It took me a long time to decide to come onto a blog post to share my story. Yes, you read it right. It took me 11 times and just shy of 2 years to pass the NBCOT. I finally did it and I am an OTR.

I graduated in May 2016 with my Masters Degree in OT. I had a full time job lined up right out of college. I moved an hour away from my hometown, got an apartment, and began my full time job in a SNF 2 months after graduation on a temp license. I sat for the exam 3 months after graduation. I worked full time and studied for roughly 5-6 days a week, 4-6 hours a day. Mostly 6 hours on the weekends and 4 hours on week days, sometimes less. I felt confident that I would pass the exam on the first try. I came out of there feeling relieved. The worst part was waiting. Once the results came in, I was shocked. I couldn’t believe I failed the exam (score 427). I was embarrassed to tell my co workers, let alone my friends and family. They supported me and a month later I sat for it again. Soon after that, I found out I failed. I didn’t tell anyone. I thought, “how is this happening? What am I doing wrong?” I waited two months and tried again, thinking 3 times the charm, right? At this point, my friends or family didn’t know I was still attempting the exam.

I took the exam every 1-2 months for the first year of attempting. I didn’t know what to do. I figured if I kept trying, I would eventually pass. Not only was it emotionally, mentally, and financially exhausting, but I felt defeated. I applied to extend my temporary license. I couldn’t quit my job, I needed the money. After almost being turned down, my temporary license was renewed. At this point it was May 2017 and one year post graduation. I never spoke of the exam to anyone. I decided to take the summer off and started studying again in August 2017 since my temp license was good for another year and retook the exam for the 8th time in October. I thought having a few months off might help. This time, my score was only a 426. I felt helpless.

I took the exam in December of 2017 and again in March of 2018. In April, I looked into renewing my temporary license AGAIN. I was told it was only allowed to be renewed once. I couldn’t believe it. How was I supposed to tell my job that I had to quit and tell my friends and family that I didn’t pass this whole time. I only had 3 more attempts before my temp license expired. Which seemed like a lot, but when you failed it 10 times already, that felt like nothing. I studied every possible thing there was. I went away on a week vacation. In March, after failing for the 10th time, which seems silly but I couldn’t put my life on hold. I came back and had to really figure out what I was supposed to do. I started looking for other jobs, not OT related. I decided to take the exam on April 12th, about 1.5 weeks after my vacation. I went in with an open mind. I was so used to the process, I wasn’t nervous at all. On April 25th, the results would be in and I knew I failed. I failed 10 other times, what were the chances now? I checked the results online that night. I didn’t want my day to be ruined by looking during work.


I didn’t believe it. I logged back in and checked again for about 2 days, I was in shock. It took me 5 days to tell my job and to realize it was real. I never felt happier. Studying for 2 years and spending thousands of dollars that I had to keep saving, finally paid off.

Reflections and Insights

Now to go on to the studying tools. I used TherapyEd textbook, AOTA PDFS, random study material from college, and I would listen to Miri’s videos while driving to and from work. The first several tries, I would skim the TherapyEd textbook because it was boring. I would jot down key terms. I bought a big poster board and I made a list of stuff I wasn’t comfortable with and a list of stuff I knew pretty okay. Aside from studying the book, I took all 3 practice exams. I highly recommend studying the rationales. Even if you already saw the correct answer and know the answer, take time to look it up and study those topics and rationales. In the beginning, I would just skim. But after several failed attempts, I read this each word and wrote down key notes I felt were important. I went through so many notebooks. I just wrote and wrote and even studied what I wrote over and over again. It was very repetitive. I found the AOTA PDFS super helpful. I understood this information much more and felt it was easier.

11TH TIME AROUND. Like I just mentioned, I mostly just wrote stuff over and over. I was trying to memorize everything, which wasn’t good. I tried to change my study habits by understanding the question. I didn’t care about the answer. But I talked myself through the question and pulled out the key things:

  1. What setting?
  2. What phase are we in? Eval/assessment/intervention/discharge?
  3. Diagnosis…contraindications etc.

Once I had a better understanding of the questions, I felt a little more confident. The last week leading up the exam, I focused more on myself. I would skim my notes I had written. I wrote down key interventions for the “bigger diagnosis” (CP, SCI, TBI, mental health, etc). I listened to Ted talks and any kind of inspirational videos. I felt like I knew all of the information there was to ever know about this exam. I had to rediscover myself and bring my self-esteem back up. This was harder than sitting down and memorizing information. I kept telling myself, “I didn’t make it through 5 years of college for nothing.”


My advice for anyone during this process is not to get discouraged. Easier said than done, I know. But if you can’t pass the 1st or even the 5th time, it’s okay. It will happen. Don’t give up. Focus your energy and time on YOURSELF. It will happen.

Elizabeth Ryan, OTR/L