It Was All a Dream: Getting the Medical SLP Job You Want!

“I let my tape rock ‘til my tape popped”—The Notorious B.I.G

Graduations are typically joyous occasions—a time to celebrate all that one has accomplished. However, I strangely felt the opposite when I graduated with my Master’s in Speech-Language Pathology. My immediate and extended family had traveled half-way across the country and were so excited to watch me walk across that stage, but my mind was riddled with anxiety, self-doubt, and feelings of failure. After three years of hard work, I had done it. I had accomplished my goal. I had just finished my dream externship in adult acute care at one of the best hospitals in the country. And now I was about to start my dream job as a medical SLP, right? Wrong.

In the midst of the whirlwind that was my last year of graduate school, I honestly had forgotten to start applying for jobs—or perhaps just mistimed the start of my job search. Regardless, reality was setting in quickly (read: I was soon-to-be broke and living back home). So a month or two before graduation, I haphazardly shot off a few applications to some local hospitals, which resulted in some quick rejections. I realized this job search thing was going to take a bit more effort…eh actually a lot more effort.

I remember at our pre-graduation “senior send-off”, everyone in my cohort was asked to stand up in front of a room full of faculty members, classmates, and their families and tell what SLP journey they would be embarking upon following graduation. Mostly, people rattled off schools, SNFs, early intervention centers, and private practices. Few people were going to hospitals, rehabs, or outpatient clinics. As my turn approached to make my announcement, I literally thought I was going to die. Just minutes before this moment, all of my professors were raving to my parents about how I was such a “great student” and an “amazing clinician” who would “go on to do wonderful things”, yet here I was trying to think of the most eloquent way to tell this room full of people that I currently have no plan after I walk across this stage. I assumed this is what it felt like to be a washed-up child star—your 15 seconds of fame in the distance and the adult world on your heels.

After graduation, I buckled down and spent the next few months at home applying for medical SLP jobs like it was my job. And as the weeks passed, after countless messages that read “thank you for your interest, but…” I started to resign to the fact that maybe I wasn’t destined to be a medical SLP like I had thought. Maybe I was being a little too ambitious. I mean, surely I had squandered my chances in these last months at home. My dream of becoming a medical SLP seemed to be fading fast and growing less and less tangible. Nevertheless, I persisted.

And eventually my persistence paid off. Long story short, when I least expected, I was offered a hospital position that would help to set the trajectory for the rest of my career. Notice I didn’t say “perfect position”. It wasn’t exactly what I wanted, but it was what I needed at that time to get me to where I wanted to go. My Clinical Fellowship (CF) experience was so valuable and helped mold me into the SLP I am today.

While my new-grad job search isn’t my fondest memory, I must admit it forced me out of my comfort zone and taught me a few important (and difficult) lessons—both personal and professional. Now, years later, having worked at several hospitals, the questions I inevitably get asked are: How do I get a medical CF placement? What steps do I take to become a medical SLP? How do I transition to medical SLP after having worked in another setting?

So, I decided to compile a list of my straight-no-chaser tips to landing the elusive medical SLP job.

1. Be prepared to wait: We all know great things take time. I was absolutely certain I ONLY wanted to work in a hospital, and I was determined to hold out for what I really wanted because that’s how much it meant to me. If your plan is to apply to a few hospitals and jump ship if you haven’t gotten an offer in a few weeks, there is a high likelihood your medical SLP job search will result in disappointment. You and everybody else wants a medical SLP job, so just know it likely will not happen overnight. Side note: It’s okay to not have a job for a while, if you can swing it financially. Take that time to unwind from the craziness of graduate school and get your head on straight. After being away from home for 7 years, I believe my parents secretly enjoyed having me back home for a few months (lol). I knew I had their support, and that made the waiting game a lot easier.

2. Be intentional: Don’t wait until after you graduate to have this epiphany that you want to work in acute care at a Level I Trauma Center. Your chances of landing your dream medical SLP job will be significantly higher if you plan ahead. Choose a graduate program that offers a variety of medical placements and medical coursework…and make sure you get assigned to those placements. If your graduate program can’t offer what you need, it’s probably not the program for you. As soon as I knew I want to pursue medical SLP, I let my advisors know and they were more than happy to tailor my clinical experiences accordingly. By the time I graduated, I had had clinical placements at an ENT office (with videostroboscopy experience), several SNFs, an acute care hospital (with MBSS experience), an outpatient voice/dysphagia clinic, and adult cognitive-linguistic patients. Also, after months of waiting and just weeks before my placement was set to start, I was offered a spot for an amazing medical externship, which allowed me to serve some of the most medically complex patients across a variety of clinical populations. Basically, it’s very difficult to convince someone you want to work as a medical SLP when you have NO clinical experience working as a medical SLP. So as soon as you know this is what you want to do, start being intentional about your clinical path.

3. Be persistent: The job application process can feel extremely daunting. Every rejection letter chips away at your confidence. And for my fellow introverted SLPs, the emails/phone calls/interviews just make you want to retreat. But do not consider your work done after you press “submit” on that online application. Be persistent—send the HR rep an email or try to find contact information for the lead SLP or rehab manager, and express to them your interest in the position. I lost count of how many applications I completed, the number of cold calls I made, or the number of times I followed up with a hiring manager. And.that’s.so.fine. Don’t stop.

4. Fight temptations: In the midst of your medical SLP job search, you will get a lot of calls and see a lot of job postings for positions in other settings. You will see many of your friends and classmates accepting positions in other settings. And the longer you are jobless, the more tempting these offers will seem. But if you are serious about becoming a medical SLP, don’t do it. Don’t settle for a job you aren’t truly interested in or passionate about. It won’t end well. And sometimes if you start in another setting (e.g., schools), it can make it more difficult for you to transition into the medical setting in the future.

5. Be flexible: I had a “plan” when I finished graduate school. I was going to move back to North Carolina, get my dream job, and live my best life. Pretty simple. But that plan quickly unraveled and I reluctantly had to be a little more flexible. I often hear people say “I want to become a medical SLP, but [insert stipulation]” They need to work at a particular hospital, in a particular setting, with a particular population, or in a particular city. If that works out for you, congratulations. But chances are it won’t. You know that saying “You end up how you start off?” Well, that’s not the case in this situation. I’ve gone from rural Midwest to metropolitan cities. I started off in inpatient rehab and ended up acute care. I’ve worked PRN and transitioned to full-time. I have worked at community hospitals and moved to Level I Trauma Centers. You can absolutely change your course within the setting; you just have to get your foot in the door.

6. Know your stuff: I know working in a hospital seems glamorous—the white coats, trachs/vents, FEES/MBSS, the ICU, the fast-paced environment, etc. Trust me, I get it. I love Grey’s Anatomy just as much as the next person. But don’t be fooled—suctioning secretions and looking it people’s mouths all day is far from glamorous. Cool? Yeah. Glamorous? No. But you know what’s not cool? Not knowing your ish. We are in the business of changing lives, and frankly, THERE IS NO ROOM FOR MEDIOCRITY. I really can't stress this enough. If you think you are going to make it in the medical setting on a wing and a prayer…think again. No one is interested in hiring a liability. Employers want to know that you have strong clinical skills, and most employers aren’t interested in doing a lot of on-the-job-training, particularly if you are a seasoned SLP. Which is why I really stress getting your experience early (see #2), but if that’s not possible, it brings me to my next point….

7. Do the [continuing] education: When you interview for your medical SLP position, be prepared to talk to the interview panel about your most recent CEUs. If “you ain’t been doing the education *Kanye voice*”or if your CEUs are unrelated to medical SLP, it may be time to realign. Showing that you have the initiative to pursue CEUs speaks volumes. In fact, some employers are willing to hire a candidate who may be lacking in hands-on experience, but has CEUs that demonstrate that they are serious about gaining knowledge in the medical setting. And even if you aren’t’ lacking in hands-on experience, in a field that is constantly growing and evolving, CEUs will make you a much more competitive candidate.

8. Find a mentor: Sometimes who you know is more important that what you know. This is a tough pill to swallow, because you can be the best and the brightest, but you just simply don’t have the connection. So, find a mentor—better yet, find a sponsor. During my brief stint in Corporate America, I quickly learned the difference between a mentor and a sponsor. A mentor provides guidance and can advise you in your professional career—that’s helpful. A sponsor, however, is someone who advocates on your behalf, is invested in your success, and has your best interest at heart. Think about it like this, a sponsor is someone you would trust to undoubtedly champion for you even behind closed doors. Research conducted by the Center for Talent Innovation (CTI) shows that that the majority of women and minorities “need navigational support" to advance in their careers and would benefit from professional sponsorship; however, are less likely to receive this support.

9. Start early: Do as I say, not as I do. Don’t wait until a month before graduation to start applying for jobs, unless you are interested in taking some time off before you start working. Some competitive medical CF placements start accepting applications almost a whole year in advance. I would much rather a hiring manager tell me “we haven’t started accepting application yet” than to tell me “we have already selected our applicants for this year.” It can also sometimes be months before you hear back regarding an application you've submitted (see #1), so you want to start your job search early enough to allow time for the application/interview/onboarding process. Be especially mindful of when you start applying for positions if you graduate in the “off season” of the year, like August or December instead of traditional May, because you may need to start applying even earlier.

The truth is, medical SLP isn’t for everyone. Also, the medical setting comprises a smaller number of positions in our field, so in reality, there just aren’t enough medical SLP positions for everyone who wants one. It is extremely competitive, but if you follow my advice above, it will certainly help to keep your resume in the running. Landing your dream medical SLP job won’t necessarily be easy, but it will be worth it. Just remember, the dream is free, but the hustle is sold separately.