How I passed the NBCOT OTR exam (with a 520) after studying for 21 days

I am nearing the 1 month anniversary from the date that I opened up the student dashboard on NBCOT.org and saw the glorious screen featured above. After 4 days of absolute despair and uncertainty (I swore I failed), I received the news that I passed. Not only this, but I passed with a 520; a score I definitely did not anticipate receiving after so much self-doubt. 

So how did I manage to pass the NBCOT on the first try with a mere 21 days of studying under my belt? Below I outline the specific resources I used and my study strategy that led me to this accomplishment. 

NOTE: I do want to preface this by saying that my strategy may not work for everyone. Each person has their own specific study style and that is perfectly okay. However, I am writing this for those of you who tend to study better under pressure and to prove that passing with 3 weeks of focused studying IS possible. So here’s how I did it.

Resources I used:

-AOTA NBCOT Exam Prep 

-3 Therapy Ed Exams 

-OT Miri

-1 NBCOT 4 hour exam (don’t recommend)

-NBCOT Facebook Support Group 

AOTA Exam Prep

I would say that AOTA Exam prep was definitely the most valuable amongst all of the resources I used. My specific study method included spending 1 day with each PDF (sometimes 2 for the harder subjects) and taking a 40-50 question exam on that topic. If I received lower than a 65%, I would review the PDF and take another exam with 15 questions to solidify what I just studied. Towards the end of my studying, I was scoring between 65-80% on all subjects. As far as the CST portion goes, the only advice I can give you is… practice, practice, practice! I ended up studying over 30 CST scenarios which allowed me to gradually increase my scores on this section.

I want to stress that the MOST benefit from this source is reviewing the rationales when you answer a question wrong as well as when you answer correctly. Reviewing the rationales allows you to understand how the NBCOT wants you to think and clinically reason through each of the questions. It is hard to learn this through memorizing facts so reading through the rationales is the BEST way to form a general idea of how to answer the questions.

Therapy Ed (Exams)

Just as I finished up my last fieldwork, I remember opening up the Therapy Ed book to begin reading through the chapters. I believe I made it through half of the second chapter when I said to myself….this is impossible. This book has SO MUCH INFORMATION condensed into each chapter that retaining all of the specifics is incredibly difficult. (Unless of course you have eidetic memory like Spencer Reid from Criminal Minds AKA my boo!) Anyways, I ended up using the chapters in this book to find more information on specific topics instead of reading through the entire thing.

I find the real value in this resource in the PRACTICE EXAMS. Don’t be discouraged if you don’t score well on these exams (I personally scored between 67-72 on the 3 exams). This is TRULY one of the best resources out there as it contains 3 practice tests that simulate the real exam; you are allotted 4 hours to complete both the CST portion and the 170 multiple choice questions. After completing the exams, you can use the back of your Therapy Ed book to go through EACH and EVERY question, highlighting the rationales and understanding why you answered correctly/incorrectly.

OT Miri

OT Miri is my go-to girl! She is an absolute angel from heaven that was put on this earth to help us new grads pass the NBCOT. She has numerous Youtube videos that showcase her bubbly personality and her amazing ability to make information that you ‘NEED TO KNOW’ stick. I am still able to picture her SCI and pediatrics videos vividly as they were unbelievably helpful when taking the exam.

I recommend watching her videos towards the end of your study session when you are beginning to feel tired of reading and taking practice exams. She is literally a breath of fresh air and she has an uncanny ability to keep your interest with her entertaining life stories and examples.

NBCOT Practice Test (ugh)

I personally wish I didn’t pay the 40 dollars to take this practice test. Why? The test does not provide you with rationales as to why you scored the way you did. What the test DOES provide you with is a score exactly like the score you will receive after the NBCOT. 3 days before my exam, I took this practice test and scored a 440. I DIDN’T PASS. I remember that horrible ‘sinking’ feeling when I saw that number on the screen after feeling so exhausted with 3 long weeks of studying.

Thankfully, I did not listen to the little nervous voice in my head telling me to reschedule my exam because “I wasn’t ready”. I ended up feeling confident that I worked my A$$ off these past 3 weeks and I was going to sit for that exam, like it or not. I wasn’t going to let a 440 on a practice test stop me from doing my best on the real thing. And as you see, I ended up passing with 80 points to spare. So listen to your gut guys; if you feel you did everything you could to study and you feel confident in your clinical reasoning skills, TAKE IT. You got this. (That was my mantra) 

NBCOT Facebook Support Group

Last but not least…. this amazing support group! If you aren’t already, follow the NBCOT Facebook support group to share ideas, resources, and words of encouragement (my favorite) to other OT peers in the same boat as you. I can’t even begin to explain how useful this was as I was able to learn from others who have conquered this NBCOT beast before me. Members have posted SUPER VALUABLE information under the “Files” tab; specifically the Contraindications/Safety PDF and Splints PDF are my favorite!

One word of caution though: If you are a first-time test taker like I was, there will be stories that pop-up of individuals that have taken the OTR and COTA exam multiple times without passing. This test is not easy and these stories are a testament to that.

However, don’t let this discourage you from taking the test if you truly feel ready. Instead of feeling discouraged or fearful of the exam after reading these posts, think about the strength and resilience these members have to continue to work hard towards their goal! I drew inspiration from these members, finding my own confidence and resilience to sit for the exam after 3 weeks of studying. And can I just say… it is absolutely BEAUTIFUL to witness the magnitude of love and support given to these members from the OT community. The OT world is full of empathetic and compassionate people willing to help others in any and all forms. #GoOT

What my schedule looked like

Week 1 & 2: Study 1-2 PDFs per day and take 40-50 question exam on that specific subject on AOTA Exam Prep. STUDY RATIONALES!!

Once I was tired from studying and practice questions, I would relax for 1-2 hours and watch OT Miri before winding down for bed.

***During week 1 and 2, I would study Monday-Friday for 8-10 hours each day. On the weekends, I studied for maybe 1-2 hours max. The rest of the time on weekends was dedicated to getting out of my house and doing something fun for a much needed mental health break.

Week 3: I took 3 Therapy Ed Practice exams (simulated like the real thing to build my testing stamina) and 1 NBCOT Practice exam (that I regret). After each Therapy Ed exam, I took a 2 hour break to eat, relax, watch TV or workout. Then I would study the rationales using the Therapy Ed book. Before bed, I would always watch 1-2 OT Miri Videos.

***I will admit that some anxiety kicked in during my last week of studying and there was NO occupational balance. I studied every day up until the day before my exam where I finally took a day off.

4 Last Minute Tips

–Trust Your Gut! I remember reading somewhere that UNLESS you have one of those lightbulb Aha! moments, you should not change your answer on the exam. I followed this virtuously during this exam and I am certainly glad I did.

–Manage your Time. For this exam (at least in my experience), time management is key! Take practice exams in a simulated test environment and try not to drink too many fluids before the test. Due to the security practices in most testing centers today, a bathroom break can easily take up to 5-10 minutes even if you are sprinting from door to door. If you MUST use the restroom, try going during the 7-minute tutorial before the beginning of the multiple choice exam. Watch the tutorial the night before the exam so you are familiar with the information. I recommend spending no more than 35-40 minutes on the CST portion and stick to the 1 minute per multiple choice question rule.

–Deconstruct the Question. OT Miri has a great video on this test-taking strategy. Ask yourself, what is this question really asking me?  Luckily, the NBCOT has a handy highlighting and strikeout tool that helps you really identify the focus of the question. This makes eliminating answer choices MUCH easier and thus increasing your chances of selecting the correct answer.

–Think Client-Centered, Occupation-Based, & Safety ALWAYS. This is the golden rule. If the answer option is NOT safe, immediately strike it out. The best option is usually the one that is client-centered, occupation-based, and safe!

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And that’s a wrap! I hope that you or someone you know find this useful and if anything, feel a little more confident about taking on the NBCOT! Remember, You got this! 

If you found this resource useful, PLEASE consider donating a small amount (even just $1 is appreciated) using the button below to help fund my work in mentorship, diversity, equity, and inclusion within the OT community and healthcare.

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