SLP in the Medical Field

[dvchay]

So now that acceptances are starting to roll in, I'm wondering if anyone has advice. I want to work in a hospital after I graduate. I'm wondering what sorts of things I should be looking for in a graduate program to make me more successful in a hospital setting! Any advice is appreciated, thanks!

[speechietobecle]

Definitely want to go to a program that is more medical based than school based. If the program you are applying to has a heavy emphasis on schools, its probaby not the best option. Look at the curriculum posted on the website and at the clinical externship opportunities the school has. However, you could always do medical even if you go to a school-based program because ASHA requires that everyone gets experience at both school and medical settings before they graduate their programs. Hope this helps! I am currently applying to programs too and this was the advice I was given during the application process!

[sophie24]

I think you should be very careful when choosing your profession and program of study. Who do you want to work for?

[rossee]

I'm a home health aide, I don't work at the hospital but I also help people, so you can try this career if you're interested in.

[jomyers.online]

Hello @dvchay!

I am looking into working in a medical-based setting as well, so I've scoured around and found as much advice as possible. I will reiterate several times that if you graduate from an accredited program and you are licensed in your state, then you are able to practice in any setting your SLP heart desires. This is more for those that are looking for ways to expand their depth and breadth of knowledge in the area of medical SLP practice, or those that are looking for ways to improve their applications while they are still in their programs to make the job search easier when they graduate. I'm not an expert, so take everything here with a grain of SALT (lol).

Quick bites if you don’t feel like reading this loooooong post:

• Read, read, read: ASHA SLP Health Care community, Dysphagia Cafe, Tactus Therapy, Medical SLP Collective, Honeycomb Speech Therapy, SLP subreddit (search “medical” or “medSLP”)
• Spend too much of your time reading? Listen to some podcasts instead: Down the Hatch, Swallow your Pride
• Join ASHA Special Interest Groups, which are only $10 each for student membership: 2 (neurogenic communication disorders), 13 (dysphagia), 15 (gerontology)
• Take CEUs: speechpathology.com ($99 for all of their online courses), Aphasia Toolbox, MedBridge

 

First, take a look at which medical settings might interest you:

Acute care
Working in acute care, you’ll see complex cases, with many SLPs reporting that the majority of their caseload includes dysphagia and trachs/vents. You’d be working with patients with speech, language, and swallowing difficulties stemming from head injuries, strokes, and other medical issues that result in a typical stay of a few days to a few weeks. There are options for further specializations, like working in a neonatal intensive care unit (NICU). Click here for more information about Acute Care settings.

Skilled Nursing Facility
At a Skilled Nursing Facility (often shortened to SNF online, you’ll also see this setting referred to as “long-term care”), You’ll see patients for an average stay of about a month. SLPs report that most of their caseload includes patients with CVA (stroke) and work primarily in the area of swallowing. SNFs get a bad rap online for productivity standards and you’ll occasionally hear about pressure to bill insurance fraudulently. Click here for more information about Long-Term Care settings.

Pediatric Hospitals
At a Pediatric Hospital, you’ll be working with children from birth to 18 years old. This is another setting that you’ll see shortened online: you’ll find people refer to these settings as “Peds” or “Pediatrics.” As a SLP specializing in pediatrics, you’ll see a range of disorders. Click here for more information about Pediatric Hospital settings.

Acute Inpatient Rehabilitation
Working in inpatient rehabilitation (a.k.a.: “inpatient rehab” or just “inpatient”), you’ll see patients with traumatic brain injuries (TBI) and stroke patients with an average stay of a few weeks. You’ll be working with adults on memory, swallowing, comprehension, expression, and attention goals. Click here for more information about Inpatient Rehab settings.

Outpatient Clinics
You’ll have the opportunity to provide services to a wide range of clients in outpatient settings, with ages ranging from infancy to 80+ and a wide variety of diagnoses and goals. The average length of time for working with a patient is 3 months, but this varies. Click here for more information about Outpatient Clinic settings.

 

Classes to look for in your program:

If you are already interested in a few programs, compare their curriculum maps and elective courses. You can highlight classes that you are interested in and this process might help you narrow down your decisions. While all accredited programs will prepare you to work in any setting, you’ll find that some programs have dedicated classes in medical-based topics and concerns, while others have a larger part of their curriculum geared toward school-based SLP topics and concerns.  

Classes to look for include Dysphagia, Neurogenic Motor Speech Disorders, Pediatric Feeding & Swallowing, Interprofessional Practice, Traumatic Brain Injury, Treatment of Voice Disorders in Medical Settings, Dementia, Neuroanatomy & Aphasia.

 

Opportunities to look for in your program:

In addition to classes, look for clinical experiences that will help you gain knowledge and experience in medical settings. Advice is frequently tossed around online about finding programs that have hospitals nearby or hospital and medical affiliations, but I’ve yet to find a comprehensive list of these programs. For now, here’s a short list of programs that provide opportunities for specialization: 

• The University of Washington offers a dedicated Medical SLP track and has affiliations with 17 hospitals
• Chapman University offers an emphasis in medically-related conditions
• New York Medical College offers LSVT LOUD training, FEES, anatomy dissection classes, an external clinical rotation specifically for medically based competencies, and interprofessional activities with the PT program
• MGH Institute offers concentrations that include electives, dedicated practicums, and mentorship in areas like Adult Neurogenic Communication Disorders and Medical Speech-Language Pathology. 
• Portland State University offers a medical concentration with dedicated elective courses, clinical placements in dysphagia and adult medical, and two medical practicum placements

 

Edited March 4, 2021 by jomyers.online

[jomyers.online]

Try to complete your CFY in a medical setting.

 

What’s a CFY? A CFY, or clinical fellowship year, is the first year of mentored practice for new graduates. Your CFY is not found through your school or negotiated for you by faculty. You’ll be searching for a position solo, interviewing for the first time as a full-fledged SLP! Essentially, you will be working with a license (or initial license) and toward your certification with additional support from your mentor. This is more or less comparable to other professions, like teaching or medical doctors, in which newly-minted graduates are not fully licensed or credentialed until they have a certain amount of mentorship and experience in the field. As a CF, you'll be a licensed graduate working toward your ASHA CCCs. Most newly-minted SLPs that would like to work in medical settings following certification would like to complete their CFY in a medical setting as well, but it can be difficult to find medical CF positions in areas where there are quite a few SLP programs or the market is otherwise saturated. It is after your year of mentored practice that you earn your ASHA certification, or your CCC’s, so you can move into a medical setting after your CFY if you completed it in a school setting. If you are licensed in your state to practice Speech Pathology, you are able to practice in any setting you’d like to (provided that you can find a position in the setting you’d prefer to work in).

 

When should you start looking?

 

Most advice suggests that you should begin looking for CFY opportunities as early as possible, because it’s much easier to secure positions if you already have an “in.” To improve your chances of securing a medical position, start developing relationships with program directors and professional acquaintances before most even think about their CFY. To do this, you can intern, shadow, or cold-call SLPs in the settings or areas you are looking at working in. You can make use of any clinical or practicum placements that you have during graduate school by excelling in those medical placements and letting SLPs at that facility know that you would enjoy the opportunity to become a colleague of theirs. Searching for a medical CFY can be different from searching for a school-based position in that medical settings usually won’t run on the typical academic calendar. Instead, they’ll post openings and hire throughout the year, and they’ll usually want to hire for open positions as soon as possible. The type of medical setting you’re interested in can also influence when you’ll start job searching in earnest: you might notice that certain settings tend to hire at specific times of the year depending on your area. 

 

Where can I find medical SLP positions for my CFY?

 

So where do you start looking? Graduates on instagram, blogs, reddit, and here have found success on indeed, cold-calling local hospitals, and even DM’ing on instagram or facebook medical SLP groups.  Another strategy that others have found success with is asking mentors or professors to put in a good word for you or provide a recommendation to their professional contacts. The search can be grueling, many have stated that they applied for 20-30 positions before they found a good fit. Something that can improve your chances of securing a medical position is if you are willing to move. This is because rural positions are typically harder to fill, so applying to rural areas could increase your chances of a job offer. This strategy could also work if you’d like to live in a more populated area and have a longer commute. If you think you’d otherwise be the perfect fit for a position, and the posting states that your CCCs are required, inquire with the hiring director and make a case for yourself. They might be willing to accommodate by finding you a mentor.

An important thing to note is that you should be looking for quality mentorship in your CF. If you are the only SLP at your facility, you will not likely benefit as much from that mentorship connection as someone who has a mentor on-site 100% of the time.  

 

Would it help to pursue any additional certifications?

 

While expensive and *usually* not required of new graduates before they're hired, you could prioritize varying your experience and improving your technical training outside of graduate school in an effort to stand out among the crowd by pursuing additional certifications. There are sometimes student discounts for training programs, so if it’s something you’re going to have to complete anyway you might as well. Don’t go all out and do everything if the facilities you’d like to work for don’t utilize these programs, it would be an unnecessary drain on your time and money. That being said, if you're interested in a few of these, go for it!

• MBSImP, or the modified barium swallow impairment profile, has a student discount available
• Passy Muir has free trach/vent CEUs
• FEES (Flexible Endoscopic Evaluation of Swallowing) trainings are offered all over the country, online or in-person. Learn more about it from ASHA.
• STEP by Dr. Ianessa Humbert is a community centered around swallowing training and education with a monthly membership fee of $15
• LSVT LOUD, or the Lee Silverman Voice Treatment, is a dysphonia treatment program that has a significantly reduced price for students with the option to upgrade to a full membership after graduation
• SPEAK OUT & LOUD Crowd is a training by the Parkinson Voice Project for individual and group therapy techniques for SLPs working with patients with Parkinson’s
• VitalStim is a certification in neuromuscular electrical stimulation for dysphagia
• TEP (Tracheoesophageal Puncture and Prosthesis) is offered as a workshop by the MAYO clinic
• Laryngeal Imaging is offered as a workshop by Emory (with FEES included)
• MDTP (McNeill Dysphagia Therapy Program) can be taken as an ASHA CEU and  is offered by UCSF 
• MoCA certification 
• PhortE (Phonation Resistance Training Exercises) can be taken as an ASHA CEU

Edited March 4, 2021 by jomyers.online