Can I Do My CF in a Hospital? Most acute-care facilities want more experienced clinicians, but some strategies may increase your chances of landing a hospital-based job. Student's Say
Student's Say  |   July 01, 2018
Can I Do My CF in a Hospital?
Author Notes
  • Michelle B. Garmizo, MA, CCC-SLP, is a bilingual speech-language pathologist from Miami, Florida, with experience in acute care and inpatient rehabilitation settings.
    Michelle B. Garmizo, MA, CCC-SLP, is a bilingual speech-language pathologist from Miami, Florida, with experience in acute care and inpatient rehabilitation settings.×
Article Information
Healthcare Settings / Student's Say
Student's Say   |   July 01, 2018
Can I Do My CF in a Hospital?
The ASHA Leader, July 2018, Vol. 23, 42-43. doi:10.1044/leader.SSAY.23072018.42
The ASHA Leader, July 2018, Vol. 23, 42-43. doi:10.1044/leader.SSAY.23072018.42
“You shouldn’t get your hopes up about finding a hospital position after graduation.”
This was the response from my master’s program internship coordinator when I told her I wanted an internship working with adults in a medical setting. Her point was that most fast-paced, productivity-driven hospital environments are not conducive to providing the supervision needed to hire a recent speech-language pathology graduate.
I was not to be deterred. I wanted my last internship to be in my ideal setting to increase my chances of securing a clinical fellowship (CF) in that type of setting.
I did get a student internship in a rehabilitation hospital and I loved it! I had to drive 45 minutes through traffic to get there, but I knew I had found my niche. I was providing services to patients with interesting diagnoses—brain injury, stroke, spinal cord injury, dementia, debility, and head and neck cancer. After the three-month internship, I was sad to leave but excited to get my first “real” job as a speech-language pathologist.
I graduated and moved in with my mother in Miami while I hunted for CFs. Four months later, I was still on the couch scouring online job boards and growing sick of it. I opened my search not just to cities, but to surrounding areas of cities that looked interesting. Finally—and thankfully—my persistence paid off a month later. After about 100 applications, several phone interviews and a handful of face-to-face interviews, I finally moved almost 1,000 miles from home for my dream job.
If you’re interested in finding a hospital-based CF, consider the lessons I learned in my job hunt.
Get related hospital experience. If your graduate program has only limited hospital placements, consider finding your own internship elsewhere, in a hospital farther away from campus or even in a different city or state—you can sublet your place and live with your parents, a friend or other relatives or get a short-term rental for the semester.
But—first make sure your grad program allows this arrangement. The program and hospital have to be willing to enter into a formal agreement that stipulates the requirements of each.
Stand out. I have since been responsible for hiring positions open to CFs and certified speech-language pathologists, and I find that many new grad applications look the same—they all boast a 3.75 GPA, NSSLHA membership and clinical rotations. How can you differentiate yourself? Pursue certifications that you can complete as a student or recent graduate, such as voice strengthening or swallowing studies. Some programs offer training for students at a reduced cost.
Apply to everything. When I was searching for a CF, many postings indicated “two years of experience required” or “CCC required.” Sometimes it felt like a waste of time, but I applied anyway. You have nothing to lose. Even if your application leads only to a phone interview, take advantage of the opportunity to practice your interviewing skills. The job I eventually accepted said “CCC preferred”— definitely a deterrent, and I almost didn’t apply.
Tailor your interview. Chances are, your interviewer will ask you several scenario-based questions. For example, “Tell me about a time you had a challenging patient.” This is not the time to talk about working with a child with disruptive behavior. This is the time to talk about your setting-relevant experience with the gentleman who had a right-hemisphere stroke who constantly told you his speech was fine and that he didn’t need you, despite deficits in insight, attention, safety, problem-solving and reasoning.
Location, location, relocation. There were few hospital-based CF opportunities in Miami, but I was willing to move almost anywhere. The CF I landed was not in my dream city, Raleigh, North Carolina—in fact, it was in Pinehurst, a retirement village located more than an hour away from Raleigh and any other major city. Hospitals in rural areas are more likely to hire and train a CF because they get fewer applicants than hospitals in big cities. I ended up loving this hospital—I stayed on staff for four more years—and chose to live in a Raleigh suburb and commute an hour to and from work.
Have a Plan B. If you can’t CF hunt from your parents’ house after graduation, have a backup plan. Would you consider a position at an inpatient rehabilitation facility (IRF) or skilled nursing facility (SNF)? Patients in these facilities have often gone from the emergency room to intensive care to acute care before being discharged to an IRF or SNF. They have the same diagnoses as those in the hospital and, therefore, SNF or IRF work could be a stepping-stone to a hospital-based position.
Also, work in these settings often may include opportunities to collaborate with hospital-based SLPs. For example, patients in an SNF might need to go to a hospital for a swallow study. If you are the patient’s primary SLP, try to go with the patient, or pick up the phone to talk to the hospital SLP who performed the study. Take the time to forge relationships!
Get your foot in the door. If you take a job in a different setting, don’t give up on your long-term goal. Continue to complete medically related CEUs (think: trachs, vents, dysphagia, neurology), pursue certifications that make you stand out, and (after you have your CCC-SLP) pursue PRN (as-needed) hospital positions. Get your foot in the door and get the hands-on experience to supplement your continuing education. For example, when I relocated and had to leave my job, my replacement was an SLP who had been working for us PRN. She had been there only a few months, with not much experience, but she knew our documentation system and procedures. Because we knew her, we were willing to provide additional training.
Looking back on my internship coordinator’s discouraging words about hospital positions, I recognize she meant well. However, now that I supervise students in their last rotation, I take a different approach: I share information about the challenges but also give them tools and knowledge to navigate the process. Is it hard? Sure, but if you learned anything in graduate school, it is that nothing worth having comes easily.
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July 2018
Volume 23, Issue 7