Over the last 20 years Australia has seen a huge growth in new occupational therapy programs. Each new program is an historic event that changes occupational therapy’s national profile. Each new course raises expectations. Governments fund universities expecting a civic and economic return on public investment through teaching, community engagement and research. Universities expect occupational therapy academic staff to fulfil this institutional obligation and bring a return on staffing and infrastructure costs. Students expect their employability, life and career opportunities will be enhanced. The profession expects the program will be high quality and will add to occupational therapy’s esteem. Clients and the community expect ethical, safe and competent graduates will help them.