The profession of Speech-Language Pathology (SLP) involves evaluating and treating individuals across the lifespan who have communication and swallowing disorders. Becoming a practicing SLP requires extensive academic preparation, culminating in a master’s degree from an accredited program. Following graduate coursework and supervised clinical practicum, aspiring professionals must successfully navigate the Clinical Fellowship (CF). The CF is the mandatory, post-graduate, supervised training period required for entry into the field, serving as the final step in transitioning a student into an independent healthcare provider.
Defining the Clinical Fellowship
The Clinical Fellowship is designed as a mentored professional experience that bridges the gap between academic theory and autonomous clinical practice. This period is a temporary, paid position where the individual, known as the Clinical Fellow, works in a professional setting under the guidance of an experienced clinician. The CF allows the new graduate to integrate specialized knowledge with the complexities of managing a full caseload, including assessment, diagnosis, and treatment planning across diverse patient populations.
The American Speech-Language-Hearing Association (ASHA) oversees the CF process, establishing the national standards that all fellows must meet. The experience is overseen by a mentor, often referred to as the CF Supervisor, who must hold the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP). The fellowship is a dedicated, structured period intended to develop advanced clinical decision-making skills and ethical professional conduct. Successful completion of the CF is a prerequisite for achieving ASHA’s national certification.
Requirements and Supervision During the CF
The Clinical Fellowship is defined by specific quantitative benchmarks. ASHA requires a minimum of 1,260 hours of clinical experience, accumulated over a minimum duration of 36 weeks (equivalent to a full-time schedule of 35 hours or more per week). Fellows can complete the hours part-time, provided they work at least five hours per week, though the entire experience must be completed within four years.
A significant portion of the total time, 80%, must be dedicated to direct patient contact, including assessment, diagnosis, treatment, report writing, and consultation. The remaining time is allocated to professional development, such as observation, administrative duties, and research.
The supervision structure is a defined component of the CF. Mentors are required to conduct a minimum of 36 supervisory sessions throughout the fellowship period, with at least 18 sessions involving direct, on-site observation of the fellow’s clinical work. The supervisor must hold the CCC-SLP and have at least nine months of post-certification clinical experience.
The mentor evaluates the fellow’s performance across 18 core skill categories, using the ASHA Clinical Fellowship Skills Inventory form. Formal evaluations occur at three distinct checkpoints, marking the transition between segments of the experience. To successfully complete the CF, the fellow must achieve a satisfactory rating in all skill areas by the final segment.
Gaining Full Certification
Upon successful completion of all required hours, weeks, and supervisory benchmarks, the Clinical Fellow moves to the final stage of professional credentialing. The CF supervisor signs off on the final paperwork, confirming that the fellow has met all established standards and is prepared for independent practice. This sign-off is submitted to ASHA as part of the application for national certification.
In addition to completing the fellowship, the aspiring clinician must pass the national examination in speech-language pathology, known as the Praxis exam. A passing score of 162 is required for ASHA certification, demonstrating the necessary theoretical knowledge. Once the CF is complete and the Praxis score is verified, the individual is awarded the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP). The CCC-SLP is the nationally recognized professional credential, signifying that the SLP has met rigorous standards set by ASHA.
The CCC-SLP is distinct from state licensure, which is the legal requirement mandated by each state regulatory board to practice within its borders. Although the CCC-SLP is often accepted by states as the basis for granting licensure, the national certification and the state license are separate credentials that must both be obtained to practice legally.