MISSOULA — Kim McKearnan grew up in Great Falls and dreamed of becoming an occupational therapist. But the program wasn’t offered in Montana, so she wound up leaving Big Sky Country for over 20 years to pursue her calling.
Now she’s back home as founding director of the new Occupational Therapy Doctorate Program at the University of Montana. It’s the first such program in state history offered at a public institution of higher learning.
The new OTD program was approved to become a candidate for accreditation in April. It started accepting applications this summer, and the first occupational therapy students will start at UM in fall semester 2025.
“We’re planning to have 25 students in our first cohort,” McKearnan said. “We are starting a bit smaller as we fine-tune our processes and curriculum. Our intention is to grow to have 35 to 40 spots in the coming years.”
Occupational therapy is a wide-ranging career field that helps patients of all ages overcome challenges completing everyday tasks or activities.
Occupational therapists often work with patients with cognitive, physical, developmental or psychosocial disabilities. They work in hospitals, clinics, schools, homes, assisted-living or long-term care facilities, and a variety of other settings such as community centers or shelters
“OTDs can work with premature babies all the way up to older adults recovering from a stroke,” McKearnan said. “We literally care for people from birth to death.”
Montana has a significant need for more OTDs. According to state data from 2022, 12 Montana counties had no licensed occupational therapists. Data from 2023 said seven OT positions at Montana schools had gone unfilled or faced severely limited candidate pools.
The 2022 Montana Post-Secondary Workforce Report suggests 33 additional occupational therapy graduates will be needed annually through 2030.
To help address this need, the state’s Behavioral Health System for Future Generations Commission supported a $3.2 million investment to launch public OTD and physician associate programs at UM. (The first PA students will start on campus in fall 2026.)
“There is just an incredible need for occupational therapy services in Montana right now,” McKearnan said. “We’ve heard here in Missoula and across the state of wait lists for kids of six months or longer because there aren’t enough therapists to go around. That’s a period of development that you can’t get back, so you need to be able to get in and get those interventions. If you can’t get services, you don’t get to make up time in that really critical period.”
According to U.S. News and World Report, occupational therapists earn about $93,000 on average nationally. UM’s clinical doctorate program will take three years to complete, with the first graduates hitting the job market in 2028. It’s a graduate program, so applicants need to have earned a bachelor’s degree.
The OTD program also requires select prerequisite courses such as human anatomy and physiology, abnormal psychology and medical terminology. UM has readied pre-OTD advising for undergraduates to prep for the graduate program.
Speaking from her office UM’s Skaggs Building, McKearnan seems to revel in the challenge of launching a new UM graduate offering from scratch. OTD will be part of UM’s College of Health — specifically its School of Speech, Language, Hearing and Occupational Sciences.
OTD currently has two employees: McKearnan and Janna Smith, an assistant professor who serves as the new unit’s academic fieldwork coordinator. They expect to hire two to three additional OTD faculty members before next fall.
Smith, who also was forced to leave the state for her occupational therapy training, said Montana now has some OTD offerings from private colleges. However, UM intends to offer a more competitive price and take advantage of being nested among a larger university’s established programs.
“We are very fortunate to be situated in the College of Health, where we can do a lot of interprofessional education and clinical experiences,” Smith said. “We have the advantage of working with physical therapy, speech-language pathology, athletic training, social work, psychology and pharmacy. Working with those other departments is already planned as part of our curriculum.”
She said the first two years of the OTD program are largely in the classroom with shorter clinical experiences. After that, Smith will help arrange six months of supervised clinical experiences for students and then they will participate in a capstone experience.
These final capstones are tailored to the individual and could include everything from working at a neonatal intensive care unit to research or an advocacy project.
Historically, one could become an occupational therapist with a bachelor’s degree, and many programs later upgraded that requirement to a master’s. Now the industry standard is a clinical doctorate.
McKearnan said UM already offers an online pathway for working OTs wishing to upgrade their current degree to a doctorate.
“In school districts, you often can earn a wage increase by obtaining additional education or higher degrees,” she said. “You also might want the doctorate if you want to work in academia.”
McKearnan said it’s a competitive process to earn a spot in the University’s first OT class, and the tentative deadline is Nov. 1 to apply for one of the coveted 25 spots. She’s heard again and again from students who have waited years for such an opportunity.
One of those is Jennifer Malotte, a 2020 UM graduate in health and human performance, who works at Desmet Public School in Missoula.
“I heard that starting a UM Occupational Therapy program might happen back in 2020, and I've been working since then to get everything as ready as possible to apply,” she said. “I had considered moving or going out of state but decided to stay in Missoula when I realized they were going to start a program here.”
Malotte said she feels a calling to the profession.
“I see many kids who would benefit from occupational therapy – there is a big need for this profession,” she said. “I’ve talked with OTs, and they tell me about their high caseloads. I’ve always wanted to pursue a fulfilling career where I get to help people. I believe occupational therapy can truly improve a person's quality of life, and I am looking forward to applying and hope it becomes my future career.”
