Occupational Therapist Licensing: Quebec's Separate OEQ Route Versus SEAS Everywhere Else

Before we get to what this actually costs, understand what you’re paying for — because occupational therapist licensing Quebec OEQ splits Canada into two structurally different systems, and the stages you pay into aren’t the same on either side of that line.

Stage one, everywhere except Quebec: SEAS

Nine provinces and territories route internationally educated occupational therapists through the SEAS substantial equivalency assessment OT process. SEAS — the Substantial Equivalency Assessment System — is run by ACOTRO, the Association of Canadian Occupational Therapy Regulatory Organizations, and it compares your education and competencies against what a Canadian-educated OT would hold. This is the first real cost line in the process: a formal, structured assessment, not a quick document check.

Here’s the nuance that trips a lot of applicants up on cost planning: SEAS determines substantial equivalency, but it doesn’t by itself grant you permission to write the national exam. That authority sits with the provincial regulator — COTO in Ontario, ACOT in Alberta, CBRPT/COTBC in British Columbia, NBAOT in New Brunswick, NSOTR in Nova Scotia. In practical terms, this means budgeting for two separate administrative relationships, not one: SEAS assesses you, and your provincial regulator separately decides whether you can proceed to the exam.

Stage two, everywhere except Quebec: NOTCE

Once your provincial regulator has cleared you, the notce exam for foreign occupational therapists is the national hurdle: the National Occupational Therapy Certification Examination, administered by CAOT (the Canadian Association of Occupational Therapists). Pass NOTCE, complete provincial registration, and you’re licensed to practise.

Quebec: an entirely different cost structure

Quebec doesn’t run SEAS or NOTCE at all. Instead, you apply directly to OEQ — the Ordre des ergothérapeutes du Québec — and complete OEQ’s own review programme in place of the national SEAS-then-NOTCE sequence. For quebec ordre des ergotherapeutes foreign applicants, this means the entire assessment and bridging structure is provincial from the start, with its own timeline, its own review content, and — as with every Quebec-based process in this file — a French-language requirement layered on top.

What the honest cost breakdown actually looks like

This file doesn’t carry a published fee schedule for either SEAS, NOTCE, or the OEQ review programme, and rather than guess at numbers that change and vary by applicant circumstance, the honest answer is: get current fees directly from ACOTRO, your target provincial regulator, or OEQ before you budget. What can be said with confidence is the structure of the cost, which is two-stage everywhere but Quebec (assessment fee, then exam fee, then provincial registration fee) and single-stream in Quebec (OEQ review and registration, without SEAS or NOTCE ever entering the picture).

The decision this should drive

If you’re weighing Quebec against the rest of Canada for occupational therapy, don’t treat it as a lifestyle choice layered on top of an identical licensing process — it’s a genuinely separate system, and the two paths don’t share fees, timelines, or governing bodies. Decide on Quebec versus everywhere else as a licensing decision first, then let language, culture and job market considerations follow from there rather than the other way around.