In higher education, we are approaching a crossroads in the preparation of occupational therapy professionals and being challenged from many sides. Trends in higher education are toward interprofessional education. This can, on one hand, be positive in enhancing professional skill development or, on the other hand, be negative if it reduces the core content to a universal common denominator. Trends in open access to curricular content, such as massive open online courses, make it easier to share the growing body of knowledge in our domain of practice. The positive side is opening access to more stakeholders, and the negative side is professional encroachment, when others take knowledge and apply occupational therapy practice under a different guise. Trends in expanding educational delivery models, including online, hybrid, or blended formats and satellite programs, can serve the profession positively by minimizing geographic barriers to train students where they live, be it in rural or geographically isolated areas, or they can be negative by removing opportunities for active learning in a supportive student community.