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Has the entry-level occupational therapy degree in the U.S. shifted from master's to doctorate requirements recently?
Executive summary
No, available reporting shows that both master’s (MOT/MSOT) and doctorate (OTD) degrees remain accepted entry routes to practice occupational therapy in the U.S.; ACOTE considered—and briefly proposed—a doctorate-only mandate but later backed away and the profession currently retains dual entry-level degrees [1] [2]. Multiple school and career guides report a clear trend: more programs offer or prefer OTDs and many institutions are “shifting toward” doctoral options, but master’s programs still exist and remain recognized for licensure [3] [2] [4].
1. What changed (and what didn’t): the mandate that wasn’t
The confusion traces to a 2017 ACOTE proposal that would have required entry-level programs to transition to doctoral degrees by 2027; ACOTE then suspended that mandate and ultimately the profession maintained dual entry-level degrees, meaning the earlier proposal did not become a permanent, enforced change [1]. AOTA’s public guidance and program listings continue to describe both master’s and doctorate programs as valid entry-level paths [2].
2. Why people say “it’s shifted”: enrollment, marketing and program growth
Many universities and recruiters highlight a shift toward offering OTD programs and advertising the doctorate’s advantages—leadership, research and advanced training—so prospective students see more doctoral options and hear that the field is “moving” that way; industry blogs and university pages repeat that trend, which amplifies the perception of a wholesale switch even where licensure rules haven’t changed [5] [6] [3].
3. Licensure and certification: what regulators and certifiers say now
State licensure continues to be based on graduation from an ACOTE-accredited entry-level program and passing NBCOT certification; NBCOT’s eligibility language treats an “entry-level master’s/doctoral degree” as the relevant credential and requires foreign-educated candidates to undergo an equivalency review (OTED) if their degree doesn’t match current U.S. entry-level standards [7] [2]. That wording preserves both degree routes as qualifying paths to sit for the national exam [7].
4. Employer preferences vs. legal requirements
Although the law and accreditation permit both degrees, some employers and academic careers increasingly prefer or recruit OTD graduates for leadership, teaching or specialty roles, which contributes to practical pressure to pursue a doctorate even when a master’s would legally suffice to practice clinically [3] [6]. Observers note the extra cost and time of OTD programs versus MOTs and report that initial pay differences are often minimal, so the calculus is about career goals not baseline licensure [8] [9].
5. How schools are responding—dual offerings and pathways
Many institutions now offer multiple pathways: entry-level MOT/MSOT, entry-level OTD, and post-professional OTD or MOT-to-OTD bridge options that let graduates work after a master’s and later pursue a doctorate; schools explicitly state graduates of either route sit for the same board exam [10] [11] [12]. Admissions pages continue to list bachelor’s-then-master’s or bachelor’s-then-doctorate sequences as standard [12] [13].
6. What prospective students should check right now
Prospective students must verify program accreditation (ACOTE) and state licensure rules for the state where they plan to practice, and confirm any particular employer preferences—because accreditation and licensing still accept master’s-level entry but market demand and specific hiring practices can favor OTDs [2] [4]. Admissions and career guides recommend aligning degree choice with career goals: clinical practice sooner (MOT) versus leadership/academic aims (OTD) [5] [6].
7. Where reporting is thin or contested
Available sources document the 2017–2019 proposal, the later suspension and the continuing co-existence of degrees, but they differ on emphasis: some outlets frame an active “shift” toward OTD as a prevailing trend [3] [6], while professional bodies stress both degrees remain entry-level [2]. Sources do not provide a single, authoritative date showing a completed transition to OTD-only entry; ACOTE’s earlier mandate was not implemented as a permanent requirement according to reporting summarized here [1] [2].
Bottom line: legally and in accreditation terms, entry to the U.S. occupational therapy profession has not recently converted to doctorate-only—both master’s and doctorate entry programs still qualify graduates for certification and licensure—yet program offerings, employer preferences and institutional marketing increasingly favor the OTD, creating a practical “shift” in parts of the field [2] [3] [1].