I passed on my 4th attempt on May 4, 2018, after a 4-year study hiatus and 5 years of being out of school! The news brought tears of joy to myself and to many people in my life, including the director of my OT program. My struggles were in no way a reflection of my OT program, but just an outcome of a series of unfortunate events.

Only by the grace of God was I able to get this 5 year weight off my shoulders. The last 8 months have been full of obstacles and hardship- I had to put my dog down due to cancer, I lost job loss due to state budget cuts, I was getting out of an emotionally abusive relationship, my mother and father were going in and out of the hospital with my father passing away in January. I had lost all sources of income and was forced to move out of my house.  It was one obstacle after another.


What motivated me to try one last time was a nudge from God/ losing my job/ and discovering OT Miri! The encouragement that I received from OT Miri was just what I needed to change my mindset from “I will never pass, I failed 3 times before” to “I can conquer anything the exam throws at me!” Thanks to OT Miri, I had the will power to make one last attempt and her tips and tricks were so helpful. I have a learning disability and struggle with memorizing large amounts of information. I also struggle with “leaky brain syndrome.” In other words, after not utilizing information for 4 years, I had to relearn a lot over 8 months. If you qualify with a documented disability, and would benefit from testing accommodations, please do so. I would have never finished the exam without them. Also, the AOTA Exam Prep Facebook group has been such a valuable resource throughout my journey.

Resources I Used

After 4 years of not studying, I wanted to know where to start. So 8 months prior to the exam, I took a full Therapy Ed exam without doing any review. I received a score of 55, but the way I saw it, I got more questions right than wrong even after 4 years of not having reviewed anything. This perspective helped me to realize that I have not completely lost my OT mojo. For the next three attempts, I continued to use Therapy Ed because it was the only one I could afford at the time. However, on my fourth and final attempt, I stayed away from Therapy Ed. Instead, I utilized the AOTA Exam Prep and reviewed everything topic by topic using the PDFs. I will say that AOTA exam prep rationales were frustrating and inconsistent at times. But the volume of questions was helpful. I took practice questions on each topic areas and scored 60- 75 on the AOTA practice exam containing 170 questions.

In addition, I used my school notes, the Pedretti textbook, OT Miri and the Occupational Therapy Examination Review Guide by Caryn Johnson. The online exams for Johnson are very confusing, but the actual book is well written with good rationales and formatting that meshes well with the boards.  Finally, for pediatrics, I used the 45 days and Counting and also read chapters from the Occupational Therapy for Children textbook by Case Smith, which was really helpful to relearn what I had forgotten.

 School textbooks are the most under-used and under-valued suggestions for the NBCOT Exam.

Tip 1: Stick to Your Learning Style

We all have different learning styles so you have to do what works for you! What worked for me may not work for you. I took extensive notes on each topic because that is how I retain information. I am also an auditory learner, so I used Kirtzweil program for reading and OT Miri videos. I ended up making two 5-subject notebooks of notes. It is a lengthy process but we have to do what works with our learning style.

Tip 2: Pick a Testing Center Close to Your House

For the first 3 attempts, I had to drive 2 hours the night before the exam and sleep in a hotel room. Between test anxiety and inability to sleep in a bed that is not mine, I didn’t sleep more than 30 minutes to an hour for each of the previous 3 exams. For my 4th attempt, I was able to test in my town, 4 minutes from my house. This made the world of difference as I was able to spend the night before my exam in my house and had a much better nights sleep in my own bed.

Tip 3: Eat well

I am hypoglycemic, which has affected my performance in the past. I get time and half (Testing Accommodations) so it makes for a really long test without food/ water. Something I didn’t think about my first 3 attempts was altering my eating for the exam so I wasn’t seeing spots or feeling like I’m going to pass out halfway through the exam. On test day, I woke up early, ate breakfast, showered, ate “lunch” (protein and carbs). I also made a big high protein shake, which I had during my test break. This made it a lot better as I didn’t have the sugar crash which helped me to be able to focus.

Tip 4: Reinforce Positive Affirmations

To help with my negativity the morning of the exam, I watched the below video 3 times, in addition to previously watching it. It helped to change my thoughts before my 4th attempt.

Exam Day

Historically, I am one of those people who thinks everything is important and that has been a disadvantage because I tend to focus and overthink on all the distracting information and choose the wrong answer. But this time around, I read just the question statement first and foremost, then glanced at the answer choices. After that,  I looked further into the scenario if more information was needed. Sometimes I was able to answer the question just by focusing on the question statement and answer choices.

Side note: The highlight and strike out features turned out to be very useful for me. Strike out those wrong answers!

After the Exam

I came out of the exam feeling numb- like I expected to receive a big fat Fail! Over the past 5 years, I was so used to failing and not working in the profession that, I expected my 4th attempt to be just another confirmation that I didn’t have what it took. So I was rather shocked when I got my results May 4! So shocked that I almost passed out, literally. I kept staring at the score on my computer expecting the numbers to flip. But I passed with a 464! This is a 38 point increase from my third attempt in March 2014, when I received a score of 426.

If you are struggling, remember that you never know how close you are to your goal! As Miri says: “there is nothing you can’t conquer on this exam.” For me, it was a changed mindset and the way I studied and a lot of people praying for me. We made it through OT school, we can beat this one last test! Just remember, no one can take that degree from you. Many prayers and blessings to you on your journey! Thank you to those who have contributed to my success!!

“Disability (learning or physical) doesn’t determine how far we go in life; but it does dictate how and when we jump those hurdles.”

Jennifer Gardner, OTR