Choosing a workplace as a PT, OT or ST: what “hospital-based” really covers

Browse job listings for rehab professionals and you’ll often see the words “hospital-based.” But a day on an acute care ward, helping patients get out of bed from the bedside, and a day on a convalescent ward, practicing again and again with life after discharge in mind, are completely different, even though both are “hospital-based.”

In this article, we check where physical therapists (PT, 理学療法士), occupational therapists (OT, 作業療法士) and speech-language-hearing therapists (ST, 言語聴覚士) actually work, using statistics from their professional associations and the Ministry of Health, Labour and Welfare (MHLW), and lay out ways to look at workplaces when choosing one.

Where PTs work

Here are the main workplaces of members of the Japanese Physical Therapy Association (as of the end of March 2026, excluding members on leave).

Acute care is the largest, followed by convalescent rehabilitation wards. The same association’s statistics also show that when members’ workplaces are grouped by headcount, “one-person workplaces” are the most common type of facility. At clinics and long-term care facilities, it isn’t unusual for there to be only one or two PTs.

Association members are only part of all license holders (144,943 members, against a cumulative 247,546 people who have passed the national licensing exam), so the distribution may not match the whole picture exactly.

OTs and STs differ a little from PTs

Occupational therapists: psychiatry plays a big part

According to the MHLW’s Survey of Medical Institutions (October 2023, full-time equivalent), 50,304.4 OTs work in hospitals, of whom 7,176.5 (14.3%) work in psychiatric hospitals. For PTs, the share in psychiatric hospitals is 0.5%. In the Japanese Association of Occupational Therapists’ member statistics as well, the conditions members mainly work with are cerebrovascular disease (45.2%), followed by schizophrenia and related disorders (10.1%). Even within OT, the work changes completely depending on the field: physical, mental health, developmental, or older adults.

Speech-language-hearing therapists: fewer people, and swallowing is a big part of the work

The cumulative number of people who have passed the ST national licensing exam is 44,817 (from the 1st exam in 1999 to the 28th in 2026), far fewer than PTs or OTs. Besides speech and language therapy and hearing, STs also handle dysphagia (swallowing) training, and demand for swallowing care has grown as the population ages. The pass rate for the February 2026 national exam was 66.4%, lower than for PTs (89.7%) and OTs (91.2%).

Source: 厚生労働省「令和5(2023)年医療施設（静態・動態）調査・病院報告の概況」(MHLW, Survey of Medical Institutions and Hospital Report 2023: overview; 2024); 日本作業療法士協会「2024年度 会員統計資料」(Japanese Association of Occupational Therapists, FY2024 member statistics; 2025); 日本言語聴覚士協会「会員動向」(Japanese Association of Speech-Language-Hearing Therapists, membership trends; 2026); MHLW announcements of national exam results for each profession (2026)

Three ways to compare workplaces

Pay and supply-demand come as combined figures

Public statistics on rehab professionals’ pay only exist as a combined figure for PTs, OTs, STs and orthoptists. In the MHLW’s Basic Survey on Wage Structure (2025), full-time workers’ monthly pay (contractual cash earnings, きまって支給する現金給与額) was ¥309,900, and annual bonuses were ¥717,200. Converting as monthly pay × 12 + bonus, the editors estimate annual income at about ¥4.44 million (this is not an official annual income statistic). The average age was 36.2. The hourly wage for part-time workers was ¥1,993.

The supply-demand picture depends on which numbers you look at. The job openings-to-applicants ratio at Hello Work (public employment service) for “medical technicians” (医療技術者: a category combining rehab professionals with laboratory technologists, radiological technologists, dental hygienists and others) is high at 3.08 (FY2025), while a government projection says the supply of PTs and OTs will be about 1.5 times demand around 2040 (2022 report). The situation likely varies by region and field (home visits, long-term care, small facilities and so on), but ratios by field are not published.

Source: 厚生労働省「令和7年賃金構造基本統計調査」(MHLW, Basic Survey on Wage Structure 2025; 2026); 厚生労働省「一般職業紹介状況」(MHLW, Employment Referrals for General Workers; 2026); 厚生労働省「理学療法士・作業療法士需給分科会 これまでの議論の経過と報告」(MHLW, PT/OT Supply and Demand Subcommittee: progress of discussions and report; 2022)

What changed in 2026

• Better pay for home-visit rehab: With the June 2026 revision of the long-term care fee schedule (介護報酬), home-visit rehabilitation became eligible for the care worker treatment improvement add-on (介護職員等処遇改善加算) for the first time (add-on rate 1.5%). Home-visit nursing is also eligible (1.8%).
• Base-up evaluation fee (ベースアップ評価料): In the FY2026 revision of the medical fee schedule (診療報酬), the fee that funds pay raises at hospitals and clinics was extended to cover all staff.

For both, whether a given provider has filed for them and how it reflects them in pay varies from workplace to workplace. Try asking when you visit.

Source: 厚生労働省「令和8年度介護報酬改定の概要」(MHLW, overview of the FY2026 long-term care fee schedule revision; 2026); 厚生労働省「令和8年度診療報酬改定の概要 1．賃上げ対応」(MHLW, overview of the FY2026 medical fee schedule revision, part 1: responding to pay raises; 2026)

What to check on a workplace visit or trial shift

• What the ward or service doesAcute care, convalescent, community-based integrated care, or long-term care. Even within one hospital, the work differs by ward.
• How many others in your professionIf it’s a one-person workplace, who you can turn to when you’re stuck. If you’re new or returning after a break, how training is set up.
• The field you’d coverFor OTs: physical, mental health, developmental, or older adults. For STs: adult swallowing and aphasia, or children’s development and hearing.
• Working with other professionsFor STs: coordinating food textures and oral care with registered dietitians and dental hygienists, and whether you can take part in swallowing assessments.
• Weekend and holiday shiftsWhether you work weekends and public holidays, and how often.
• How home visits workVisits per day, how you get around, getting around on rainy days.

For things to check whatever your profession, see the workplace visit and trial shift checklist.