Non-thermal acceleration of particles in magnetohydrodynamic (MHD) turbulence plays a central role in a wide variety of astrophysical sites. This physics is addressed here in the context of a strong turbulence, composed of coherent structures rather than waves, beyond the realm of quasilinear theory. The present description tracks the momentum of the particle through a sequence of frames in which the electric field vanishes, in the spirit of the original Fermi scenario. It connects the sources of energy gain (or loss) to the gradients of the velocity of the magnetic field lines, in particular the acceleration and the shear of their velocity flow projected along the field line direction, as well as their compression in the transverse plane. Those velocity gradients are subject to strong intermittency: they are spatially localized and their strengths obey powerlaw distributions, as demonstrated through direct measurements in the incompressible MHD simulation of the Johns Hopkins University database. This intermittency impacts the acceleration process in a significant way, which opens up prospects for a rich phenomenology. In particular, the momentum distribution, which is here captured through an analytical random walk model, displays extended powerlaw tails with soft-to-hard evolution in time, in general agreement with recent kinetic numerical simulations. Extensions to this description and possible avenues of exploration are discussed.