Studying Occupational Therapy in Japan: Programs, Curriculum & the National Exam

By Hiroemon · Last updated: 2026-08-08

This page explains Japan’s OT education system for general understanding, based on the statute, the current ministerial ordinance and guideline, and official statistics listed in the references. It is not admissions or immigration advice, and requirements change — always confirm with the individual school and the relevant ministry before acting.

I’m a licensed occupational therapist in Japan. I studied at a four-year university program, did my clinical placements, sat the national exam, and have since supervised students on placement from the clinical side. So this page mixes two vantage points: the system as the statute and ministry documents define it, and what it feels like to move through it. More about me is on the about page. If your question is about practicing here with a foreign license rather than studying here, that is a different path entirely — see Working as an OT in Japan.

Two Routes, One License

Japanese law does not name school types. The Physical Therapists and Occupational Therapists Act says that to sit the OT national exam you must have completed three or more years of the required knowledge and skills at a school designated by the Minister of Education, Culture, Sports, Science and Technology (MEXT) or at an OT training facility designated by the prefectural governor. That single sentence produces the two routes students actually choose between:

• Four-year university programs, which award a bachelor’s degree alongside exam eligibility. This is the route I took.
• Three-year vocational programs (senmon gakkō (専門学校)), which reach the same exam a year sooner.

Both routes converge on identical exam eligibility and an identical license. There is no “assistant” tier in Japan and no distinction on the license between a three-year and a four-year graduate. What differs is the degree, the cost, and — in my observation — how much room the schedule leaves for anything beyond the required curriculum.

One point worth flagging for readers used to other systems: the Ministry of Health, Labour and Welfare (MHLW) does not designate these programs. MHLW administers the national exam and issues the license; the programs themselves are designated by MEXT or by prefectural governors.

How many schools, and where

JAOT’s 2025 directory lists 204 schools offering 210 courses, filterable by three-year or four-year course, day or evening study, and WFOT approval status. On the international side, WFOT’s Japan page lists 134 approved education programs as of July 2025. Those two numbers count different things and should not be equated: not every Japanese OT course holds WFOT approval, and approval status is tracked per course by different bodies on different dates.

The Curriculum Is Set Nationally — to the Unit

Japan does not leave curriculum design to individual schools. A ministerial ordinance sets the minimum content every OT program must deliver, and the current version — applied to students entering from April 2020 — raised the total from 93 to 101 units:

Minimums from the current ministerial ordinance; schools may exceed them.

Alongside the ordinance, the ministry’s guideline notice sets a floor of 3,150 hours of instruction for OT programs (the PT figure is 3,120). It is worth keeping the two documents apart: the units, the faculty requirements, and the practicum quality rules below are binding ordinance text, while the hour floor, the placement structure, and the supervisor requirements come from the guideline, which is formally technical advice to prefectures.

Clinical practicum: 22 units, tightly specified

Practicum is the largest single block in the curriculum, and the rules around it are unusually specific. At least two-thirds of practicum time must happen in medical service facilities, and at least half of that in hospitals or clinics. At least one unit must involve day rehabilitation or home-visit rehabilitation — a direct reflection of where the profession is heading, as I describe in the practice guide. Those rules sit in the ordinance itself. The guideline adds the structure — observation, assessment, and comprehensive practicum — and states that assessment and comprehensive placements are preferably clinical-participation style, with the student joining the care team under supervision.

The 2020 reform also professionalized the supervisor role: under the guideline, a clinical practicum supervisor must have at least five years of post-license practice and must have completed a designated supervisor training course. I have supervised students on placement myself, and the change in expectations is real — what used to rest on an individual clinician’s goodwill is now a defined role with a training requirement behind it. From where I stand, the practicum is still the part of Japanese OT education that varies most between sites, because the ordinance prescribes units, not the shape of the experience: how placements are sequenced across the years is left to each school.

The National Exam

The exam runs once a year — by statute at least annually, in practice every February, with results published in late March. The 61st exam was held on February 23, 2026, at eight sites across the country, and the results were published a month later:

The paper is split into general questions (one point each, 158 points) and jitchi mondai (実地問題) (three points each, 120 points). To pass you need 167 of 278 points overall and at least 43 of 120 on the case-based section — so a candidate strong on memorized facts but weak on clinical reasoning can fail on the second condition alone. Despite the name, there is no hands-on practical test for general candidates; oral and practical formats exist as accommodations for candidates with severe visual impairment.

A 91.2% pass rate looks generous next to licensing exams in some other countries, and it is worth understanding why. The filter sits earlier: only graduates (or expected graduates) of designated programs may sit the exam at all, schools prepare students for it intensively over the final year, and a school’s pass rate is a public recruitment metric. By the time you are in the exam hall, the system has already selected heavily. That was certainly how it felt to me sitting it — the exam was the visible endpoint of a year that had been organized around it.

On language, the ministry’s public notice does not contain a sentence stating the exam is in Japanese only. What the documents do show is that the notice, the application materials, and the exam subjects are published exclusively in Japanese, with no English version referenced anywhere — the same evidentiary situation I describe in more detail for foreign-trained applicants in the licensing guide.

Can You Study OT in Japan in English?

This is the question I get asked most by people abroad, and the honest answer has three layers — none of which is a simple yes.

• There was one, and it ended. Tokyo Metropolitan University’s graduate school ran an English-taught master’s program in occupational therapy under a Tokyo Metropolitan Government project for medical professionals from Asia. Twelve students from Thailand, Indonesia, Bangladesh, and the Philippines completed it. The university’s own site marks the project as ended in 2024.
• What exists now is an English-accessible door, not an English-taught degree. The Tokyo Global Partner Scholarship route includes occupational therapy at master’s and doctoral level for 2027 entry, with full tuition exemption and a monthly stipend. You can apply and be examined in English, and the language requirement can be met with English proficiency instead of Japanese. But the guidelines never say instruction is in English, and they ask applicants to be willing to reach everyday-conversation Japanese by graduation.
• Something is coming in 2028. The department announced in May 2026 that it will introduce a special selection for international students conducted in English, starting with 2028 entry, with guidelines due around July 2027. Whether “in English” describes the selection process or the program itself is not yet stated publicly.

My reading, as someone inside the system: entry-level OT education in Japan is built around Japanese-language clinical placement in Japanese healthcare settings, which makes a fully English-taught entry-level route hard to imagine in the near term. Graduate study is where the openings are, and they are opening slowly. If you are exploring this, write to the department directly rather than relying on any summary — including mine.

What It Costs

Tuition varies by sector more than by program length. At national universities the standard annual tuition set by ministerial ordinance is 535,800 yen with an admission fee of 282,000 yen — though institutions may set up to 1.2 times that standard. At private universities, the health-sciences category that contains OT programs averaged 996,030 yen in tuition plus 257,732 yen admission and 242,818 yen facilities fees for first-year students in the 2025 academic year — roughly 1.5 million yen for year one. That category also covers nursing, PT, and other health professions, so it is an indication rather than an OT-specific figure.

For vocational schools no national average is published, so I will not invent one; individual schools publish their own fee schedules. When I was choosing, the arithmetic that mattered was not tuition alone but the fourth year — a year of fees against a year of salary — and I would tell any prospective student to run that calculation honestly before choosing a route.

After Qualifying: Continuing Education

Licensure in Japan is not time-limited, and there is no mandatory renewal requirement for the OT license itself. Professional development runs instead through JAOT’s voluntary system, restructured in April 2025 into three tiers: Registered Occupational Therapist (a new foundational tier introduced in 2025), Certified Occupational Therapist (generalist), and Specialist Occupational Therapist (12 fields, including dementia, hand therapy, cancer, dysphagia, and driving and community mobility).

The scale tells you how selective these are. As of August 2026, 2,063 occupational therapists held certified status, and 180 specialist certifications were held (a cumulative count across the 12 fields — one therapist can hold more than one) — against 118,465 licensed OTs nationally. In other words, these credentials mark a small minority, and most Japanese OTs practice, as I do, on the entry-level license alone. Where the profession’s research and academic ladder runs from here is the subject of the research guide.

Frequently Asked Questions

Primary Sources & References

Claims on this page were checked against the sources below on 2026-08-08. Exam results, school counts, and fees change annually — verify against the current versions before relying on them.

• Physical Therapists and Occupational Therapists Act (e-Gov statute text) — exam eligibility, designating authorities, annual exam requirement
• Ordinance on Designation of PT/OT Schools and Training Facilities (e-Gov) — three-year minimum, 101 units, 22 practicum units, faculty requirements
• MHLW summary of the PT/OT curriculum reform and the ministry’s training-facility guideline — 3,150-hour floor, practicum structure and supervisor requirements
• MHLW results of the 61st national exams (2026) — candidate numbers, pass rates, and pass criteria
• JAOT directory of OT training schools (2025) and WFOT’s Japan page
• Tokyo Metropolitan University — announcement of an English-language special selection from 2028 entry and the university’s scholarship guidelines and project reports
• MEXT survey of first-year student fees at private universities (2025) and the ordinance on national university fees
• JAOT continuing-education system (2025 revision) and the association’s certification lists