Choosing the first job: Insights from new graduate occupational therapists from a regional Australian university

Abstract

Introduction

There is an increase in the number of graduates entering the occupational therapy workforce with graduates having to navigate both broader systemic influences and personal preferences in their decision‐making process. This study investigated how and why occupational therapy graduates from a regional Australian university selected their first job as practising occupational therapists.

Methods

An online exploratory, cross‐sectional survey design was utilised to collect quantitative and qualitative data from new graduate occupational therapists. Descriptive statistics were used to analyse quantitative responses. Free‐text responses were interpreted using reflexive thematic analysis.

Consumer and Community Involvement

There was no consumer or community involvement.

Results

A total of 30 new graduate occupational therapists completed the survey. The most commonly reported practice areas of work were disability, health and aged care. The most commonly reported practice settings were community, clinic and hospital. Participants rated work–life balance, professional development opportunities and interpersonal relationships as the most important factors that are considered when seeking their first job. Proactive and multifaceted processes, combining practical job‐seeking strategies, reflective decision‐making and the use of professional networks, were used to navigate the employment process.

Conclusions

Job selection was influenced more by relational, developmental and lifestyle workplace factors than by specific practice settings. Understanding these factors is important for informing occupational therapy education and recruitment strategies.

PLAIN LANGUAGE SUMMARY

This study looked at new occupational therapists' (graduates) experiences around choosing their first job. Thirty graduates completed a survey. The most common areas to work in were disability, health and aged care. The most common settings to work in were community, clinic and hospital. The study found that lifestyle, opportunities to gain new skills and knowledge and relationships with other workers were most important to graduates when choosing a job. To decide on their first job graduates used a variety of job seeking strategies, thought about their decision and had assistance from other people.

Key Points for Occupational Therapy.

• First job is influenced more by relational, developmental and lifestyle workplace factors than by practice setting.

• Graduates combine practical job‐seeking strategies, reflective decision‐making and utilisation of professional networks to navigate the employment process.

• Understanding graduates' job choice can inform occupational therapy education and recruitment strategies.

1. BACKGROUND

The occupational therapy profession is characterised by a diverse range of practice areas offering graduates a broad array of employment opportunities (Crowe & Mackenzie, 2002). In the Australian context, occupational therapy workforce distribution and employment opportunities are influenced by service demand, funding structures such as the National Disability Insurance Scheme (NDIS) and geographic disparities between metropolitan, regional, rural and remote areas (Australian Institute of Health and Welfare, 2024). These factors contribute to a dynamic employment landscape in which graduates must navigate both broader systemic influences and personal preferences when selecting their first role (Yisma et al., 2023). Career decision‐making encompasses more than choosing a job, which is one element of career decision‐making along with choosing a field of study, moving jobs and retirement (Gati & Kulcsar, 2021). Career decision‐making is a process involving compiling, analysing and comparing information to then choose the best option (Gati & Kulcsar, 2021).

In 2021, the most common settings for Australian occupational therapists to work in were private practice (including group and solo) (25.7%), hospital (including outpatient and rehabilitation/physical development service) (22.8%), community health‐care services (11.1%) and disability service (10.1%) (Occupational Therapy Australia, 2023). The most common practice areas for occupational therapists in 2021 were paediatrics (21.3%), disability (15%), aged care (13.4%) and rehabilitation (12.8%) (Occupational Therapy Australia, 2023). However, the growth of practice areas has changed over recent years (from 2013 to 2023) with increased growth in disability services (9%) and paediatrics (6%) and decreases within rehabilitation (−6%) and aged care (−1.3%) (Occupational Therapy Australia, 2023). This distribution of and changes in the occupational therapy workforce need, particularly related to settings and practice areas, has the potential to influence employment opportunities and subsequently job selection for graduating occupational therapists.

In Australia, occupational therapists must be registered with the Occupational Therapy Board of Australia through the Australian Health Practitioner Regulation Agency (AHPRA) to practice as an occupational therapist (AHPRA and National Boards, 2025). In 2024/2025, there were 2273 first time domestic registrants (including new graduates) (AHPRA and National Boards, 2025), which is an increase from 2074 in 2023/2024 (AHPRA and National Boards, 2024). This is in line with an increase in the number of graduating occupational therapists from 1474 graduates in 2015 to 1919 graduates in 2019 with new occupational therapists entering the profession exceeding those exiting the occupational therapy workforce (Occupational Therapy Australia, 2023). This increase in graduates and numbers within the occupational therapy workforce may further influence the availability of occupational therapy positions for new graduates and subsequently the career decision‐making process and ultimately graduate first choice of job.

Although setting, practice area and position availability are important systemic influences on new graduate positions, personal preferences also have the potential to influence new graduates in their job decision‐making process. Student experiences within occupational therapy practice have been explored across a range of contexts. Previous research has examined factors influencing the decision to pursue occupational therapy as a career (Boehm et al., 2017; Craik et al., 2001), as well as determinants of practice area preferences among students (Lewicki et al., 1999). The role of practice education in shaping practice preference has also been widely investigated (Crowe & Mackenzie, 2002; Keller & Wilson, 2011). Recently, Schlatter et al. (2025) explored the employment preferences (work settings and practice areas) of final year occupational therapy and speech pathology students across Australia, as well as the factors influencing these preferences. Findings indicated that occupational therapy students most commonly preferred community, hospital and private practice settings with team dynamics, supervision and support and work–life balance identified as the most influential factors affecting employment preferences (Schlatter et al., 2025).

Research has also explored new graduate occupational therapists' experiences of entering professional practice. Dymmott et al. (2022) conducted a systematic literature review exploring the experiences of early career allied health professionals' (including occupational therapists) and doctors working in rural, regional and remote areas in high‐income countries. The review found that experiences varied due to professional and organisational factors (e.g., supervision, workplace culture); rural areas provided unique and rewarding opportunities (e.g., high levels of autonomy, broad clinical opportunities); and personal and community factors played an important role in working in rural areas (Dymmott et al., 2022). Similarly, in Sweden, Sjoberg and Lexen (2024) explored new graduate occupational therapists' experiences of transitioning from student to clinician. New graduates frequently reported feeling underprepared for professional practice and unready to assume the responsibilities of being a licensed occupational therapist (Sjoberg & Lexen, 2024). As a result, many described learning on the job while often simultaneously navigating major life transitions such as relocation, which contributed to feelings of instability (Sjoberg & Lexen, 2024). Within the Australian context, Miles et al. (2026) explored work readiness among new graduate occupational therapists who had completed their final placement in a rural or remote community. All participants commenced employment in a metropolitan area, with two participants having relocated to a different city for employment, with the rural placement experience being attributed to providing them with the confidence to move. The findings suggested that aspects of work readiness change over time, that relationship building was central to work readiness development and that the ability to work autonomously is a key component of work readiness (Miles et al., 2026).

Despite growing literature exploring the experiences of new graduate occupational therapists, little research has examined selection of their first occupational therapy position. A recent study in Canada explored intrinsic factors (‘personal needs coming from within the individual that relates to growth and self‐actualisation’), extrinsic factors (‘come from outside the individual and are related to the conditions surrounding the job’) and practice education experiences that influenced new graduate occupational therapists' employment decisions (Lui et al., 2025, p. 2). Lui et al. (2025) identified factors influencing choice of first job, including work–life balance, mentorship opportunities and the variety and number of placement experiences. Within the Australian context, Fay and Adamson (2017) surveyed new graduate occupational therapists from a university in Geelong, Victoria, to examine where, when and how quickly they obtained employment. Fay and Adamson (2017) noted ‘the university and occupational therapy course have a background of representing regional and rural areas, with a large number of students coming from across the state and interstate’ (p. 472). The most common employment settings were hospitals (29.5%) and group private (23%), whereas the frequently reported practice areas were paediatrics (18%), rehabilitation (14.8%) and occupational health (14.8%) (Fay & Adamson, 2017). Participants reported that the primary reasons for accepting their first position were an interest in the practice area (78%), the location of the position (48.3%) and because they ‘needed a job’ (46.7%) (Fay & Adamson, 2017). 38.3% of participants' employment was within 50 km of their pre university postcode (Fay & Adamson, 2017). Devine (2006) also explored the perspectives of occupational therapists who graduated from a regional university (James Cook University [JCU]) and were employed in a rural or remote locations. Participants were practising in rural Queensland or Victoria, although it was not clear how long‐ago participants had graduated and whether this was their first job (Devine, 2006). The findings suggested that the decisions to work in rural areas were influenced more by characteristics of the position itself, such as opportunities to work within multidisciplinary teams, practise in a preferred area and assume greater responsibility and autonomy, than by the geographical location or a specific desire to work in a rural community (Devine, 2006).

Although some research has explored new graduates' decisions regarding their first occupational therapy position, there remains a paucity of contemporary literature exploring graduates' experiences in the job decision‐making process in a regional context. Therefore, this study aims to investigate how and why occupational therapy graduates from JCU, located in Townsville, Queensland, Australia, select their first job as practising occupational therapists. JCU is a regional university with a focus on issues in the tropics. The occupational therapy course has a focus on preparing graduates to work in rural, regional and remote areas particularly in Northern Australia. Specifically, the research questions are as follows:

1. What factors influence occupational therapy graduates when selecting their first job as an occupational therapist?

2. How do occupational therapy graduates obtain their first job as an occupational therapist?

2. METHOD

2.1. Study design

An online exploratory, cross‐sectional survey design was employed to collect quantitative and qualitative data from new graduate occupational therapists. Ethical approval was obtained through the James Cook University Human Research Ethics Committee (25H‐0217).

2.2. Positionality statement

Researchers were four occupational therapy academics from JCU where participants completed their occupational therapy degree. Two of the researchers are themselves graduates of JCU, and one researcher is the practice education coordinator.

2.3. Participants

Purposive sampling methods using specific, predetermined criteria provided a finite number of potential participants (n = 155). The inclusion criteria were participants who (1) graduated from JCU Bachelor of Occupational Therapy (honours) degree within the last 3 years (between 2022 and 2024); (2) are registered as an occupational therapist in Australia; and (3) commenced their first job as an occupational therapist in Australia.

2.4. Data collection

An online survey was developed, informed by Lui et al. (2025), and the research team's expertise and experience. The survey consisted of demographic questions (graduation year, age, gender), details of commencement of first job (month/year, location/setting, employment status) and first job main practice area details. The survey also explored whether finding employment was a priority, if the first job selected was the preferred choice of job, if graduates accepted the first job offered and whether they were still working in their first job. The survey contained 17 intrinsic and extrinsic employment related factors, of which participants were asked to rate their importance in decision‐making when seeking employment, using a 5‐point Likert scale from 1 (not important) to 5 (very important). Questions were also included in the survey to explore how participants searched for their first job, prepared for the job application process and advice or guidance received in selection of their first job.

The survey was piloted with one academic staff member who was a JCU graduate but did not meet the post‐graduation inclusion criteria. Minor revisions were made following the pilot prior to deployment on the Qualtrics platform (Qualtrics, n.d.). Recruitment occurred between July and September 2025. The survey was distributed via JCU occupational therapy Facebook pages and through JCU student email addresses to eligible graduates who met the inclusion criteria. The beginning of the survey contained the information sheet and obtained informed consent from participants.

2.5. Data analysis

Survey data were imported into Statistical Package for the Social Sciences (SPSS) Statistics (V.31) (IBM, 2025) and analysed using descriptive statistics by L. M. Descriptive statistics were used to summarise participant demographics and survey responses. Categorical variables were reported as frequencies and percentages. Responses to Likert‐scale items were analysed using frequencies, percentages, means and standard deviations to identify the relative importance of factors influencing graduates' first employment choices. Free‐text responses were interpreted using reflexive thematic analysis whereby multiple researchers (L. M., J. E. and K. S.) were involved to ensure trustworthiness and reduce individual bias (Braun & Clarke, 2006, 2021) when identifying common patterns in new graduate occupational therapists' experiences around (1) preparing for the job application process and (2) advice or guidance received in selection of the first job. For each topic, the analysis involved L. M., J. E. and K. S. independently reading through qualitative responses to familiarise themselves with the data. J. E. and K. S. independently generated initial codes and then met to further refine the codes and construct initial themes. J. E., K. S. and L. M. continued to review and refine these themes through iterative discussion, ensuring they accurately reflected the underlying codes before defining and naming the finalised themes. Themes were then presented with supporting data extracts and interpreted in relation to the research question.

3. RESULTS

3.1. Participants

Thirty complete surveys were included in this study with a response rate of 19.4%. An additional 10 responses were excluded due to insufficient completion, with only 5%–10% of data recorded. An overview of the sample is presented in Table 1. Most participants were aged under 25 years and identified as female. Responses were relatively evenly distributed across 2022, 2023 and 2024 graduation cohorts. The majority of participants (80%) reported that securing employment upon graduation was a priority, and 86.7% obtained employment within 3 months of graduating. Just over half of participants (57%) were still employed within their first occupational therapy job with a mixed response between years of graduation: 56% of graduates from 2022, 20% of graduates from 2023 and 91% of graduates from 2024 were still employed within their first occupational therapy job.

TABLE 1.

Characteristics of participants.

Characteristics	n	%
Age, years
≤25	19	63.3
26–35	8	26.7
≥36	3	10
Gender
Male	5	16.7
Female	25	83.3
Year of graduation
2022	9	30
2023	10	33.3
2024	11	36.7
Was finding employment a priority upon graduation?
Yes	24	80
No	6	20
Time needed to find employment upon graduation, months
<1	17	56.7
2–3	9	30
3–4	2	6.7
>4	2	6.7

3.2. Characteristics of first employment

Table 2 describes the characteristics of participants' first job. Most participants commenced employment in a full‐time, permanent capacity (63.3%), whereas 30% commenced work either full‐time or part‐time in temporary/contract roles. Townsville was the most common employment location for first employment (63.3%) followed by Brisbane (10%) and then regional cities in North Queensland, including Cairns (6.7%) and Mackay (3.5%).

TABLE 2.

Characteristics of participant's first job.

Characteristics	n	%
Employment status
Full‐time, permanent	19	63.3
Part‐time, permanent	2	6.7
Temporary/contract (full‐time or part time)	9	30
Employment location
Townsville	19	63.3
Brisbane	3	10
Cairns	2	6.7
Mackay	1	3.3
Gold Coast	1	3.3
Port Macquarie	1	3.3
Rockhampton	1	3.3
Sunshine Coast	1	3.3
Toowoomba	1	3.3
Area of practice (sector)
Aged care	7	23.3
Disability	16	53.3
Health	14	46.7
Education (schools)	3	10
Civic services (local government)	1	3.3
Other	6	20
Area of practice (location)
Hospital	6	20
Community	17	56.7
Residential aged care facility	1	3.3
Workplace	3	10
Clinic	7	23.3
School	4	13.3
Telehealth	4	13.3
Other	1	3.3
Age of life stage
Working with infants	2	6.7
Working with children	12	40
Working with adolescents	18	60
Working with adults	23	76.7
Working with older people	12	40
Population served
Aboriginal and Torres Strait Islander	21	70
Culturally and linguistically diverse	15	50
Metropolitan or regional	22	73.3
Rural	11	36.7
Remote	7	23.3
Refugee and asylum seeker	3	10
LCBTQIA	10	33.3

Note: Participants were allowed to select all that apply or multiple responses.

Participants reported a wide variety of practice areas with the most common being disability (53.3%), health (46.7%) and aged care (23.3%), respectively. The most commonly reported practice setting was in the community (56.7%), followed by clinic (23.3%) and hospital (20%). Participants also reported working with clients across all stages of life from infancy through to older persons, serving varied populations, including persons from metropolitan or regional areas (73.3%), First Nation peoples (70%) and culturally and linguistically diverse populations (50%).

3.3. Factors influencing employment decisions

Participants rated the importance of 17 intrinsic and extrinsic employment‐related factors in their decision‐making when seeking employment. The results are presented in Table 3. Participants rated lifestyle/work–life balance (M = 4.33, SD = 0.79), professional development opportunities (M = 4.33, SD = 0.75) and interpersonal relationships (colleagues, manager, etc.) (M = 4.27, SD = 0.85) as most important when seeking their first job.

TABLE 3.

Factors influencing employment decisions.

Factors	First employment
	M	SD
Close to family/friends	3.73	1.06
Student placement experiences	3.47	0.99
Lifestyle/work–life balance	4.33	0.79
Practice area sector	3.77	0.84
Practice location (setting)	3.67	0.91
Practice area age of life stage	3.47	0.99
Practice area population	2.60	1.23
Practice area health condition	2.87	1.15
Town/city	4.00	1.13
Income/salary	3.23	1.02
Professional development opportunities	4.33	0.75
Job advancement (career growth)	3.80	1.05
Job security	3.97	0.98
Reputation of facility	4.07	0.77
Job autonomy/flexibility	4.03	0.75
Additional benefits offered by the employer	3.53	0.96
Interpersonal relationships (colleagues, manager, etc.)	4.27	0.85

3.4. Preparing for the job application process

Participants described a range of strategies used for the job application process. These included preparing tailored resumes and cover letters specific to the roles for which they were applying. Networking was also a prominent approach, with some participants securing employment through student placement experiences: ‘I was offered a Job through my 4th year uni placement: so discussed job readiness activities directly with my supervisor. I completed an interview with two managers prior to commencing my role as an OT Assistant, before transitioning to an OT/Rehab consultant role’. Additionally, innovative strategies were reported, such as developing a personal website and QR code to promote themselves to potential employers at professional events: ‘I made my own website which I then downloaded a QR code for and used this at the OT AUS CONFERENCE … That immediately put me ahead, as I interviewed with two of the businesses showcased at the conference who remembered me (6+ months later)’.

A key approach involved developing an understanding of both self and workplace expectations. This included reflecting on personal skills and areas for development, reviewing selection criteria carefully, researching potential employers and engaging in work shadowing opportunities: ‘A lot of self reflection, what type of OT (at that stage of my life) did I want to be, reflecting on skills, what I want to learn!’

Participants also reported drawing on multiple sources of support. University‐based resources, including course content and career services, were utilised: ‘Sought guidance from University employment services e.g. resume check, interview preparation guidance’. In addition, participants sought input from others, including current employees, known therapists, peers, supervisors, contacts listed in job advertisements, other graduates within the workplace and family and friends: ‘I worked as an allied health assistant, so asked my colleagues at the time for advice’. These interactions were used to gain insight into application processes and interview expectations.

Practical preparation strategies were also identified. These included relocating to preferred employment locations, completing professional registration requirements (e.g., APHRA), and interview preparation. One participant reported attending an interview as a means of gaining interview experience: ‘Went for an interview in a place I never intended working just to have a practice run at interview’.

3.5. Advice or guidance in selecting first job

Participants reported seeking advice and guidance from a range of sources when selecting their first job. These included family, friends, university staff, previous placement practice educators and current or former employees of prospective workplaces.

The advice sought commonly related to workplace characteristics, including organisational culture, structure, workload, supervision and professional development opportunities: ‘I spoke to current employees of my workplace about the workplace culture, supervision etc to confirm it is a place I wanted to work’. Participants also accessed general guidance through university career and employability services.

Advice received varied in focus. Some participants were encouraged to prioritise lifestyle considerations, such as choosing a preferred location, and to view initial employment as an opportunity to gain experience and refine career interests over time: ‘Try something 'cause you can always adjust later’. In contrast, others were advised to be selective and wait for a role that aligned closely with their professional and personal preferences: ‘Be picky and wait for the right role with everything you want’. This included ensuring alignment with workplace culture, support structures, and opportunities for work–life balance, supervision and professional development. Additional advice related to the application process itself, including tailoring resumes to specific roles, using appropriate language aligned with job requirements and demonstrating authenticity and clear communication during applications and interviews: ‘Make sure my resume aligned with the language used in the job ads’.

4. DISCUSSION

4.1. Job‐seeking and preparation

The findings of this study indicate that new graduate occupational therapists, from a regional university, engaged in a proactive and multifaceted approach when seeking their first professional role. Participants described navigating a dual process that combined practical, action‐oriented strategies with reflective and analytical decision‐making. Within the Australian context, these behaviours can be understood in relation to a complex and evolving workforce landscape. Variation in employment opportunities is influenced by service demand, funding models such as the NDIS and disparities across geographic contexts (Australian Institute of Health and Welfare, 2024). As a result, graduates appear to adopt strategic approaches, including relocation and networking, to navigate this dynamic environment and optimise access to their preferred employment.

Beyond these practical actions, reflective processes were central to participants' decision‐making. Graduates emphasised the importance of understanding their own strengths, professional interests and learning goals, as well as critically evaluating potential workplaces. This aligns with findings by Hicklenton et al. (2021) who highlighted the role of personal values in shaping job seeker preferences. These findings suggest that employment decisions are not solely driven by external opportunities but are also influenced by alignment between individual values and workplace characteristics.

The role of social capital was also evident, with participants drawing on both personal and professional networks throughout the job‐seeking process. These networks, including peers, clinicians, practice educators and university staff, provided both practical advice and access to opportunities. Consistent with Jacobs et al. (2019), networking behaviours can be understood as a proactive strategy for accessing career‐related resources. Therefore, opportunities for students to develop their networks in preparation for graduation are important. Universities could be well positioned to implement mutually beneficial networking opportunities between undergraduate students and clinicians to foster professional networks and early career pathways such as careers fairs. To avoid preferential treatment of organisation(s), opportunities could be offered to providers across the university's region, with participation rotated annually or multiple events held where demand exceeds capacity. Face‐to‐face and online formats could further broaden participation to organisations both within and beyond the university's local area.

Participants also described drawing on university‐based resources, including discipline‐specific supports and institutional career services, to assist with resume preparation and interview skills during the job‐seeking process. Embedding career development through reflective activities and career planning throughout the curriculum could also be beneficial to students. This may include structured career education that supports students in understanding labour market trends, early identification of career pathways and developing job‐search competencies.

Collectively, these findings highlight that early career occupational therapists actively engage in both strategic and reflective processes to navigate the transition to practice. This underscores the importance of individual agency, supported by social and contextual factors, in securing initial employment.

4.2. Job selection

Selecting a first role as an occupational therapist was described as a multifactorial process, extending beyond the application phase and encompassing broader considerations related to workplace fit and long‐term career development. Similar to the preparation phase, graduates sought guidance from both personal and professional networks when evaluating employment options. Whereas advice relating to applications focussed on practical elements such as resume development and interview performance, decision‐making during job selection centred more strongly on assessing workplace characteristics. Participants reported seeking information about organisational culture, team structure, workload expectations, supervision and professional development opportunities. These findings align with the quantitative results of this study, reinforcing the consistency between reported preferences and observed trends. Advice commonly emphasised the importance of selecting roles that aligned with both professional goals and personal needs, including access to structured supervision, opportunities for skill development and sustainable work–life balance.

A key finding of this study is the strong emphasis placed on relational, developmental and lifestyle workplace factors when selecting a first professional role. Participants consistently prioritised work–life balance, access to professional development and the quality of interpersonal relationships within the workplace, including team dynamics and managerial support. These findings suggest a shift away from traditional extrinsic motivators, such as salary or specific practice setting, towards a broader focus on workplace environment and sustainability. This is consistent with existing literature, which identifies intrinsic job attributes as critical determinants of employment decisions. Lui et al. (2025) found work–life balance, mentorship opportunities and placement experiences as factors influencing the choice of first job of new graduate occupational therapists in Canada. Ahamad et al. (2022) highlight the influence of work–life balance and job characteristics on recruitment outcomes, as well as the importance of employee recommendations as a credible source of workplace insight. Similarly, Schlatter et al. (2025) and Gillette et al. (2022) identify team dynamics, supervision and support and work–life balance as the most influential factors in job selection among occupational therapy and speech‐language pathology final year students/graduates. The prominence of these factors may reflect the transitional nature of early career practice, during which graduates are developing professional identity, confidence and clinical competence. Supportive workplace environments that foster mentorship, collaboration and manageable workloads are therefore critical in facilitating successful transition to practice. This is in line with research by Toal‐Sullivan (2006) where Canadian new graduate occupational therapists initially experienced difficulties with contextualisation of theoretical knowledge and research skills into practice with their skills developing over time and the support of colleagues being critical to learning.

In this context, work–life balance extends beyond lifestyle considerations and becomes integral to wellbeing. These findings have important implications for employers, suggesting that recruitment strategies should prioritise the promotion of supportive workplace cultures, structured supervision and meaningful professional development opportunities to attract new graduates. Research exploring initiatives around how employers not only attract graduates but retain them is required. This information could be especially valuable for practice areas and settings experiencing growing demand for occupational therapists to support the attraction of new graduates.

The diversity of occupational therapy practice settings also emerged as a significant factor influencing job selection. Participants reported considering a wide range of practice settings, populations and service delivery contexts, reflecting the breadth of the profession. This aligns with research by Schlatter et al. (2025) who suggest that contemporary occupational therapy students may place less emphasis on specific practice settings compared to earlier cohorts, instead prioritising broader workplace attributes. Within the North Queensland context, this diversity of practice settings is further shaped by regional workforce demands and population characteristics. Graduates reported working with a range of populations, which reflects the demographic profile of the Townsville region, where Aboriginal and Torres Strait Islander peoples represent approximately 9% of the population, compared to 4.6% in Queensland and 3.2% nationally (Australian Bureau of Statistics, 2021). This finding highlights the importance of ensuring graduates are equipped with the cultural capabilities and confidence required to provide culturally responsive care which aligns with the demographic and health‐care needs of the communities in which the graduates are employed.

Geographic factors also influence how graduates' access and secure employment within these diverse practice settings. In the Australian context, where informal recruitment pathways and placement experiences often play a significant role in shaping early career opportunities, such strategies may be particularly influential in regional settings (Crowe & Mackenzie, 2002; Rodger et al., 2007). For graduates, prior placement experiences, professional networks and local connections may facilitate entry into the workforce, particularly in areas where recruitment processes are less formalised or where workforce shortages exist. Although universities do provide opportunities for students to have a variety of placement experiences, including within rural, regional and remote areas (e.g., Miles et al., 2026), occupational therapy clinicians also need to continue to support student exposure to these areas and subsequent development of professional networks. The challenge is how to support these clinicians who may already be over‐worked. Further research around what support clinicians need to continue to offer placement experiences is required.

Notably, 63.3% of graduates remained in Townsville to commence their first role, suggesting that location preference and connection to place play a significant role in early career decision‐making. This is consistent with previous research by Fisher et al. (2024), which identifies rural origin, proximity to home and partner employment as key determinants of workforce location. The importance of remaining close to established social and professional networks may further reinforce these patterns. However, it is also important to consider how to attract graduates to locations outside of where the university is situated to assist in meeting the needs of the occupational therapy workforce as a whole particularly in rural and remote areas where workforce challenges continue to be a concern (Hayes et al., 2025). Further research to explore this would be beneficial.

Overall, job selection among new graduate occupational therapists is shaped by a complex interplay of individual values, workplace characteristics and broader workforce factors. Whereas the diversity of practice opportunities provides flexibility, graduates appear to prioritise supportive work environments, positive team dynamics and sustainable work–life balance over specific practice settings. These findings highlight the need for employers and workforce planners to consider not only the availability of positions but also the quality of workplace environments. Creating supportive, well‐structured and development‐focussed workplaces is likely to be critical in attracting early career occupational therapists within an increasingly competitive and evolving health‐care landscape. Universities and professional bodies can also play an important role by providing students with placement and broader professional development opportunities to develop the skills required for the health‐care landscape they will enter while ensuring clinicians are equipped to support ongoing student development.

5. LIMITATIONS

Several limitations should be considered when interpreting the findings of this study. First, the sample was drawn from graduates of a single university in North Queensland, which may limit the generalisability of the findings. Whereas the regional focus provides valuable insight into workforce experiences in a specific setting, employment opportunities and decision‐making processes may differ in metropolitan or differently resourced environments.

Second, the study relied on self‐reported data, which are subject to recall bias and social desirability bias. Participants may have selectively remembered aspects of their job‐seeking experiences or presented their decision‐making processes in a more favourable or rationalised manner. This may influence the accuracy and completeness of the data collected.

Third, the relatively small sample size and voluntary participation may introduce selection bias. Graduates who chose to participate may have had more positive or more engaged experiences with the job‐seeking process, potentially limiting representation of those who experienced greater challenges or disengagement.

Additionally, the cross‐sectional design captures participants' perspectives at a single point in time, shortly after graduation. As career trajectories evolve, perceptions of job selection and influencing factors may change.

6. CONCLUSION

This study highlights that new graduate occupational therapists navigate employment through a proactive and multifaceted process, combining practical job‐seeking strategies, reflective decision‐making and the use of professional networks. Job selection was influenced more by relational, developmental and lifestyle workplace factors, such as work–life balance, supervision, professional development and team dynamics, than by specific practice settings, with decisions also shaped by workforce context.

Understanding these factors is important for informing occupational therapy education and workforce planning. Insights from this study support the alignment of undergraduate curricula and practice education with graduate needs, strengthen transition‐to‐practice supports and inform employer recruitment strategies.

Overall, this research contributes to understanding the first job decision‐making process of early graduate occupational therapists.

AUTHOR CONTRIBUTIONS

Louise Myles: Study conceptualisation and design; survey development; ethics application; data analysis; writing of the first draft and editing of the manuscript. Jackie Eagers: Study conceptualisation and design; survey development; ethics application; recruitment; data analysis; writing of the first draft and editing of the manuscript. Karen Salata: Study conceptualisation and design; survey development; ethics application; recruitment; data analysis; writing of the first draft and editing of the manuscript. Katie Headrick: Study design; survey development; ethics application; editing of the manuscript.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

DECLARATION OF USE OF ARTIFICIAL INTELLIGENCE

The authors declare no use of artificial intelligence.

Myles, L. , Eagers, J. , Salata, K. , & Headrick, K. (2026). Choosing the first job: Insights from new graduate occupational therapists from a regional Australian university. Australian Occupational Therapy Journal, 73(5), e70130. 10.1111/1440-1630.70130

DATA AVAILABILITY STATEMENT

Research data are not shared.