For aspiring clinical speech pathologists, completing an American Speech-Language-Hearing Association (ASHA) clinical fellowship is a crucial component of your education. The ASHA is the governing body that certifies speech pathologists (and other speech and hearing professionals) to practice in their chosen field.
After successfully completing clinical speech pathology coursework and a clinical practicum, your master’s degree program will culminate in an internship that demonstrates your career readiness. It’s one of the final steps in earning your speech pathology certification, also called a speech-language pathology (SLP) certification. This page highlights what you need to know about completing your ASHA fellowship.
What Do You Learn During the ASHA Clinical Fellowship Experience?
The purpose of the clinical fellowship is to apply everything you learned in your academic studies—evaluating your strengths, identifying areas of weakness, and building further clinical skills that are consistent with ASHA’s SLP Scope of Practice. Under the supervision of an independent practitioner or clinical educator who practices in the field, you will receive on-the-job training. The instructor will conduct an evaluation, assessing your readiness to practice and help you develop any areas of limitation so that when the time comes, you’ll have the confidence and skills needed to support your clients through high-quality, professional care.
With a clinical practicum already under your belt, the supervised ASHA clinical fellowship is an opportunity to refine your expertise. When you have successfully completed your ASHA clinical fellowship by demonstrating your ability to apply the necessary knowledge and skills on-site, you’ll be ready to obtain your credentials through ASHA.
Common Steps to Completing the ASHA Clinical Fellowship
Completing your clinical fellowship requires a few key components. Before you begin, you need certain prerequisites—like building foundational knowledge of the practice through education and pre-professional experience. Then, you need to carefully select where you want to complete a clinical fellowship—and with whom. And you need to work on absorbing all of the feedback and experience you receive at the clinical site.
Below, find a comprehensive list of steps needed to complete the ASHA clinical fellowship from start to finish.
1: Earn a CAA-Accredited Master’s in Speech Pathology
The thought of jumping into work as an SLP may be exciting, but first, you need to meet ASHA Standards and Implementation Procedures for the Certificate of Clinical Competence in Speech Language Pathology (CCC-SLP). You must complete all required coursework and clinical experience through an accredited master’s degree program in speech language pathology. Accreditation is overseen by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA), which verifies that a given program meets certain quality and educational standards.
You may find that you need more flexibility than a standard full-time, on-campus master’s in speech pathology program can provide. Today, there are a variety of ways to earn your master’s degree—including getting a master’s in speech language pathology online. Many CAA-accredited online programs even offer part-time enrollment for students with unique circumstances, like those who work a full-time job or are parents.
2: Select Your Clinical Fellowship Setting
Selecting a clinical fellowship setting can be a challenging part of the process. But there a few factors to consider to help you decide which setting is the best for you. You will be spending a lot of time on-site, so you need to take into consideration what you want to get out of the experience, what you want to learn, and where you’d like to work after your fellowship is over.
There are a variety of settings where SLPs can work. Some common site locations include hospitals, private or independent medical practices, schools, nursing or rehabilitation centers, and in-home health facilities. The type of setting you choose for your ASHA clinical fellowship isn’t necessarily where you will end up but selecting the location you believe you’re interested in pursuing can provide foundational career experience.
3: Choose Your Clinical Fellowship Mentor Wisely
Your clinical fellowship mentor, or “CF mentor,” is an important part of your clinical fellowship experience. For any aspiring SLP, it’s important to find a mentor whose expertise aligns with your particular career goals. In addition, you may want to look for someone who will provide some level of personal support throughout your fellowship, as the field can be challenging.
ASHA recommends evaluating your prospective mentor’s career experience and speaking with past clinical fellows to ensure they had a positive experience. It’s also a good idea to confirm the mentor fills out paperwork quickly and work with them to create a supervision plan that ensures there won’t be any delays in obtaining your certification. Mentoring SLPs are required to meet a minimum amount of work experience in the field and hold a current, active certification.
4: Confirm Your Speech Pathologist State Licensure Requirements
Every state has differing requirements for obtaining a license. Make sure to familiarize yourself with the specific requirements for a speech pathologist license in your state before beginning your clinical fellowship—you may be required to hold a temporary license during your internship.
Note that SLP state licensure is different from the ASHA CCC-SLP. The CCC-SLP is optional, although in some states, this certification is required to get a license. In other states, having the CCC-SLP is a sufficient credential to apply for your license. Either way, certificate requirements are rigorous.
5: Review the SLP CF Report and Rating Forms with Your Mentoring SLP
Getting a clinical fellowship mentor’s feedback is perhaps one of the most important components of your experience. ASHA needs thorough information from your mentor to determine if you have earned the certificate.
The fellowship is broken into three distinct segments, and your mentoring SLP must fill out a current Clinical Fellowship Skills Inventory (CFSI) form once per segment. This form outlines your progress in a number of skill sets pertaining to client evaluation, treatment, management, and interaction. Make sure you understand the distinct requirements for the 18 core skills—and feel adequately prepared to demonstrate competence in these areas. Each skill is rated from 1 to 5, and clinical fellows must achieve at least a 3 in all skill areas during their final segment in order to earn the CCC-SLP.
6: Identify Strengths and Areas for Improvement with Your Mentor
Your CF mentor is there to ensure you meet certification and licensing requirements in the short term—and set you up to become a qualified SLP in the long term. Based on their experience, your mentor can tell you where you are excelling and provide guidance on not only where you need to improve, but how to make it happen.
Ideally, your clinical fellowship mentor will begin to identify areas for improvement early on so you can strengthen these skills later on in your fellowship. But it’s up to you to review the requirements and aim for the highest possible rating in all fields.
7: Maintain Consistent Feedback Sessions with Your CF Mentor
The goal of the mentorship isn’t just to solicit advice. Mentorship provides an opportunity for you to develop, refine, and master skills holistically, across all areas of your SLP practice. Speech pathologists have a demanding role that requires interpersonal skills, scientific knowledge, and sound evaluation skills in order to successfully develop the best treatment plans for clients.
Though your mentoring SLP will lead feedback sessions and provide you with guidance, you may be able to get even more out of the experience by observing your own progress and coming to sessions prepared for meaningful discussion. If you find that you are excellent in one area (such as evaluation or treatment) but consistently weaker in another (such as management), you can work with your mentor to create a plan of action to improve.
8: Earn a Rating of 3 or Higher on Clinical Fellowship Report & Ratings Forms
As you now know, the CFSI forms have a ranking system of 1 through 5—with 5 being the highest rating. A 3 is considered a good rating and it is the minimum number required in all skills throughout your final fellowship segment.
To achieve a 3 or higher in any skill category, you must demonstrate that you can regularly perform that skill independently, self-sufficiently, and accurately. When you receive your CFSI for the first segment, make sure to have a thorough conversation with your CF mentor to determine what next steps to take to help you improve in any areas where you may have had a low—or less than ideal—rating. If you take your feedback seriously early on, you can focus on improving your rating and skills throughout the second segment and refining them throughout the third segment.
9: Submit Your Completed SLP Clinical Fellowship Forms to ASHA
At the culmination of your fellowship, you must provide the proper forms to ASHA to earn your CCC-SLP. Due within 90 days of ending your clinical fellowship, the required documentation includes a membership and certification application forms and a Speech Language Pathology Clinical Fellowship (SLPCF) form. The SLPCF forms report all information on your mentor, site location, hours worked, and ratings for each of the three segments.
You should carefully fill out all information following the completion of your fellowship. Any mistakes or inaccuracies could cause application rejections or delays. Once you have verified that everything is correct, review the paperwork with your mentoring SLP and sign the forms. The form can also be completed online.
10: Check on Your Certification with the ASHA National Office
The best way to gain clarity on your certification status is to check in with the ASHA national office periodically. Whether you submitted your membership application and SLPCF online or by mail, it can take ASHA an average of six weeks to process your materials. Your clinical fellowship experience won’t be reviewed until you’ve submitted the membership application, so it is recommended to submit the membership application prior to the end of your clinical fellowship. That way, ASHA can initiate the review process when your materials are received.
ASHA recommends paying your membership dues while your certification is still under review. You will receive an email or letter letting you know when your certification is granted. At that point, you will finally boast a CCC-SLP—and be a member of the largest speech language pathologist organization in the country.
Recommendations for Selecting a Clinical Fellowship Site
Selecting a clinical fellowship site is a highly personal decision. After all, you will be committing 1,260 hours over 36 weeks to studying in this location. You should think strategically about where you can get the most experience working with the populations you desire to help throughout your career.
It can be helpful to actually articulate where you think you want to work—and write down some goals you have for the clinical fellowship.
Questions you might ask yourself include:
- What speech pathology specialization am I most interested in? There are various concentrations prospective SLPs can consider. For instance, if you’re skilled in more than one language, you can become a bilingual speech-language pathologist. Some SLPs specialize in helping people with dysphasia (a degenerative language disorder). From speech production to cognition to feeding and swallowing, the range of specializations SLPs can pursue is extremely broad.
- Who do I want to help? Determining which population you want to impact with your career, will help you narrow down where you’d like to gain experience and perhaps work. Are you interested in helping young children? The elderly? Think about the types of settings in which you can help this population. SLPs can work in hospitals, schools, private practices, acute care settings, outpatient facilities, and a variety of other locations.
- What goals do I want to achieve with a clinical fellowship? Every prospective SLP has different career goals. Some may aspire to work in a prestigious office, while others may care less about the organization. Perhaps you want to help low income individuals, children with autism, or people with developmental disorders. Identifying the goals you want to accomplish may help you pinpoint the best clinical fellowship site for you.
- Does my desired clinical fellowship setting meet state requirements and ASHA qualifications? Not every setting will meet the minimum requirements needed to obtain a state license or ASHA certification. Ensure that the prospective site does more than just offer screening since you will need to gain experience in the areas of evaluation, treatment, management, and interaction.
- Does the clinical fellowship site provide my clinical fellowship mentor—or am I responsible for finding them? If you don’t have existing connections in the field, it can be helpful for the clinical fellowship site to match you with a CF mentor. But find out if it’s possible to speak with the prospective mentor, learn about their experience, and make sure the mentorship is the right fit.
The more strategically you select your work site, the more you’re likely to get out of the experience—even if that means discovering where you don’t want to work. If that happens, you’ll still have the opportunity to identify a setting better suited to your career goals once you become a professional.
Can You Choose More Than One Clinical Fellowship Setting?
You can choose more than one clinical fellowship site in special circumstances. ASHA outlines those circumstances on its site. Note that you will require a new SLPCF form every time you switch. You need a minimum of 6 indirect and 6 direct clinical contact hours per segment under each CF mentor (18 direct and 18 indirect hours in total). Completing less than the required amount at any clinical fellowship site will negate the hours, and they will not count toward your certificate. If finishing your required hours on time—within 36 weeks—is your primary goal, you may want to stick to one site.
To make the most informed decision, research a prospective site as much as possible. Speak with people who currently work in these settings to help you narrow down your clinical fellowship site. Ask how many SLP clinical fellows are already working there. Having other fellows at the site can be an enriching experience, but you also want to ensure you’ll be able to get personalized attention from your mentor. Connect with previous SLP clinical fellows to gain insight into their experiences as well. Check to see if there are penalties for moving to another site—some sites may have contracts in place, and you should read the fine print to make sure you aren’t jeopardizing your progress toward a certificate.
Advice for Picking a Qualified Clinical Fellowship Mentor
Your CF mentor is an integral part of the experience, so selecting the right CF mentor for you is a big decision. Before committing to a placement site, confirm that your prospective mentor has all of the qualifications to set you up for success. Here are some questions you may want to explore:
- Did the mentoring SLP have their own CF mentor when they completed their ASHA clinical fellowship? This can be an indicator that they understand the process and the value of the mentorship.
- Do they have the time to supervise you? If your mentoring SLP is constantly too busy with clients or supervising other fellows, they may not be able to provide you the attention you seek and need.
- How many years’ experience do they have? While a young mentor may be relatable, an SLP who graduated and became certified within the past couple of years may not possess the wealth of knowledge needed to help you succeed. You may encounter a variety of scenarios in your training and can benefit from the supervision of someone with years of experience.
- Do they meet the minimum ASHA clinical mentor criteria (as of January 1, 2020)? If the clinical mentor doesn’t meet ASHA criteria, your experience under their supervision may not be valid. Make sure their membership and certification are up to date.
- Are they able to come to your chosen clinical fellowship work setting? Your mentoring SLP needs to observe you on-site, so it’s important that they have the time and are able to get to the chosen location.
How to Get Good Ratings on the Clinical Fellowship Report and Rating Form
For aspiring SLPs, a great deal depends on one piece of paper – the Speech Patholotgy Clinical Fellowship Report and Rating Form (SLPCF). At the end of your clinical fellowship, the SLPCF submitted to ASHA will determine whether you earn your certification or not. Here are some tips to best prepare to get good ratings on the forms—and demonstrate your mastery of the required skills.
1: Read the SLPCF Rating Form Before You Start Your Fellowship
The SLPCF rating form is always available to you on the ASHA site, even before you start your clinical fellowship. It’s a good idea to begin reviewing this form early on so you can show up to your work site with an understanding of expectations and prepare any questions you might have for your CF mentor. The speech pathology clinical fellowship report and rating form specifies exactly how to track your hours worked each week. You will want to identify a clear and accurate system to log your direct and indirect hours to ensure you are completing all requirements in a timely manner.
2: Familiarize Yourself with the Clinical Fellowship Skills Inventory
The 18 core skills of an SLP may seem daunting at first. But the more you familiarize yourself with them, the more confident you can be as you look to master each one and execute them with accuracy. Review the ASHA clinical fellowship skills inventory to learn what you should accomplish by the end of your clinical fellowship.
As you read through the CFSI, you may notice that the highest rating in most skill areas emphasizes independence. At the end of your fellowship, you should be able to make accurate decisions regarding client needs—independent of supervisory guidance. If your performance meets or exceeds that of a 3 rating, you will be well on your way to earning your certification.
3: Ask Your Clinical Fellow Mentor for Guidance on Each Skill
Your clinical fellowship mentor is there to help you master each of the 18 core skills outlined in the CFSI and ratings form. Lean on their experience to help you solve problems and improve in areas you find particularly challenging. Ask them how they’ve approached certain situations in the past—and learn how they overcame their own challenges. Your mentoring speech language pathologist is there to support you every step of the way.
If you are struggling with certain skills, ask your CF mentor how you can improve. The best thing you can do while you are in the early stages of your fellowship is absorb feedback, ask questions, and remain curious. During the latter segment of your fellowship, focus on implementing and applying everything you have been working on. Ideally, you’ll see the rating numbers go up segment by segment as you continuously improve.
4: Plan Out Your Clinical Fellowship Direct Clinical Contact Activities
Now that you know the skills you need to pass, the next step is to schedule your direct clinical contact hours around these skills. As a clinical fellow, 80% of your time must be spent providing direct patient care. Think of activities such as assessment, diagnosis, and evaluation; creating treatment plans; writing reports; counseling; and working with clients and their families to improve outcomes. You should strive to complete these tasks self-sufficiently and accurately.
If you verified your responsibilities and the services offered during your site selection process, you should be able to easily schedule the direct clinical contact activities as needed. Work with your supervisor to ensure you are spending enough time on the required tasks.
5: Keep Detailed Notes on Your Direct Clinical Contact Hours
As an SLP-in-training, you should feel empowered by and proud of your work. Keep detailed, thorough record of all of your tasks on-site. Your logs will help verify that the information your CF mentor records on your CFSI correlates with your actual performance and growth.
If you’re unsure of what information to track, search online for free templates created by previous clinical fellows. You should log your direct clinical contact hours—in other words, the services administered to each individual client, along with the date and time. Get the client’s signature and the signature of your supervisor so you have additional verification. At the end of the day, you are your biggest advocate. Tracking all of your responsibilities and accomplishments and having documentation for the future, will help you take ownership and embrace your independence as an SLP.
Information last update May 2020