How I Passed the NBCOT On My First Try
(And you can too!)

While I was studying for the dreaded NBCOT, I loved reading other new OTs’ success stories on the Facebook group as well as looking up what to do if I failed the first try.

Since it seems most of us enjoy seeing success stories, I thought I’d share my unbiased thoughts and opinions of the resources I tried as well my study habits and what I felt worked best for me.

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

I honestly think I only had one or two days in the beginning where I put in a full 8 hour day like I thought I was supposed to. I couldn’t handle that much cramming after depleting my brain during fieldwork and school.

And honestly, I think if you have a solid four weeks at least, you don’t need to do full days every day. I mean, you can if you want to, of course.

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

These are the resources I had the most success with:

  1. Therapy Ed
  2. AOTA Test Prep
  3. Quizlet Flashcards

Therapy Ed

Luckily for me, my program required us to purchase the Therapy Ed Certification book for one of our last “wrap up” courses during I think our second to last semester.

I was sometimes not the greatest about buying all of my required textbooks, but I heard so many good things about the book and how it helped quite a few people pass on the first try, so I very likely would have purchased it anyway, and 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 with the test-taking strategies.
Pass the NBCOT on first try.

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 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).

FACT: You may have already heard this, but the Therapy Ed tests are HARD.

Harder than the actual NBCOT. 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.

Oh boy, reading that 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 a day if I was feeling crazy, but couldn’t do this day after day after day.

I can say some major cognitive rest breaks are needed after digging into this book.

AOTA’s Test Prep Online

The second and my favorite study material was AOTA’s Test Prep online tests plus PDF’s on all the main topics (hands, peds, work, neuro, burns, etc.)


The PDF’s were SO much easier and shorter to read 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 Therapy Ed did, so I still recommend you purchase Therapy Ed, read it cover to cover once, and take the practice exams throughout your studying.

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.quizletI think a nice variety of materials will help you feel a bit less burned out and/or slightly more interested (I hope!)

I attempted study sessions with my friends from my cohort, but we almost always just ended up talking about how stressed we were and switched to chats about life and whatnot.

I personally did better studying by myself.

When not studying, please make sure to carve out fun/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 would NOT recommend getting an OT job on a temporary license full time and thinking you’re going to just have time to study during the evenings.

You are going to be absolutely exhausted from working as a new OT and will have major pressure not to fail since failing = no more temporary license.

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.

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, ya know, air conditioning.

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

Pass the NBCOT on first try.

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

I believe she also mentioned pass rates were higher when this was done.

A final step we were taught was to write our full names on the whiteboard they give you, followed by “OTR” before you start, 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 do peds!).

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!

And 88% of you first time test takers will pass the NBCOT on your first try too (according to the 2015 average pass rate of first time test takers).

Check out this cool NBCOT Performance Data page to see exam results for your own school’s program for the past 3 years.


If you don’t pass the first, second, even third time, it’s okay!

Just keep at it and revamp your study strategy, try new materials, think about getting a tutor, and spend more time studying vs. working.

Easier said than done, I know. But it will happen, and you will be an amazing OT!

These are just my experiences; if you tried something totally different and it worked for you, please share in the comments below, as we can all use as many tips as we can get with that exam!

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  • caroline November 8, 2016   Reply →

    thank you for the helpful advice!

  • Kayla Meyer November 11, 2016   Reply →

    Thanks for the post and sharing your experience! I’m getting ready to finish up fieldwork next week and preparing to begin the process of studying. Your post was very insightful and has lots of great suggestions I plan to use!

    • Sarah Stromsdorfer, OTR/L November 11, 2016   Reply →

      Thanks, Kayla! Congrats on being almost done with fieldwork and best of luck beginning the studying process! I’m glad you enjoyed the post 🙂

  • Katie July 6, 2017   Reply →

    When going through the TherapyEd book, did you go chapter by chapter in order? Also, were you writing down a bunch of notes on each chapter. I agree with you, this book is a bear!!

    • Sarah Stromsdorfer, OTR/L July 6, 2017   Reply →

      Hi Katie, I went through generally a half chapter to one full chapter (at the most) daily and in order, and just read through it all one time. I did spend extra time studying the practice test questions and answers towards the end of my studying. I did devote more time to AOTA’s exam prep overall after reading TherapyEd one time through.

  • tom July 31, 2017   Reply →

    This was helpful thank you. I will be taking mine in 3 weeks time. I’m really concerned about remembering all the things I have studied even though I prepared for so long. I just needed an inspiration of other OT’s who passed the exam. Just the positivity of reading this success story of yours makes me more confident to take the exam. Thanks again. 🙂

    • Sarah Stromsdorfer, OTR/L July 31, 2017   Reply →

      I’m glad the post was encouraging and I wish you the best of luck! Just remember to relax, don’t let the stress get to you and you’ll be fine 🙂

  • T Fields August 24, 2017   Reply →

    As a Graduate student nearing the end of my MSOT program, this article was rewarding, refreshing, and helped me to relax. With the start of my last FW approaching, I can see the light at the end of the tunnel and no more darkness and doubt that I CAN AND WILL PASS…….thanks to you!

  • sonja Lottie December 9, 2017   Reply →

    Hi. My name is Sonja Lottie. I’m here at the library now study out of the purple book. I pretty stress because my mind works that way. The problem I am having is sticking with a study plan. when I score low I feel that my plan is not working. I just can’t stick to my plan I keep changing. I really feel like I need some help. Thank you for your post, it did make me feel better. I know that I am capable!! ty again.

    • Sarah Stromsdorfer, OTR/L December 17, 2017   Reply →

      I’m glad the post helped! For some quick tips, you could try sticking to the same study plan to get into a routine, or try switching it up (as long as you stay on task 5 days a week!). Just keep at it daily and you should be fine! You’ve got this 🙂

  • Jean Hubbard March 17, 2018   Reply →

    It’s refreshing to hear others tips and methods when studying for the NBCOT exam, especially when these method allow you to succeed in passing. Kudos
    As a graduate preparing to take my exit exam, which appears more stressful then the test. Your advice and methods gives anyone seeking it, some good tips to organize their own study study plan.
    Thank you!!!

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