Internationally qualified occupational therapists seeking employment in the United States must secure professional certification via the National Board for Certification in Occupational Therapy (NBCOT) through the Occupational Therapist International Eligibility Determination (OTIED) process prior to state-level licensure applications.
Success Rate
5–9 Months
$1,500 – $2,500 USD
Total Duration
Estimated Cost
Success Rate
Difficulty Level
Follow these steps to achieve your global medical career
Initiate an online application on the NBCOT portal and submit a granular curriculum matrix, official university transcripts, and specific syllabus descriptions.
Take and pass the TOEFL iBT with the explicit score requirements mandatory for occupational therapy certification (minimum total score of 89 with a Speaking score of 26).
Upon receiving an approved OTIED determination, apply for the national certification exam to receive your official Authorization to Test (ATT) notice.
Complete the 4-hour computer-based testing containing simulation scenarios and multiple-choice items evaluating evaluation, intervention planning, and clinical safety frameworks.
Apply directly to the local state regulatory board using your active NBCOT credentials, completing background fingerprints and localized jurisprudence testing rules.
Essential prerequisites for this pathway
Downloadable guides and references
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