How to Secure Your Ideal Medical SLP Clinical Fellowship Position

Jan 16

Picture it… You are sitting in your last graduate class, hand in your remaining assignments, present your final presentation, and turn in the end of your clinical hours to your director.

Congratulations, you made it through grad school! You should be immensely proud of all the hard work and countless hours you put in to make this all possible. It’s now time to finally be done with school and begin your career as a speech-language pathologist. You dreamed of this moment since the first day of freshman year, and it came within a blink of an eye.

After you walk off that stage (or virtual stage... thanks, COVID), reality starts to sink in. “Am I ready for this? Am I prepared enough for this?” Let me walk you through some tips I learned and provide you with some information to make this transition into the real world as smooth as can be.

Interviewing for Medical SLP Positions

Beginning the interview process can be very overwhelming. If I can give any piece of advice, it’s this - do not settle! It can be very disheartening when your friends and colleagues in your graduate class are getting offers and starting their clinical fellowships before you but don’t rush into the first job you see, or even the second. Take this time to gain experience in the interview process and get comfortable asking the right questions.

Here are some questions that helped me gain insight and make an informed decision:

How accessible will my supervisor be to me?

This will vary from setting to setting. I have friends of mine with supervisors who don’t work in the same building. I have other friends, including myself, that work side by side with their supervisor. This is important because the level of independence will vary from person to person. Some CFs might want a more hands-off supervisor and be available as needed, and others might want their supervisor available more often for guidance.

What are the productivity expectations?

I’m sure you’ve heard of productivity levels/expectations many times before, but let me break down what productivity actually means. Let’s pretend a company said their productivity level was 90%; this would mean 90% of your workday would be seeing clients in therapy. So, if you work an 8 hour day (480 mins), you would see clients for 432 mins of that workday. That gives you 48 minutes for all of your daily treatment notes, evaluation reports, progress notes, and of course, things like bathroom breaks. This is an unattainable productivity level and leads to burnt-out SLPs. Make sure your productivity is sustainable for you, especially when first starting out because you will need extra time to learn and adapt to systems and procedures.

What is the typical caseload size, and what types of populations will I be working with?

This goes hand in hand with question 2, but finding out how large your caseload can be and the types of clients you will be working with will help determine if that setting is the right fit for you. Are you primarily interested in dementia and stroke recovery? A SNF may be a good fit for you. Interested in building long-term relationships and rehab? Apply to outpatient clinics. There is a medical setting for wherever your passions lie.

What materials do I have access to and is there a budget for updated materials?

Some companies don’t provide materials, so you must ask this to plan accordingly. If they don’t provide you with any materials, you need to ask for a budget for purchasing materials. Even though you don’t need CEUs during your CF, I would ask if they have a budget for any continuing education memberships, such as Medbridge*, so you have resources to consult when you need to research a unique clinical case!

How long does it typically take CFs to complete their fellowship with your company?

There are a few factors to consider for this question...

Are you full-time or part-time? If you are a part-time employee, it may take longer to finish your CF hours.
Are you hourly or salary? If you are an hourly or fee-for-service employee, you will only get paid when you see a client, which may impact your CF hour accumulation.
What does your CF supervisor count as hours? Ask what your supervisor will allow you to count towards your CF hours.

In addition to this question, I would recommend considering how long your CF contract is valid. If it is a 12-month contract, but you finish your CF hours in the expected 36 weeks, will you be paid as a CF for the remaining time of your contract? Once you receive your C’s, your pay should increase to reflect your certification.

What types of benefits are offered with the position?

Most companies will come out and state their benefits, but you need to decide what benefits are most important to you to make your final decision. Types of benefits can include PTO/Sick time, 401k, materials, health insurance, license fee reimbursement, etc.

BONUS QUESTION: Once you are assigned a supervisor make sure to ask, “What are your expectations for me as your CF?”
Establish with your supervisor what expectations they have for you. For instance, are you expected to build your own caseload? Are you expected to start seeing clients right away? Can you observe first before beginning to see clients? Are you expected to meet the productivity level as soon as you start, or will there be a grace period? Determining what your responsibilities will be right from the start will put you more at ease when you begin the job.

Tips to Get You Started Out Confidently

1

If you are anything like me, you set the bar very high for yourself. This can be both a good and bad thing. However, as you enter your clinical fellowship, you need to give yourself some grace. You are not going to know everything, and even as you progress in this career, you will always be learning something new.

2

Clients are not always textbook. You learn an abundance of information in grad school about what to look for and how to treat different populations of clients. However, even though you may have clients with the exact same diagnosis, every client is unique. Be prepared to modify a particular treatment or assessment to best fit that client’s needs. A significant part of this field is critical thinking and decision-making. Always use your best judgment and do your own research in evidence-based practice.

3

There are many resources to guide you in clinical decision-making and provide you with evidence-based treatments. The two resources I am new to include MedBridge* and the Med SLP Collective*, which are great resources where you can watch videos with step-by-step instructions on evidence-based treatments and provide answers to your ongoing questions.

4

Other resources that I found very helpful include Honeycomb Speech Therapy and Tactus Therapy. Multiple SLPs on Instagram, including both Tactus Therapy and Honeycomb Speech Therapy, post daily tips and tricks. Many new clinicians are likely to already use Instagram daily, so take this as an advantage and follow other speech-language pathologists to grow your network. Check out our Instagram page, @neurospeechsolutions, because we also provide tools and resources for MedSLPs.

TLDR: Take Away

Make sure you are set up for a successful clinical fellowship by having a supportive supervisor with a company that will supply you with the tools you need to treat your clients in an ethical, evidence-based way.

Remind yourself that you are prepared enough and you are smart enough. Imposter syndrome is genuine, and you will question yourself daily, but push those feelings to the side and keep moving forward.

You are never alone in this field; the speech-language pathology world is full of mentors and resources to help you provide the best treatment for your clients and continue your growth into a competent and confident clinician.

* These are affiliate links. When you purchase a subscription using this link, Neuro Speech Solutions will receive a commission at no extra cost to you. It’s a win-win! *

ABOUT THE AUTHOR

Sarah Morgan, MS, CF-SLP

Sarah is a speech-language pathologist completing her clinical fellowship with Neuro Speech Solutions. A native of Syracuse, she moved to Buffalo to specialize in adult neurogenic speech therapy. Sarah enjoys working with clients post-stroke and brain injury to help them communicate their thoughts and feelings and return to doing the things they love.

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