What It’s Like to Get an International OT Degree

We want to thank Sarah Bence, OTR/L for sharing her amazing experience of getting an international OT degree in today’s guest article. We hope it helps give you some ideas and inspiration to get your occupational therapy degree abroad if that’s a path you’ve been wanting to take.

My path to becoming an occupational therapist was unusual, to say the least. I pursued an occupational therapy degree abroad. In late 2017, I graduated with a MSc in Occupational Therapy in England. I’ve since been through the process of transferring my degree to the USA, and I currently work as an occupational therapist in my home state.

It is definitely possible to study OT abroad, for your entire degree! However, when I originally considered this life path, back in my senior year of college, there were zero resources online. I had no clue if anyone had even done this before, or if it was an unreasonable route to consider.

Now that I’ve been through the process of getting an international OT degree, and transferring it back to my home country, I wanted to share that experience and my advice with you.

Why I Decided to Study OT Abroad

There are multiple reasons why I decided to study OT abroad, and my reasons will be different from yours. That’s okay! But, it’s important to take stock of your own motivations before making the huge decision to study OT abroad.

My senior year of college, I knew that I wanted to pursue being an occupational therapist as my career. However, I was an English and Creative Writing major! I had a lot of psychology, sociology, and kinesiology classes up my sleeve, but I was still missing some prerequisite courses to apply for masters or doctorate programs in the United States. I also really didn’t want to take the GRE, not going to lie!

Occupational therapy programs in the UK require less prerequisite classes (and no GRE) for entry, than programs in the USA. I was only missing one anatomy class, and it seemed a waste to spend a whole year in the US taking that single class and waiting to apply for OT school, when I could potentially enter a program immediately after college if I went to the UK. That’s how the gears started turning…

However, I had other, more personal motivations to study OT in the UK. My boyfriend is British, and he was living in the UK. Closing the gap in our long distance relationship was a big motivation to me looking at schools in the UK.

I also had a deep desire to travel, that I didn’t feel I could fulfill while living in the USA. There are so many amazing places to see in North America, but I had just come back from studying abroad for a year in the UK (during my undergraduate degree). I felt a yearning to see more of the UK, and Europe, and had this pull in my soul to go back to England.

Finally, the stars aligned when I looked at the finances. The OT programs I was considering in the US, and the living costs of those programs’ locations, would put me back $100,000 – $150,000 for two years.

In contrast, the programs I was looking at in the UK were around $30,000 total for international students at that time, and had plenty of scholarships available to make that tuition even lower.

In short, my values were:

• Immediate entry post-college
• My relationship
• Travel
• Finances

Your values might be totally different, and this is something you should dive deep into as you decide whether to pursue this path.

I say this because it is not an easy path to study OT abroad. Spoiler: I am glad I did it, but there was a lot of bureaucracy, struggle, and difficult times. I probably would have regretted this choice if my motivations hadn’t been so strong!

What it Was Like Studying OT Abroad in the UK

Choosing the right program

I was accepted to four universities in the UK, and ultimately decided to study at the University of Plymouth, which is a large university along the southwest coast. Plymouth is WFOT accredited, and the staff there went above and beyond to answer my questions and compare their curriculum to OT graduate programs in the USA.

The location by the ocean, scholarship opportunities, and the program’s focus on research and occupational science ultimately helped my decision to attend.

At the time, there were no international OT programs that were ACOTE accredited. However, there is now one program in London at Brunel University that is ACOTE accredited, so I would definitely consider this university if you are looking into studying occupational therapy abroad in the UK.

Brunel is actually the only program outside of the United States that is approved by ACOTE. The benefit of studying at an ACOTE program is that you are immediately eligible to take the NBCOT exam (the national boards in the US) if you want to practice OT in the US. This way you don’t have to go through the OTED degree transfer process (more on this further down!).

USA vs. UK Differences

There are a lot of differences in studying OT in the UK versus the USA. I was prepared for some of these because I studied abroad in the UK during my undergraduate degree, which did help with the academic culture shock.

1. Type of degree

The first major difference is that in the UK, and many other countries, a Bachelor’s degree is the entry level degree for OT. However, if you ever want to use your degree to work in the USA, keep in mind that only people with Master’s or higher are even eligible to take the board exam.

Luckily, the UK introduced what is called a “pre-registration” Master’s program over the last decade. The pre-registration Masters is designed for people who already have an undergraduate degree, and want to become OTs. It is a two-year program, and the equivalent to Master’s programs in the USA.

Keep in mind that there are also “post-registration” Masters, which are usually one year in length and designed for already-qualified OTs who want to do a research project. Don’t confuse the two!

2. Grading and assessment

Another huge difference between OT programs in the UK and USA is how students are assessed. In general, there is a lot less “busy work” at UK universities. Most classes come down to your grade on one single exam or one essay – there is no grade for participation, and no small daily or weekly projects that are graded.

This means there is a lot of pressure to do well on one assignment. My Master’s grade came down to a handful of essays, presentations, clinical placements, and my final 90-page research project.

3. Teaching style and philosophy

The style of teaching is also different in the UK. There is more of an emphasis on self-teaching. I didn’t take an exam during my entire Master’s, and I didn’t buy a single textbook (!).

I think this style of learning and assessing worked in some instances (I can write a killer essay now). However, I really missed the USA-style of teaching for certain subjects, including anatomy, kinesiology, neuroscience, and the more hard-science topics.

I also got the impression that there were a lot less hands-on practicals and lab work in my program, than there are at programs in the USA. I can count on two hands the number of times we worked on transfer training or lifts in the lab. This obviously worried many of us in my cohort, but it was explained to us that most of this training happens in placements, or on the job after you graduate. In the UK, it is very popular for new graduates to work in a “rotation” scheme, where you get intense training and work for 3-9 months in a different setting in one community (kind of similar to medical school rotations).

4. Healthcare system

Finally, a huge difference with any international OT education will be the country’s healthcare system. In the UK, there is a universal healthcare system called the National Health Service (NHS). Needless to say, this is totally different from our privatized, insurance-backed system in the USA.

This affected everything from how we were taught about occupational therapy, the OT scope of practice in the UK, documentation, how long I spent with patients during fieldwork, and more.

Fieldwork in the UK

Similarly to programs in the US, my Masters included three clinical fieldwork assignments. In the UK, these are actually called “placements.”

Each placement was 12 weeks long. Our first placement was immediately after our first semester, so January of the first year. The second placement started in September of our second year, and the third and final placement started in May of our second year. In between each placement, we returned to campus for another semester of classes.

At my university, there was a designated staff member who organized and assigned all of our placements. As students, we had no say in what settings or location our placements were in, although they did try to give everyone an even mix of acute care, community, and mental health settings.

My first placement was in a non-profit refugee resettlement agency, my second placement was in a large regional hospital’s emergency department, and my third placement was in a community mental health service. Both my second and third placement were associated with the NHS.

I loved my placements, particularly my first and third. However, I do feel like I was at a disadvantage when I applied for OT jobs in the USA after graduation. All three of those settings could be considered “role emerging,” and aren’t common settings in the USA. I didn’t have any experience in the more common and traditional settings of acute care, SNF, or pediatrics.

In general, there is a bigger emphasis on occupational therapy in mental health settings in the UK, and way fewer occupational therapists that work in pediatric outpatient or schools. If you know you want to work in pediatrics, you might be at a disadvantage. Still, I wouldn’t change my placement settings as I believe they’ve given me a strong cultural competence and mental health background that I can use no matter what setting I work in!

Living in the UK

I absolutely loved living in the UK but it did come with navigating some culture differences and culture shock.

Housing

After I applied and was approved for my tier 4 student visa, I started looking at housing options.

I decided to live off-campus, in a rental house for students over the age of 21. I chose a house with six other roommates, because I wanted to increase my chance of meeting people and making friends – seeing as I didn’t know a single person in the city.

Rent in the UK is often given by the week, rather than the month. My room in a gorgeous Victorian terrace house was £89 per week, or approximately $124. That comes out to $496 per month, inclusive of all bills and Wi-Fi. It was also only a five minute walk to the train station, a 10 minute walk to campus, and a 20 minute walk to the ocean! I thought this was a pretty good deal.

Groceries

I purposely chose a house that was close to a main street, that had smaller grocery shops, restaurants, and bars on it. I didn’t have a car, so I got the majority of my groceries on foot, packing what I needed into a backpack. About once a month, I would ride to a “superstore” grocery store (more similar to what we have in the USA) with one of my housemates to pick up bulkier, heavier items.

I did a lot of my grocery shopping at an Aldi’s that was walking distance from my house. In the UK, Aldi’s and Lidl are by far the cheapest grocery options. I also would pop into the small Co-op or Sainsbury’s on the main drag to pick up snacks or extra items as needed. I spent about £30 ($40) on groceries each week, plus another £10-25 on going to pubs, restaurants, takeaways, or cafes with friends.

Making friends

My plan to live in a large shared house to help meet people worked out – I met some of my best friends in the UK this way! However with a large house comes a large mix of personalities, so I wouldn’t recommend this tactic to everyone.

I also made some amazing friends in my OT program. However, this was difficult at first. My cohort was very small (nine people), and many of them commuted in from other cities, or were older, had families, and were at a different stage of their life. It took some time, but I did make a lifelong best friend on my course who ended up moving into the city and my house after the first semester.

Other than that, I did force myself out of my comfort zone, and in my first year I joined a lot of student societies, including the International Student Society. Through this, I met some incredible friends from all over the world, who were studying various topics at the same university. Making these friends was really one of my favorite parts of studying abroad. In fact, just last year I flew to India for one of these friends’ week-long weddings!

All this isn’t to say it was easy to make friends, and create a support network in the UK. Apart from my boyfriend and a few friends from my undergraduate study abroad (all of whom lived at least an hour away from my university), I had zero connections when I arrived. My first few months, in particular, were very lonely. I missed my family and my friends back home a lot.

Working

While on a tier 4 student visa in the UK, you are permitted to work part-time, up to 20 hours a week. I took a job as a yoga teacher, and also a part-time job with the university as a writing tutor in their learning and development department.

Working helped me offset my living expenses, and also pay for the travel I did throughout Europe. I also feel that it really helped me become a part of the local community, and meet more people outside of my occupational therapy program.

Travel

The huge benefit of studying OT internationally is travel, and the opportunity to immerse yourself in a new country and culture. During my full-time Masters, when I also worked two part time jobs, I traveled to over 20 countries! That’s actually when I started my travel blog, which was a major outlet and stress relief during my program.

From where I lived in England, I took a £12 flight to Norway, a weekend trip to Prague between classes, traveled through Morocco and Spain on spring break, regularly took the train to London on weekends, hiked gorgeous coastal paths, and more!

It was an amazing experience – I never could have afforded, or had the time, to travel that much if I’d been living in the USA.

What Happens After? Where Can You Work with an International OT Degree?

This is an amazing question, and should be the #1 topic on your mind as you decide whether to get your OT degree abroad.

It can become very complicated to actually put this degree to use, whether you decide to try and work in the country you studied in, or transfer your degree back home to the USA. You should have a game plan as you go into your degree, and start preparing early.

Keep in mind that getting a degree abroad doesn’t guarantee you can work in that country when you graduate. If you want to work in the UK, for instance, there will be some specific visa hoops to jump through and you will be limited on the types of jobs and employers you can apply for.

To transfer any international OT degree back to the USA is also a time-consuming and expensive process. In my experience, the expenses were still way less than if I’d done my degree in the US, but it was a long process and incredibly stressful.

You will have to complete a degree transfer process known as the Occupational Therapy Eligibility Determination (OTED) which has many stages and will likely include taking some extra courses (I took an extra neuroscience course during my degree, and a few extra CEU courses after graduation).

Once you’re approved by OTED, you have to take the NBCOT exam and you may be at a disadvantage because your international OT program obviously doesn’t prepare you for this board exam the way programs in the USA do. Saying that, I did pass the NBCOT with flying colors on my first try – I don’t say this to brag, but to encourage you that an international degree can still prepare you very well to work as an OT in the USA.

Should You Get Your OT Degree Abroad?

I can’t tell you the answer to this question, because I truly believe you need to weigh your own motivations, values, and risk-tolerance. Studying OT internationally is NOT the right choice for everyone, but personally it is not a choice I regret.

In fact, despite the struggles, it was one of the best decisions of my life! I believe I am a more well-rounded, critical, and culturally competent occupational therapist thanks to my experience studying OT in the UK.

Thanks again to Sarah for sharing her amazing experience! If you want to also learn more about working as an OT abroad, be sure to check out our companion article, How to Score a Career as an International Occupational Therapist. If you have any questions or want to learn more about Sarah, check out her website Endless Distances. 

This post was originally published on March 15, 2021 and updated on November 8, 2023.