The Hola Blog

Selecting a setting for my speech language pathology (SLP) clinical fellowship (CF) was one of the most difficult decisions I had to make.

I have provided the following 3-step process for anyone who finds themselves confused and conflicted about where they should choose to complete their clinical fellowship (Some forms (The HOLA Blog 3-step CF Process Forms) are provided here and at the end of this article):

• Start out by listing your personal clinical interests and comparing them to parts of the field you are less interested in. It will look something like this:

• Next, list all of the settings you enjoy working in and rate them, like this:

• After comparing and contrasting your clinical interests and setting interests, make a list of things that mean a lot to you in a job such as benefits and scheduling:

This list is highly individualized, but is a crucial piece of the puzzle. Remember that everyone who graduates is in a unique and different place in their life. As someone married to an individual who experienced TBI, it was deal-breaker to me that my husband be included in my insurance benefits. This is not the case for everyone, so keep that in mind.

It is going to sound strange, but it immediately became clear to me what path I should take after I saw my thoughts written out on a sheet of paper in front of me. Still, determining a CF site may not be easy, especially for CFs who want to be in a medical placement but have found it difficult to obtain a position. Here is some basic advice I have followed, and I think it could be helpful for all CFs:

• Be sure to get an awesome CF mentor who knows their stuff. This can make or break an experience before it even begins! I’ve heard horror stories from friends who thought they were accepting their “dream job” but quickly left because they did not have good mentors, and it is best to avoid this at all costs. If you have any doubts, go over the documents on this website (provided by ASHA) with your mentor before starting your CF: http://www.asha.org/Certification/Clinical-Fellowship.htm. Also consider that you may have different requirements for your state license than you have for ASHA certification (some states require you to be licensed with them, others only require ASHA CCCs, etc.). Talk with your department head or another mentor to determine your situation, or do some research on your own to be certain.
• Your own happiness is worth more than prestige. This might sound ridiculous and obvious to some, but SLPs tend to be perfectionists with alpha personalities and always fight for the best opportunities. Remember, your journey is not defined by other people’s opinions or perspectives!  A CF is only a brief moment in your career, and the last time you have a guaranteed opportunity to be guided by a mentor. It is a time to continue to grow and improve your own clinical skills, and you are not expected to know everything. Do not be dissuaded by a CF decision because someone told you that it is not prestigious. That is hogwash. You know what is best for yourself! You can always change settings, this is fairly common and there is no shame in it.
• If you are curious about a setting, chat with people who work there. I was conflicted about my placement, so I reached out to 5 different mentors in my life that worked in different settings and asked them about their experiences. Talking with a colleague who graduated a year and a half before me was, by far, the most beneficial step I took in making a decision about my CF setting. I also had coffee with one of my favorite clinical supervisors who had worked in medical and school sites, and she helped me weigh my options. Talking with people who work in a particular setting is a great way to determine if you would actually like the setting, because they are aware of current events and regulations affecting practices. In some cases, you may also want to shadow a professional if you had limited experience in a setting. This is also highly beneficial, but can be challenging to coordinate. (Pro-tip: If someone lets you shadow them, buy them coffee or take them out to lunch to show your gratitude!)
• Your CF is NOT your final stop in your career. I repeat, it is NOT your final destination. It is okay to start your CF in one location, and then move to another setting. One of my best friends started by working for a school staffing company, and immediately switched to working for a skilled nursing facility (SNF) when she finished her CF. She is now the Director of Rehab at the same SNF she started at, and is happier than ever. If you listen to your own interests while also understanding and honoring your personal situations, no choice is a bad one. Also remember that once you finish a CF, you can finally take per diem (on call) positions to get your feet wet in different settings. I have other colleagues who work for schools during the week, and do per diem work in hospitals on the weekends. Many clinicians like this option because it preserves their clinical skills in a variety of areas.
• Your interests will change before, during, and after your CF. Learning and growing as a clinician is the beauty of the CF experience, so embrace it and try to be kind to yourself.

If you are still confused, I also created a SLP Clinical Setting Decision Matrix that you can use to try and clarify your options. It isn’t perfect, but you can use it to try and determine a setting that may be the best fit based on your responses. Check it out in the previous post. Here is a link to a PDF I created using my 3-steps above: The HOLA Blog 3-step CF Process Forms.

If you have any questions about my experiences or want more information, feel free to comment or contact me. To all the CFs reading this: congratulations on making it through grad school, now go out there and make a difference in the world as a SLP!