How I Passed the NBCOT® On My First Try (and You Can Too!)

Are you finishing your occupational therapy program and are looking for a solid study plan to help you pass the NBCOT® exam on your first try? If so, this post was created just for you!

While I was studying, I personally loved reading other new OTs’ success stories in the AOTA NBCOT® exam prep Facebook group as well reading up on what to do if I failed (more on that below). I absorbed SO much information that I ended up using in my study plan, which is fully outlined in this article.

I want to note that this post is not at all sponsored and the resources I used I either learned about from OT school or from other test takers. Additionally, this post is about my experience taking the OTR exam, but many of these tips will also be helpful for you if you are taking the COTA exam. 

First Off, How Long Should You Study?

I studied for approximately six weeks after I graduated, and put in about 3-4 hours a day, 6 days a week.

I only had one or two days in the beginning of studying where I put in a full 8 hour day like I thought I was supposed to. I quickly realized I couldn’t handle that much cramming after going through the intensity of fieldwork and OT school, so I pared down my studying to a more realistic amount of time.

Honestly, I think if you have at least a solid four weeks to study, you don’t need to do full days every day. It definitely doesn’t hurt to study for full days if you’ve got the motivation, though!

Based on my classmates’ experiences and my experience, 3-4 hours a day is generally sufficient if you’re retaining the information as you read it.

These are the resources I had the most success with:

1. The Therapy Ed Study Guide
2. AOTA’s Online Test Prep
3. Quizlet Flashcards

Therapy Ed

My OT program required us to purchase the Therapy Ed NBCOT® Study Guide for one of our last “wrap up” courses during our second to last semester.

Even before it was required, I’d heard so many good things about this book and how it helped quite a few people pass the NBCOT® on their first try. Even if it hadn’t been required, I very likely would have purchased it anyway, and I now recommend it to any new test taker.

I did not take the optional test prep course due to financial constraints but my classmates that took it said it was really helpful learning good test-taking strategies. If you have severe test anxiety or require extra time during exams, it might not hurt to consider it.
Something to keep in mind is that the Therapy Ed guide is DENSE. So much detail = information overload at times, as it basically covers everything you learned in OT school, plus three practice tests with the same amount of questions as the actual exam (170 multiple choice plus three clinical simulations).

You may have already heard this, but the Therapy Ed tests are HARD. I would even say harder than the actual exam. So, if you’re scoring in the 50’s and 60’s, don’t be alarmed, because almost everyone is scoring in the 60’s even right before test time.

Just a heads-up: reading this book can be a bear. It is SO, SO detailed and complex, so I would usually just read about 10 pages to maybe one chapter at a time at the most.

I can say some major “brain breaks” are needed after digging into this book, but even so, it was the most helpful and information-packed resource that I’ve found.

AOTA’s Test Prep Online

The second resource – and my personal favorite study material – was AOTA’s Test Prep online practice tests plus PDF’s on all of the main topics (hands, pediatrics, work, neuro, burns, and so on).

These PDF’s were much easier and shorter to read than TherapyEd and complemented the additional multiple choice quizzes.

I would do at least 20 questions a day (but often 50), and surprisingly had fun trying to beat my overall average and previous scores that I think I definitely saw all 1,100-something quiz questions at least once.

The answers and rationales are always provided at the end of the test, too, so I found that a lot of times I memorized the answers without even trying.

The AOTA Course alone did not have the same amount of detail and thoroughness that the Therapy Ed guide did, so I still recommend you purchase Therapy Ed, read it cover to cover once, and take those practice exams throughout your studying.

For more info about AOTA’s Exam Prep, be sure to check out our other article, Is the AOTA NBCOT® Exam Prep Right for You?

Quizlet’s NBCOT Flashcards

Third, I used Quizlet’s free NBCOT® flashcards that other students made and shared publicly for memorizing things like Rancho Levels, Allen Cognitive Levels, etc. Using Quizlet helped me break up the monotony when I needed a break from TherapyEd or AOTA’s test prep.

One thing to keep in mind is that since these quizzes are made by students, there may be some inaccuracies with answers. I definitely would not recommend this as your sole study strategy (you’ll want at least one thorough resource), and do be on the lookout for incorrect flashcards. 

Should You Study With a Group or Alone?

This all depends on what study style has worked for you in the past.

I initially attempted group study sessions with my friends from my cohort, but we almost always just ended up talking about how stressed we were about the exam and switched to other non-exam topics.

I personally did better studying by myself because I was so distractible. You might do better with a group to keep you accountable, though!

Miscellaneous Advice

When you’re not studying, please make sure to carve out some fun and relaxing time to spend with your friends, family, and significant other if you have one, because it definitely will help to keep you sane.

As far as working goes, I personally would NOT recommend getting a full-time OT job on a temporary license and thinking you’re going to have the time and energy to study every evening.

You are going to be absolutely exhausted from working as a new OT and you will have major pressure not to fail since failing = no more temporary license = no more OT job (yikes!)

I did babysit for two families approximately 15 hours a week and ALWAYS brought my study materials and laptop, as I was primed and ready to knock out as much as I could during the kids’ nap-time and bed-time. I think doing a bit of easy part-time work is much easier on you with much less stress of losing your temporary license/job.

The Day of the Test

When it came time for test day, I did the recommended steps of going easy the day before on studying, going out for a nice dinner, and making absolute sure I went to bed early enough to get a good night’s sleep.

I made sure to dress warmly even though it was summer (because brr, air conditioning).

I brought snacks and water and followed my school’s recommendation to get up after about an hour and stretch my legs/take a bathroom break.

One of my instructors strongly recommended before we graduated that everyone needs to get up at least once during the test, and I wholeheartedly agree.

I also remember her mentioning NBCOT® pass rates were higher when this was done (if I find a study on this I’ll be sure to link to it!)

One final step we were taught was to write our full names on the whiteboard they give you, followed by “OTR” before we start the exam, as well as a motivational quote like “I will pass.” 

So I took my rest break, ate a banana, and cruised along for the 3.5 hours (or however long it was) feeling pretty confident at first.

Then towards the end I started getting really stressed about not feeling like I knew any of the pediatric content (clearly I don’t work in pediatrics!).

So, like everyone else, I walked out feeling like I failed.

Feeling pretty bummed about the possibility of spending another month and another $500 retaking and retaking.

But guess what: I passed, with plenty of points to spare! 

I’m confident if you use trusted resources and give yourself enough time, with a solid study strategy, you will do the same!

But What are the Current Passing Rates?

Because I love numbers, I wanted to add in some stats for you: According to NBCOT®’s information page, 84% of test takers passed the NBCOT® in 2020 (dropping from 89% in 2019, and 91% in 2018). I was unable to locate the most up to date information for 2023, but I will continue to try to track this down.

I did find that the current fail rate, according to OT Questions, is currently 10-25% but this number includes initial fails that pass on subsequent test taking.

A Note on YouTube Studying

You may have noticed that I didn’t use YouTube videos for my studying, in part because there wasn’t a lot of unofficial NBCOT® YouTube study material available when I was studying. I love that this is another new avenue to take advantage of, but I do want to mention this:

Many OT students and new grads that I talk to mention they or their classmates are only using these YouTube videos for studying. PLEASE don’t do this!!! 

You really need at least one professionally-made resource to use as well, since these are created by experts to cover everything you need to know. YouTube videos are great to supplement your studying, but they really aren’t going to cover everything you need to know compared to a legitimate resource.

Want more pass rate information? Follow this link to see program performance data on the NBCOT certification examination by state and program level.

If You Still Don’t Pass the NBCOT®:

If you don’t pass the first, second, or even the third time, it’s okay! Please don’t beat yourself up about it. Just keep at it and revamp your study strategy, try new materials, consider getting a tutor, and spend more time studying vs. working.

For more tips on what to do if you don’t pass, be sure to check out our guide on what to do if you’ve failed the NBCOT®.

No matter how many times it takes, you will pass, and you will be an amazing OT or COTA!

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And that wraps up our NBCOT® study tips guide! These are my own personal experiences of studying for and passing the NBCOT®.

If you tried something totally different and it worked well for you, please share your advice in the comments below, as we can all use as many tips as we can to pass the NBCOT®!

Happy studying and best of luck to you!

This post was last updated on May 13, 2022.