Should You Transition From COTA to OTR?
The Pros and Cons of Making The Leap

Are tou thinking about making the transition from COTA to OTR? You’re not alone!

One of the most common questions I see in OT Facebook Groups is something along the lines of:

Should I put in all the time and money to go to school to become an OTR if I am currently a COTA?

Seeing this so frequently, I wanted to compile common responses and things to think about for those of you who have this question on your mind.

Like with a lot of major life decisions, there are pros and cons to weigh.

The pros and cons in this post come from many online discussions from COTAs exploring the prospect, COTAs that have transitioned to OTRs, and from COTAS who have decided against it.


The Pro’s of Transitioning from COTA to OTR

+ An Increase in Pay

Based on the Bureau of Labor Statistics, Master’s level Occupational Therapists (OTR’s) earn an average of $80,150 per year, or $38.54 per hour based on the median salary. This number can of course be higher or lower based on your location. The national average for COTA’s is $58,340 per year, or $28.05 per hour.

+ An Increase in Job Opportunities

Many facilities such as hospitals, outpatient clinics, and schools are hiring less COTAs (or no COTAs at all). In some cities, it can be increasingly challenging to find a clinical job as a COTA, and many have stated this is the reason for going back to school to become an OTR.

+ Greater Autonomy and Independence

As an OTR, you are in control of your patient’s plan of care, treatment planning, discharge planning, etc. As a COTA, you are following the OTR’s treatment plan and may not have a lot of options based on the OTR’s goals for the patient.

+ You Will Be Furthering Your Education

This one may seem like a given, but many COTAs that have made the transition to OTR stated they felt like they really expanded their knowledge of OT by going through the Master’s program. If you’re passionate about healthcare and helping patient’s through therapy, you may find that your enthusiasm for the field is what motivates you to pursue the OTR degree.

+ You Can Go Into Teaching

Many OT schools will hire OTR’s with a Master’s or Doctorate to become educators. This advantage ties in to the fact that the OTR affords many people additional job opportunities that otherwise may not be available to COTAs.

The Con’s of Transitioning from COTA to OTR

While there are fewer con’s than there are pro’s, these big drawbacks are enough for many COTA’s to decide against going back to school to become an OTR.

– The Huge Expense

While OTR’s have a higher salary than COTA’s, the cost of getting a Master’s or Doctorate in OT (whether through Bridging or Traditional) is extremely expensive. Many COTA’s who only plan on working ten to twenty more years state they would never be able to pay the debt off by retirement.

– It Will Probably Take A Long Time To Break Even

Using the national averages for salary and the average cost of a weekend Master’s program, it will take a minimum of 7.5 years to pay off your OTR degree assuming all of your additional income goes to pay down your OTR degree.

Looking at this more closely, we took a top weekend Master’s program offered by Belmont University. The program consists of six semesters that cost $13,150 each, so the program in total will be $78,900.

The additional income you’d make using the difference between the national averages for COTA vs. OTR is $22,810 per year (or about $15,967 after taking out 30% for taxes). The table below illustrates how much will be added to your balance at the beginning of each year in interest and how much it will go down from paying off $15,967 per year.

Years After Graduating Beginning Balance  Add 8% Interest Pay Down $15,967
(nat’l avg. salary OTR vs. COTA)
1 $78,900 $85,212 $69,245
2 $69,245 $74,785 $58,818
3 $58,818 $63,523 $47,556
4 $47,556 $51,360 $35,393
5 $35,393 $38,225 $22,258
6 $22,258 $24,039 $8,072
7 $8,072 $8,717 $0

If you put all of the additional $15,967 of income towards paying off your student loans, it would take you at a bare minimum 7.5 years to pay off the OTR degree (including 8% annual interest over that time period).

Including the six semesters in the program (2 years), your total time investment to complete the program and pay it off is approximately 10 years.

That said, this example of the quickest timeline to pay off the average OTR degree with an average income will probably be unlikely. You are most likely wanting to earn more money to pay for regular living expenses and other things within the next 10 years. This calculation is mainly to illustrate the break-even point.

More typical student loan terms are anywhere from 10-20 years. Your monthly payments will be lower, but of course you’ll be paying more for the program over time in interest.

Note: this is a simplistic example to determine the break-even point and does not represent actual interest accumulation or an actual payoff schedule.

– Even Bridge Programs Have Some Drawbacks

If you’ve decided to take the plunge into becoming an OTR, you are likely aware of the several weekend “bridge” programs. But you can also choose to attend a traditional Master’s or OTD program if you already have a Bachelor’s degree. The cost breakdown for a bridge program and a traditional Master’s program may help with your decision.

Because there are only a few weekend bridge programs, traveling or moving closer to the location of the program is usually required. Many programs require at least monthly visits to the school, which can be challenging for those with families.

Additionally, just like traditional OTR programs, getting into a bridge program even with years of experience can be a challenge due to the high number of applicants.

– Finally…The BIG Increase in Paperwork

This is a huge reason why many COTAs decide that becoming an OTR is not for them. As an OTR, a lot more of your time every day will be spent doing paperwork; this means writing evaluations, progress notes, and discharges. While OTR’s still do treatments, it is typically less due the added paperwork.


In the end, you should do what’s right for your situation. Everyone’s personal circumstances may will vary. Both careers are great choices and there’s no clear-cut right or wrong answer.

I will say that I love being an OT and I am glad I finished my OTR degree. If you are passionate about working in occupational therapy I would say you should go for it, whether it’s as a COTA or OTR. If you’re unsure if occupational therapy is right for you and the economics are a primary concern, choosing between becoming a COTA or OTR may be a tougher decision requiring more careful thought.

If you’re already a COTA contemplating this decision, or have made the jump, I’d love to hear your thoughts in the comments below. What were your biggest deciding factors for or against becoming an OTR?

And if you’re looking for even more information on making the transition from COTA to OTR, be sure to listen to the accompanying podcast on this topic from Seniors Flourish here: Pros and Cons of Transitioning from COTA to OTR


Occupational Employment and Wages: Occupational Therapy Assistants (Bureau of Labor Statistics)

Occupational Therapist Salary Info (Bureau of Labor Statistics)


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  • I'Nico February 10, 2017   Reply →

    This was spot on! I chose to attend school again for all the pros except teaching. I am in my first year of my OT program. I agree, if an individual finds that this is a thought that continuously reappears then maybe they should consider. I am still VERY excited about being in the program and about finishing it. I personally have considered the cons but as it was stated they seem worth the hassle, in my opinion. Great blog post! Loved it!

  • Ann February 10, 2017   Reply →

    Funny, I just received my acceptance letter today! I have been a COTA for 9 years and I feel that there is so much more to learn about OT! I feel that each individual has to weigh their own pros and cons as each has their own situation and factors to consider. It does help if you already obtained your BA degree! Best of luck to all those making the transition. Your blog was right on the money as far as what to consider when making the plunge! 🙂

  • Jeanine July 27, 2018   Reply →

    I was a COTA for 12 years and went back for my OTR because I wanted to be the one to make the decisions. While in Graduate school, I had 3 children and worked full-time as a COTA, this was the hardest thing I have ever done. I am finding that the pay does not differ much from a high paid COTA (which I was) to an entry level OTR but an OTR has the opportunity to excel higher with time (this is in the civil service school based system). I have also taken advantage of PSLF (Public service loan forgiveness) which will pay approx. 2/3 of my student loans because I work in a low income school district. This is a major savings. I love the empowerment of being in charge of my lesson plans and the increased knowledge I have acquired during school. I have learned where to find ALL the answers and also when to admit I don’t have ALL the answers…but that I will try to find them. I love OT and the MANY friends and colleagues I have come to know over the years.

    • Sarah Stromsdorfer, OTR/L July 27, 2018   Reply →

      Thanks so much for your input on your experience, Jeanine!

  • Lisa August 19, 2018   Reply →

    I’m going into my third year of a bridge/transition program to obtain my Master’s degree. I live in a very rural area and I have found that the need for OTRs is much greater than the need for COTAs. We are saturated with assistants because we have many technical colleges that offer the OTA program. This was one large deciding factor for me. Another factor was that I found i was already practicing much of the clinical judgement and decision making that reflects an OTRs thought process. A third factor for me was that I didn’t like being limited. As a COTA I am limited in my scope of practice, where I could work and ultimately how I could serve my clients. As an OTR I feel I will have more say and limitless ability to help my clients.


    • Sarah Stromsdorfer, OTR/L August 19, 2018   Reply →

      Thanks so much for sharing, Lisa! I would agree that obtaining your OTR will really open up more opportunities for you and give you more freedom with decision-making and your practice. Best of luck with the rest of your program!

  • Rebekah December 3, 2018   Reply →

    I am contemplating going for my OTR degree through the bridge Program. Your Pros and Cons article was so helpful and so were the comments. I have been a COTA for 6 yrs and feel very limited in my scope of practice. My situation. Is very similar to Lisa’s (above comment) as far as so much more of a need for OTRs vs. COTAs. This is due to the saturation of technical schools in my area and the output of OTAs, there is less of a demand vs. supply. I want to also further my education as Occupational Therapy offers so many avenues as well as looking to get my Hippotherapy Certification too. Thank you as all the pros and Cons were right on!

    • Sarah Stromsdorfer, OTR/L December 4, 2018   Reply →

      Thanks, Rebekah! I’m so glad the article was helpful for you. I think you’ll definitely be satisfied with the increase in job opportunities once you get your OTR degree 🙂

  • Kat April 7, 2019   Reply →

    I have been a COTA for 18 years. This was a second career for me. I have a B.A. degree and an A.S. degree. Unfortunately I cannot afford cost of OTR program. I feel we do a lot as COTA’s but don’t get the respect. I do feel frustrated with this at times. I think a job title change would help but this has been voted down in the past and ufortuntely mainly by OTRs.

    • Brianna Valerie Valenzuela June 17, 2019   Reply →

      Hello my name is Brianna Im doing a project for one of my college classes and i need to interview an OTA if anyone is free please let me know .

      • Naj June 19, 2019   Reply →

        I am free if you are still interested.

        • Brianna valenzuela June 20, 2019   Reply →

          Thank you so much can I email you my questions? My email is [email protected]

        • Brianna Valerie Valenzuela June 21, 2019   Reply →

          i’ll just post them here
          What is a typical day like at your job?
          – What training/education do I need to get a job in this field?
          – What do you like most about your job?
          – What do you like least about your job?
          – what made you want to become a OTA?
          – any advice before i start studying to become a OTA?

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