You have already put in a lot of work learning the ins and outs of the occupational therapy field. At this point, there is just one more hurdle to overcome before you can practice as a licensed Occupational Therapist® (OTR®) or Occupational Therapy Assistant (COTA®)—passing the NBCOT® exam.

In 2023, 95% of OT students who took this exam passed, yet the first-time pass rate for new graduates was 74%. If you want to be included in that figure and are feeling apprehensive, you may be looking for organization and planning to help you prepare as much as possible. But it’s not always obvious where to start or what tools to use.

Some techniques may work better than others depending on your learning style, available time, and other factors. We’ll help you start by explaining how to maximize your chances of passing the NBCOT® exam and officially beginning your career as one of over 160,000 occupational therapy practitioners.

Formulate a Study Schedule

Some people may use the strategy of cramming or chunking their studying into several large blocks of time immediately before a test. This is especially common with college courses because juggling multiple classes and deadlines simultaneously can be challenging.

It may seem like this is the best approach for the NBCOT® exam, especially for those in the habit of handling exams this way. It can also appeal to people who want to get it over and done, but this rarely works out. You must allow adequate time to arm yourself with all the necessary tools to conquer this exam.

That is why developing a realistic, comprehensive study schedule that fits your daily life is beneficial. Your exam date should be determined by how much preparation you will need. While much of the information on this exam is not new, the volume of content is significantly greater than standard college exams, requiring more structured preparation.

Before creating your study schedule, take an assessment test to get feedback on your strengths and weaknesses. These results will help you formulate an effective study plan, reducing your overall study time and test anxiety.

Once you start studying, begin with the content you are least familiar with or feel the least confident in. Then, work toward your strongest areas as you get closer to your exam. This strategy helps reduce overwhelm, test anxiety, and overall study time.

A helpful breakdown:

• Spend 70% of your study time focusing on your challenge areas
• Spend 30% on your stronger areas
• Use assessment test results to guide your study priorities

Remember, you do not need to study every topic on the exam, especially if you already have a strong grasp of certain areas.

Break Down Your Study Material into Manageable Sections

Once you start reviewing the topics on the exam, you’ll notice that some subjects come more easily, while others take more effort to understand and retain.

Effective study tips:

• Study one topic at a time and master it before moving on
• If a topic feels slow, trust the process—pacing is key
• Plan for extra time on difficult subjects
• Prioritize efficiency over hours spent studying

Focusing on one or a few topics at a time helps reduce study fatigue and brain fog.

Take Advantage of Your Learning Style

Every student has a unique learning style. Some prefer a single study guide, while others need multi-modal resources such as videos, audio, and charts.

Match Your Study Style to Your Strengths:

• Kinesthetic learners → Study while moving (e.g., listen to recordings while walking)
• Auditory learners → Listen to recorded lectures or group tutoring sessions
• Visual learners → Use charts, videos, and color-coded notes

Other helpful study tools include:

• Noise-canceling headphones or focus playlists
• Timers for structured breaks
• Ergonomic accessories for comfort

Using materials that align with your learning style will make your study sessions more effective and boost exam-day confidence.

Prioritize Self-Care While Studying

It can be tempting to study non-stop, but self-care is just as important as study time.

Ways to incorporate self-care:

• Take one full rest day per week
• Schedule short breaks between study blocks
• Try light exercise, stretching, or short walks
• Engage in hobbies or relaxation techniques
• Spend time with friends or family to maintain balance

When you take care of yourself, you retain more information and stay motivated throughout your study plan.

Use Timed Exams to Assess Retention

Timed exams simulate real testing conditions, allowing you to assess:

• Material retention
• Stamina for the actual exam
• Time management skills

Best practices for practice exams:

• If following a 3-month study plan, take 3-5 practice exams (spaced 3-4 weeks apart)
• If following a 6-week study plan, take 1-2 practice exams
• Always review incorrect answers and learn the rationale for correct choices

A final timed exam about one week before test day can confirm your readiness.

Work with a Tutor to Master Difficult Topics

Even with a structured study plan, some topics are harder to grasp alone. A professional tutor can:

• Break down complex material
• Enhance critical thinking skills
• Help with test anxiety management
• Teach you how to choose between two correct-seeming answers
• Reduce overall study time
• Increase exam confidence