids. And you obviously can’t beat the school calender if you work in the school system like I did for many years.

    I was cracking up about your home visit experiences. I have had many of the same – cock roaches, bugs, but never a mouse in my bag!!!!! I did have one father go on and on one time about how he was “not guilty of stabbing someone” which made me just a tad nervous since I was home alone with his and his child at the time.

    Great post as usual!

  5. I absolutely LOVE trading home health stories with therapists! You know if someone has been doing early intervention that they have seen a thing or two. Thanks to all for reading!

  6. Anat says:

    Hi Anonymous OT
    I am an OT in israel. It’s amazing to see how the things that you describe in your blog are also here.
    Thank you for writing them down. I was looking for for a blog of an OT, and here it is.
    inted to stay and read forward


    • Viva says:

      Hi Anat – I was recently in Israel and would love to move there someday.. can you tell me what it is like to work there (pay, job market, exc) Would it be hard to find work if my degree was obtained in the states?

  7. Kacey says:

    Thanks for your honesty, as always. I really appreciate this blog. I am just beginning my OT journey, and thankfully I already knew a lot of these issues. What helped me learn a lot was recently working in a special ed pre-k classroom for a few weeks. Definitely found out about the screaming, scratching, hitting, etc. and also found out how the kid who scratched you earlier can be happily swinging and giggling when you tickle him and it makes your entire day. If I can (for the most part!) handle 9 of those kiddos all day I feel fairly confident about handing 1 in a 60 minute session, but we’ll see! Yay OT!

  8. Keith says:

    I’m so glad that I’ve stumbled upon your blog! I’ve been doing a lot of research into careers in healthcare and read a Forbes story that references the rankings. I have a humanities background and have had a rocky career doing various writing oriented jobs. A few years back, after doing some research, I decided to pursue a MOT, and did my prerequisites and volunteer hours. Then I applied to some grad schools this past winter. The schools I applied to received a record amount of applicants (as many as 375 people vying for 32 spots!), and I was not accepted into a MOT program.

    I’m now at a crossroad–should I work on improving my numbers and apply to a wider array of MOT programs or should I become an OTA or should I pursue some other career. The thing that worries me about OT is that maybe it’s too hot of a career, what with so many people applying to grad schools and it appearing on top career lists. Is the OT field going to become saturated soon? It would be horrible if I spent so much time and money and ended up with no job. I have a track record of making terrible career choices, and I’m terrified that my choice to pursue a career in OT would turn to be another dud. I really can’t afford to make any more mistakes.

    Can any OT’s there offer some advice? Does anyone have insight into the possibility of the OT field becoming saturated?

    • Kacey says:


      I’m not an OT (yet!), but I can SO relate to what you’re going through!! I am switching careers as well, going from English teacher to OT, and I also worry about the saturation of the market. When I started my undergrad in 2001 everyone said “be a teacher, we need teachers!” and when I graduated in 2006 there were NO teaching jobs in my state.

      It’s such a gamble, especially when you’re switching careers, and what helps me (because I just turned in my application and I’m waiting to hear back about an interview for OT school) is to remind myself that no matter what, this is what I want to do. I will do whatever it takes. I truly believe set-backs happen in life to test how much you want it. If you’re not feeling completely passionate about the field, that is something to consider. As we read from Anonymous OT you need that passion to get you through the hard times within the career. Another thing to consider is that there are many different settings an OT can work in, and try to be open-minded. I love pediatrics, but if there are no jobs in that area I need to be ready to try a nursing home or hospital setting. One of the many things this field has going for it is that it is so broad, and therefore has more job opportunities.

      It’s a good thing you are thinking about these things before you are committed to a program though! If you like working with older adults a Master’s of Gerontology is oftentimes only a year-long program, and I think you can even do it exclusively online. With our baby-boomers coming right along that should be a field with lots of opportunity as well. Good luck!

      • I was also told to go into teaching due to the shortage and found no jobs available when I completed my degree! I am still in debt from my last MS and now want to go back to school and become an OT (hopefully with minimal debt this time round)! This blog entry brings up a lot of great points about the grass always looking greener on the other side. I do like that OTs can be self-employed whereas I rarely see self-employed teachers and that is one of the reasons I want to go into the field. I really hope it is worth it after reading this entry and enrolling in my first OT prerequisite!
        Do you have any MOT school recommendations? I have very little idea where I want to apply when I finally finish my prerequisites and volunteer hours. I get the feeling that when I finally finish that the market will be much more saturated just like what happened when I finished my teaching degrees!
        Loving this blog!!!!! Thanks for sharing all of your great info!

  9. C says:

    Very cool blog! Have you thought about having guest entries about practice settings other than pediatrics?

  10. Nina says:

    I am an SLP looking to make a change in career and I have always regretted not doing OT and am thinking of going back to school to be an OTA. Other than the typical paperwork and politics how do you like your job. I know the grass is always greener on the other side but sometimes think I will enjoy the actually therapy part of being an OTA compared to being an SLP.

  11. DLS77 says:

    I literally just said to my husband yesterday “I think I want to become an OT.” Then, I found your blog in the wee hours of the morning. I am so thankful I did. I need to do some more research in the field, but I am looking for a career change. I had never thought about OT until having my son who is 4 w/ ASD (he actually receives very little OT services), but I am needing a career with more of an impact. Currently, I work in higher education, so I would have to take a lot of pre-req courses, not to mention the volunteer hours, to catch up and be eligible to even apply to an MOT program. Does anyone have any ideas of the best way to secure volunteer hours? Should I approach an OT that works with my son?


  12. Play Matters says:

    Play Matters Therapy Center is a clinic that offers pediatric care in the line of occupational therapy, speech therapy, special education (sped) program, and reading & tutorial services. It is the first and only therapy center in Mexico, Pampanga, Region 3. It is located at Lagundi, Mexico, Pampanga. The center is a walking distance from SM and Robinsons Pampanga which makes its location highly accesible. It caters clients from neighboring towns of Mexico such as the City of San Fernando, Angeles City, Sta. Ana, Arayat, Candaba, Sto. Tomas, Apalit, Bacolor, etc. Because of its proximity to NLEX Exit (via san fernando exit which is beside SM Pampanga), Play Matters Therapy Center can also cater those coming from Bulacan and Tarlac. Clients also come from Nueva Ecija especially Cabiao because it only takes an hour by bus.
    The center caters to clients with learning difficulties, autism, ADHD, down syndrome, mental retardation, etc.

  13. Anonymous OT/CHT says:

    So well written! As an OT (now CHT) who previously worked in Peds, I couldn’t agree more! We have such an amazing career, but not without its stressors and drawbacks!

  14. Jessica says:

    Hello! My name is Jessica and I just finished my semester of OT school. I am being offered a grant that will cover like 60% of my tuition for the rest of my time in the program. The catch is I have to be a pediatric OT in a school based setting for 5 years. I did observation hours in a school that is only for children on the spectrum…A lot of them had severe Autism and it was a little daunting for me. (I am also taking into consideration it was my first time really interacting with children on the severe end of the spectrum) After completing my hours (12 hours, so it wasn’t much, lol) I came to the conclusion that I do not know if peds is for me. I am not saying that I don’t want to help children with disabilities or that pediatrics therapy is definitely not for me because I cannot see myself helping them…I simply just don’t know….and I hate to bring up money, but I will be honest and say that the fact that pediatric OTs are the lowest paid type of therapist is a turn off. However, like a lot of OT students, I will be graduating with a lot of student loans and bills to pay…So, having 60% of my tuition is really tempting, but I don’t want to commit to 5 years in the school system if I am not going to be happy in that type of setting-and therefore possibly even doing a disservice to those children…what are your thoughts??? Should I go for it anyway??? Do You have advice? any thought?? I would greatly appreciate your input. 🙂 Thanks!

    • Jessica says:

      I also just want to make sure I am beyond clear on the fact that I want to help and would love to be a part of that setting but my experience at that school for Autism put things into perspective and made me realize that it is not all pink and roses. So, that is why I am unsure. I personally think I would make a great pediatric OT and have certain qualities that those children can benefit from. I just have qualms about committing to something I am scared or unsure of for 5 years. It’s this whole “Is this something I really want to do?” conflict and I can’t seem to come up with an answer for myself.

      • Jessica says:

        typo correct in my first comment. ***My name is Jessica and I just finished my FIRST semester*** wanted to emphasize 1st semester so you can see how significant this grant will be for me…We are talking about me graduating with only about $40,000 vs $70,000-75,000. If that helps put things into perspective.

  15. susiedonohue says:

    Hi Jessica, my apologies if this gets printed twice. I just wrote a long post and then lost it! Briefly, what I wanted to say is there are other ways as a working OT to generate $30,000 rather than being locked into a 5-year contract with a job you don’t totally love. Pediatrics is hard and unless you really enjoy your work 5 years will seem very long and exhausting! A lot of OTs and PTs in my area work weekend Registry shifts at local hospitals to help pay off our loans. We work elsewhere during the week (many in pediatrics) and then pick up 2 weekend shifts a month (at $40-$50 an hour) doing inpatient acute care and earn about $8,000 a year that way. Most hospitals now offer rehab 7 days a week and those Sat./Sunday shifts are hard to fill. Also, a lot of clinics, hospitals and agencies offer sign-on bonuses, loan repayment options or referral bonuses (i.e. get your friend to join, earn $1,000 bonus.) It all adds up so I would advise you to look into all of the options before locking into a job in pediatrics that you might not be super-excited about. Work should be (mostly) fun and if pediatrics isn’t a top interest then consider taking a job that gives you more options, flexibility, etc. But wait until you finish your schooling and your clinical internships before you decide because you might find that you love working with a different population of people. Good luck!

  16. Taylor says:

    I was so glad I stumbled upon this blog,I loved reading it and can’t wait to start my career as an OT!!:):)

  17. Phoenix says:

    If you were an OT having worked in the field for 10+ years, and could not work full time or unsure of handling the physical aspects of the job, even if part time…say 3.5 days a week…due to health reasons that might not be cured soon, what career path would you choose in OT or related. Would a start in the academic track be too late in mid thirties ?


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