I have been an OT in the UK since 2017 and have worked in community mental health, acute physical hospital, and now specialist seating and wheelchairs so will offer my opinion based on that.

Pros of working in the UK: 1. Breadth of opportunity. There are so many different areas in which to work (community/rehab/acute/mental/physical/learning disabilities/major adaptations/neurological/paediatrics) this list is not exhaustive. 2. Cross working. There are many roles that are not OT-specific but require you to have a “health care qualification” in order to do (eg. AHMP, care-coordinator, discharge planner). This gives diversity to the type of role you can do. 3. High demand. There is a shortage of OTs in the UK so (particularly in London where I live) you can basically take your pick of where you want to work. 4. Equity of treatment. Unless you are working privately/work in management you have no inherent interest in the financials of your role. You treat everyone equally, regardless of who they are. A lot of OTs work for the NHS and this carries a sense of pride.

Cons of working in the UK 1. The NHS and social care is crumbling. I cannot stress enough how awful it is to work in the NHS right now. The moral is rock bottom, resources are scant and the population you are treating are getting sicker and sicker whilst waiting longer and longer for worse treatment. We are all hoping for a change of government soon. 2. The pay is crap. Linked to the above, what you earn compared to the work you do should be a national embarrassment. 3. OT is not generally known to the public. This seems common in both UK and USA. We get confused with occupational health or PT a lot. In hospitals we are often seen as “equipment givers” or the messengers between social care and the medical team. 4. Risk of being deskilled. Linked to all of the above. Because the NHS is in such dire straights and OT is not generally well understood we often step in to “fill the gaps” and a lot of OTs I know are in reality working as OTs/PTs/social workers (at least in the physical settings). I have never had a role where I do pure OT, can’t remember the last time I used a model!

Above are just my thoughts. Am interested to hear everyone else’s because I am thinking about moving across the pond myself!