Passing the board exam is tough for anyone, especially if you are an international Occupational Therapist (OT).
When I graduated from the Masters of Science in Occupational Therapy program in Ontario, Canada I decided that I immediately wanted to move to the California. This meant studying for and passing the National Board for Certification in Occupational Therapy (NBCOT) exam.
I had just passed the Canadian National Occupational Therapy Certification Examination (NOTCE) exam, and from what I had read online, the NBCOT had a much higher fail rate and required a substantial amount of studying to be successful. I was slightly intimidated but determined to achieve my goal of moving to California.
1. Give yourself LOTS of time to study
Regardless of whether you are already working as an OT or are a brand new graduate, it is critical to give yourself ample time to prepare for the NBCOT. The U.S. curriculum is slightly different, and there are a few topics addressed that may not be covered in the Canadian or other international OT programs. Prepare yourself for some new learning material and get yourself a good study guide (e.g., TherapyEd or Johnson). I bought the official study guide from NBCOT, but there are many others on the market. Regardless of what guide you get, take the time to go through each and every chapter. I found it took me a solid two months of studying 20 hours a week to feel adequately prepared.
2. Invest in the practice tests
The format of the Canadian and American exams is very different and may require a different study approach. I found it highly beneficial to do an online simulated exam to get familiar with the testing style. The US test is computer-based, the Canadian is not, so many people find that a hard adjustment. It is also helpful to familiarize yourself with the structure of the exam. The exam blueprint states what percentage of the exam is from each of the different domains. For example, 45% of the exam relates to domain 3: selecting interventions for managing a client-centered plan throughout the OT process.
3. You can’t do anything else until you pass
Don’t bother applying for a work permit or any other immigration documents until you receive confirmation that you passed the exam. You cannot file immigration documents until you receive a passing grade and obtain a Visa Credential Verification Certificate.
4. International Occupational Therapists need to complete the Occupational Therapist Eligibility Determination (OTED)
If you are an international OT and your school is not ‘pre-approved’, you must also complete the Occupational Therapist Eligibility Determination before being eligible to write the NBCOT. This extra step includes sending in additional documentation to prove that the curriculum you studied is similar to the education in the United States. You can find a complete list of documents required here. Be sure to submit these to your school as soon as possible to avoid delays in taking the exam.
5. Keep your chin up; it will all be worth it in the end
Even if you don’t pass on the first try, all your hard work will soon pay off when you make it to your destination. Remember, American schools help prepare their students specifically for the NBCOT. Their curriculum covers most, if not all the topics on the exam and they are familiar with the healthcare system and how it works. Different countries have different policies and different priorities in regards to what the role of the occupational therapist is in each healthcare setting. Don’t get discouraged if you are feeling overwhelmed; we have all been there at one time or another!