Returning to OT School: Where Sleep is Optional, Sanity is Questionable, and Growth is Guaranteed
Disclaimer: If you’re considering returning to occupational therapy (OT) school after 20+ years in the field, your classmates are the same age as your children, and you recently squinted through the DMV vision test, proceed only if you’re okay with dreaming in APA citations and saying the word occupations more often than your own name.
Going back to OT school as a COTA isn’t just the “next step”—it’s a leap into a swirling vortex of purpose, panic, and personal growth. Some days, it feels like competing in a triathlon, only the swimming portion is through honey, using one arm, while clutching your thesis in the other. There are meltdowns—some quiet, some snack-fueled. But then there are moments of clarity: when a once-confusing theory clicks during fieldwork, or when a classmate says, “Thank you.” And then there's the patient who, without even knowing it, reminds you why this work matters, and why you matter in it.
Why Listen to Me?
I’ve spent more than 28 years as a Certified Occupational Therapy Assistant (COTA), working in burn care, brain injury, geriatrics, and early intervention, and with veterans at the Department of Veterans Affairs. I’ve mentored students, trained teams, and witnessed incredible recoveries. But coming back to school took a different kind of courage.
Running a treatment session is one thing; running on caffeine and hope through grad school deadlines is another. I’m a wife, mom, grandmother, veteran, and full-time student—which means I can cradle a grandbaby in one arm and finish a group presentation with the other. Graduate school, especially OT school, demands intellectual endurance and emotional resilience. You juggle countless roles and still show up, sometimes with a large coffee and dark undereye circles.
You’ll often study late at night, after working a 10-hour shift, cooking dinner, and preparing for the next day. Sleep becomes less of a necessity and more of a fond memory. You bargain with yourself: “Just one more discussion post,” or “I’ll rest after I finish making my study guide.” Suddenly, it’s 2:00 am and you’re calculating how many hours of sleep it takes to function like a semi-responsible adult.
But in that blur, something shifts. You find a quiet determination that says, “You can do this.” That blurry-eyed commitment teaches you just how far you're willing to go to become the therapist your future clients deserve.
The Imposter Syndrome
Yes, it’s real. It whispers that you’re too old, that you waited too long, or that you’re not cut out for this anymore. It creeps in when your grades fall short, or when your 22-year-old classmates breeze through assignments without breaking a sweat. But here’s the truth: Your experience is not a liability, it’s your superpower.
You don’t just know how to write an intervention plan—you’ve lived it.You’ve already helped people find meaning in their lives. Now, you’re learning to do it better, with more tools, deeper knowledge, and greater confidence.
There’s beauty in becoming a beginner again. In trading familiarity for growth. In realizing that what once felt routine was just the first layer of a much deeper calling. I’ve learned to see theory not as a means for the university to make more money through more classes, but as the bridge that supports real, person-centered care. Transformation doesn’t come easy, but it comes.Returning to school means humbling yourself. It means hearing things like, “You’re not quite there yet,” and staying open enough to grow. That’s hard to hear when you’ve done something a certain way for decades, but it’s also one of the most transformative parts of the journey.
Grad school pushes you to reexamine long-held assumptions and unlearn habits that no longer serve your clients. It’s not just academic—It’s personal. You start noticing how a client’s occupational identity influences their engagement, or how a home program might fail because it clashes with the person’s daily routines. Suddenly, evidence-based isn’t just a term you memorize, it’s a lens you live through. (For all of the new OT students, note how I used all of the Occupational Therapy Practice Framework [American Occupational Therapy Association, 2020] language…)
In undergrad, you can get by as a solo act. In grad school, your cohort becomes your lifeline. I could not have made it through without the steady encouragement of my classmates and the unwavering belief of my family and friends.
The Messy Truth
You’ll cry. You’ll question yourself. You’ll fantasize about dropping out and opening a food truck. But if you hang in there, you’ll grow. Not just into a more knowledgeable practitioner, but into a more reflective, resilient, and compassionate human being. One who no longer simply follows protocols, but who shapes them. For anyone considering this path, whether you’re just stepping into the profession or returning after years away, know this: Your voice matters. Your experience holds weight. And this profession needs what only you can bring.
To the version of me who was scared 3years ago, I’d say this: You belong here. You will find your people. And one day soon, you’ll turn that tassel and whisper, “I did it… and I didn’t even plagiarize.” Until then, celebrate the small wins. Trust your instincts more than your doubts. And when all else fails, take a nap, preferably after logging into Canvas.
Final Disclaimer
If you’re diving into OT school with a full life, a busy brain, and a calendar bursting at the seams, brace yourself. You’ll question your sanity, test your limits, and discover superpowers you didn’t know you had.
Growth is rarely comfortable, especially when you're being challenged intellectually and emotionally. You’ll be tired, but you'll push through. You’ll move beyond just learning theoretical concepts to applying them in real-life settings where they can make a difference in people’s lives. It's the transformation from student to practitioner:
Along the way, you won’t just gain classmates, you’ll assemble a league of purpose-driven heroes who feel like family. And if you're lucky, you’ll graduate not just with a degree, but with the kind of confidence that makes you say, “Let’s do this.” (Preferably after coffee.)
Reference
American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain & process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001
Sharon McRae, COTA/L, is a graduate OT student at Brenau University, where she served as President of Pi Theta Epsilon, Vice President of BOTSA, and class representative. With more than 28 years in the field and current work with veterans at the Charlie Norwood VA Medical Center, Sharon is a wife, mother, grandmother, veteran, and future OT. She believes in leading with empathy, learning with humility, and surviving grad school with coffee and a sense of humor.