SLP Clinical Fellowship Requirements & Complete Guide 2025

Written by Sarah Keller, Last Updated: November 20, 2025

The clinical fellowship represents a critical bridge between academic training and independent professional practice for speech-language pathologists. This supervised post-graduate experience is more than just a requirement. It’s the final stage of professional development that transforms graduate students into confident, competent clinicians ready to serve patients across diverse settings.

Understanding clinical fellowship requirements is essential for every aspiring SLP. The fellowship determines when you can practice independently, influences your early career trajectory, and affects your earning potential. Whether you’re planning to work in schools, hospitals, rehabilitation centers, or private practice, the clinical fellowship is where theoretical knowledge becomes practical expertise.

What is an SLP Clinical Fellowship?

A clinical fellowship (CF) is a mandatory supervised professional experience that follows completion of a master’s degree in speech-language pathology. Sometimes called a Clinical Fellowship Year (CFY), this post-graduate period allows new SLPs to apply their academic knowledge in real-world clinical settings under the guidance of experienced professionals.

The clinical fellowship differs significantly from the clinical practicum completed during graduate school. While graduate clinical experiences provide supervised learning opportunities, the CF is a paid professional position where you work as a speech-language pathologist with gradually decreasing supervision. You’re no longer a student, you’re a professional in training.

During the fellowship, you’ll develop the independence and confidence needed to practice without constant oversight. The experience typically occurs in schools, hospitals, rehabilitation facilities, skilled nursing facilities, or private practices. Your setting often reflects your intended career path and provides specialized experience in your area of interest.

Why Clinical Fellowships are Required

Clinical fellowships serve multiple purposes in the speech-language pathology profession. The primary reasons include:

ASHA Certification Requirement: The American Speech-Language-Hearing Association (ASHA) requires completion of a clinical fellowship to earn the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP). This certification is the gold standard credential in the field and is recognized nationwide.

State Licensure Mandate: 42 of 50 states require clinical fellowship completion as part of their SLP licensing requirements. Even in states where it’s not mandated, most employers prefer or require the CCC-SLP, which necessitates the CF.

Professional Competency Development: The fellowship bridges the gap between academic preparation and independent practice. It allows new clinicians to refine assessment skills, develop treatment expertise, handle complex cases, and build clinical judgment under expert guidance.

Patient Safety and Quality Care: Requiring supervised post-graduate experience ensures that newly practicing SLPs have demonstrated competency before working independently with vulnerable populations. This protects patients and maintains professional standards.

ASHA Clinical Fellowship Requirements

The ASHA Council for Clinical Certification (CFCC) has established specific standards that all clinical fellows must meet. These requirements are comprehensive and designed to ensure thorough professional development. Complete details are available on ASHA’s official Clinical Fellowship page.

Hour and Duration Requirements

Fellows must complete 1,260 hours of clinical experience over a minimum of 36 weeks. This can be accomplished through two pathways:

Full-Time Fellowship: Working 35 or more hours per week for a minimum of 36 weeks. Most fellows choose this option and complete their fellowship in approximately 9 months.

Part-Time Fellowship: Working a minimum of 5 hours per week, with completion required within 4 years maximum. This option accommodates fellows who need flexibility due to family obligations or other circumstances.

Direct Patient Contact Requirement

At least 80% of your clinical fellowship hours must involve direct patient contact. This means actual time spent evaluating, diagnosing, and treating patients. Administrative tasks, documentation, meetings, and indirect consultation count toward your total hours but cannot exceed 20% of your fellowship time.

Supervision Standards

Your clinical fellowship supervisor must hold a current CCC-SLP credential and must be approved by ASHA. Supervision requirements include:

• Minimum of 36 supervisory sessions throughout the fellowship
• At least 18 on-site observations of your clinical work
• Regular feedback on your performance and progress
• Completion of three formal evaluations at different stages

Supervision intensity decreases as you demonstrate competency. Early in the fellowship, you’ll receive frequent direct observation and guidance. By the end, supervision may consist primarily of case consultations and review of documentation.

Evaluation and Performance Standards

You must achieve a minimum rating of 3 on a 5-point scale in all core skill areas on your final evaluation. The rating scale ranges from 1 (performance is below expected level) to 5 (performance exceeds expected level). A rating of 3 indicates you’ve met expected competency levels for independent practice.

Clinical Fellowship Supervision Structure

The supervision model used during clinical fellowships is progressive, meaning it changes as you develop competency and confidence. This graduated approach allows you to transition from closely supervised work to independent practice.

Initial Phase (Weeks 1-12): During the first quarter of your fellowship, expect intensive supervision. Your mentor will directly observe most of your patient sessions, provide immediate feedback, and closely review your documentation. You’ll meet frequently to discuss cases, treatment approaches, and clinical decision-making.

Middle Phase (Weeks 13-24): As you demonstrate competency, supervision becomes less frequent but remains consistent. Your mentor will observe selected sessions rather than all sessions, review representative work samples, and hold regular consultation meetings. You’ll have more independence in daily clinical decisions while maintaining mentor oversight.

Final Phase (Weeks 25-36): Toward the end of your fellowship, supervision may be limited to periodic observations, review of case notes, and discussions about complex or challenging cases. You’re functioning more independently, with your mentor serving as a consultant and resource rather than a constant presence.

Throughout all phases, your supervisor tracks your hours, documents your progress, and ensures you’re meeting ASHA standards for competency development.

The Mentor-Fellow Relationship

Your clinical fellowship mentor plays multiple roles in your professional development. While you may work with several SLPs in your employment setting, one designated mentor serves as your primary supervisor and evaluator for ASHA certification purposes.

Mentor Responsibilities

Your mentor’s duties extend beyond clinical supervision. They’re responsible for:

• Observing and evaluating your clinical skills across all required competency areas
• Providing constructive feedback to support your professional growth
• Identifying strengths and areas needing improvement in your practice
• Tracking your clinical fellowship hours and supervision sessions
• Completing required ASHA evaluation forms at three checkpoints
• Serving as a resource for questions about complex cases or clinical decisions
• Submitting final certification to ASHA upon successful completion

Mentor Qualifications

Clinical fellowship mentors must hold a current CCC-SLP credential and have at least 9 months of post-certification clinical experience. Many employers prefer mentors with several years of experience to ensure adequate guidance for new clinicians.

In some cases, you may need to change mentors during your fellowship due to job changes or other circumstances. ASHA allows this, but the new mentor must be approved and must provide supervision for at least the minimum required hours and observations.

Evaluation and Skill Assessment

ASHA’s clinical fellowship evaluation process is comprehensive and structured. Your mentor will assess your performance across 18 skill categories organized into four major domains.

The 18 Clinical Fellowship Skill Categories

Evaluation Skills (6 categories):

• Conducts screening and prevention procedures
• Collects case history information and integrates with assessment findings
• Selects and administers appropriate evaluation procedures
• Adapts evaluation procedures to meet patient needs
• Interprets, integrates, and synthesizes assessment information
• Completes evaluation reports and recommendations

Treatment Skills (5 categories):

• Develops treatment plans with measurable goals
• Implements treatment plans effectively
• Selects and modifies treatment approaches based on patient response
• Measures and evaluates patient performance and treatment progress
• Completes documentation of treatment services

Management Skills (4 categories):

• Demonstrates professional conduct and accountability
• Communicates effectively with patients, families, and other professionals
• Adheres to ASHA Code of Ethics and scope of practice
• Demonstrates understanding of reimbursement, regulations, and certification

Interaction Skills (3 categories):

• Collaborates with patients and families in treatment planning
• Provides counseling regarding communication disorders
• Demonstrates cultural competency and sensitivity

Three-Stage Evaluation Process

Your mentor will complete formal evaluations at three points during your fellowship:

• Initial Evaluation: Completed within the first 25% of your fellowship hours to establish baseline competencies
• Midpoint Evaluation: Completed when you’ve finished approximately 50% of required hours to assess progress
• Final Evaluation: Completed after all requirements are met to certify you’ve achieved independent practice competency

The ratings consider your accuracy, consistency, independence, and the level of supervisory guidance you require in each skill area. The goal is to see steady improvement across all categories, with final ratings demonstrating your readiness for independent practice.

How to Find Clinical Fellowship Positions

Unlike some medical residencies that use centralized matching systems, speech-language pathology clinical fellows are responsible for securing their own positions. Most fellows begin searching during the final semester of graduate school.

Primary Resources for CF Positions

ASHA Career Center: The American Speech-Language-Hearing Association maintains a comprehensive job board at asha.org/careers that includes clinical fellowship positions. Employers can specifically tag listings as CF-appropriate, making it easy to identify suitable opportunities.

Graduate Program Career Services: Most SLP graduate programs have relationships with local employers and maintain lists of organizations that regularly hire clinical fellows. Your program’s career services office and faculty members are valuable resources.

State SLP Association Job Boards: State chapters of ASHA often maintain job listings specific to their region. These can be particularly helpful if you’re planning to stay in the state where you completed your graduate work.

School District Websites: Since many SLPs work in educational settings, school districts often post CF positions directly on their employment pages, particularly in spring for fall start dates.

Healthcare System Career Pages: Hospitals, rehabilitation centers, and healthcare networks typically advertise CF positions through their own career portals.

Common Clinical Fellowship Settings

Clinical fellowships are available in diverse settings, each offering different experiences and preparation for specific career paths:

What to Consider When Selecting a CF Position

Not all clinical fellowship positions are equal. Consider these factors when evaluating opportunities:

• Mentor Availability and Expertise: Ensure your potential supervisor has time to provide adequate mentoring and has experience in areas you want to develop
• Caseload Diversity: Look for positions that expose you to varied disorders and age groups unless you’re certain about specialization
• Supervision Quality: Ask about the supervision structure and how frequently you’ll receive direct observation and feedback
• Requirements Fulfillment: Verify the position meets both ASHA standards and your state licensure requirements
• Salary and Benefits: Compare compensation packages, as CF salaries vary significantly by setting and region
• Permanent Employment Potential: Some employers use the CF as an extended interview for permanent positions
• Professional Development Opportunities: Look for organizations that support continuing education and professional growth

Clinical Fellowship Salary Expectations

Clinical fellows are compensated employees, not unpaid trainees. However, CF salaries are typically lower than those of fully licensed, independently practicing SLPs.

National Salary Ranges

Clinical fellows generally earn between $55,000 and $65,000 annually for full-time positions, representing approximately 10-15% less than the median salary for experienced SLPs. This differential reflects your supervised status and the additional time your mentor invests in your training.

The exact salary depends on several factors including geographic location, employment setting, employer type (public vs. private), and local market conditions. Urban areas with higher costs of living typically offer higher CF salaries than rural regions. For detailed salary information by state and setting, see our comprehensive SLP salary guide.

Salary by Setting

Different practice settings offer varying compensation structures:

• Public Schools: Often use district salary schedules with CF fellows placed at the first-year teacher level, typically $50,000-$60,000 depending on state and district
• Hospitals: Generally offer $58,000-$70,000 with comprehensive benefits packages and potential shift differentials
• Skilled Nursing Facilities: May offer $60,000-$72,000, sometimes with productivity bonuses or per-visit payment structures
• Private Practices: Compensation varies widely from $55,000-$68,000, sometimes structured as hourly rather than salary
• Rehabilitation Centers: Typically $57,000-$68,000 with opportunities for overtime pay

Benefits Considerations

Beyond base salary, evaluate the total compensation package. Full-time CF positions typically include health insurance, retirement plan contributions, paid time off, and continuing education allowances. School-based positions include summers off, which some fellows value despite potentially lower annual salaries.

Some employers offer sign-on bonuses, loan repayment assistance, or salary increases upon receiving your CCC-SLP credential and state license. These provisions can significantly enhance your overall compensation. According to the Bureau of Labor Statistics, fully licensed speech-language pathologists earn a median annual salary of $94,410, providing context for CF salary expectations.

State-Specific CF Requirements

While ASHA sets national standards for the clinical fellowship, individual states determine their own licensure requirements. Understanding your state’s specific rules is crucial for ensuring your CF meets all necessary criteria.

States Requiring Clinical Fellowship Experience

42 states require completion of a clinical fellowship as part of their SLP licensing process. In these states, you cannot obtain an independent license to practice until you’ve successfully completed your CF and received ASHA certification or equivalent state approval.

States Not Requiring Clinical Fellowship

Eight states do not mandate clinical fellowship completion for SLP licensure: Colorado, Michigan, South Dakota, Vermont, Delaware, Hawaii, Oklahoma, and Rhode Island. However, even in these states, most employers prefer or require the CCC-SLP credential, which necessitates CF completion.

Interstate Differences

Some states have additional requirements beyond ASHA standards, such as state-specific jurisprudence exams, background checks, or additional supervised hours. If you complete your CF in one state but plan to work in another, verify that your experience meets both states’ requirements. For example, California SLP licensing requirements include specific state regulations you should understand before beginning your fellowship.

For detailed information about specific state requirements, including Praxis score requirements and continuing education mandates, visit our comprehensive state licensing overview.

Clinical Fellowship Timeline

Understanding what to expect during each phase of your clinical fellowship helps you prepare mentally and professionally for the experience.

Months 1-3: Foundation Building

The first quarter of your fellowship involves intensive learning and frequent supervision. You’ll spend significant time observing your mentor, receiving detailed feedback on your evaluations and treatment sessions, and building relationships with patients and colleagues. Expect to feel somewhat overwhelmed as you adjust to full-time clinical work, but this is normal and expected.

Your mentor will complete your initial evaluation during this period, establishing baseline competency levels and identifying areas for focused development.

Months 4-6: Growing Independence

During the middle phase, you’ll notice increasing confidence in your clinical skills. Supervision becomes less frequent, though still regular and consistent. You’ll begin handling more complex cases with less direct oversight and start developing your own clinical style within evidence-based practice parameters.

The midpoint evaluation occurs during this timeframe, documenting your progress and areas where you’ve demonstrated growth since the initial assessment.

Months 7-9: Approaching Independence

The final quarter represents your transition to independent practice. Supervision focuses on case consultations, review of documentation, and discussions about particularly challenging situations. You’re functioning as a professional clinician with your mentor serving primarily as a resource and consultant.

Near the end of this period, your mentor completes your final evaluation. If you’ve met all requirements and achieved minimum competency ratings across all skill categories, your mentor submits certification to ASHA that you’ve successfully completed your clinical fellowship.

After Completion

Once your mentor certifies completion and ASHA processes your application, you’ll receive your CCC-SLP credential. This allows you to practice independently and opens opportunities for career advancement, specialization, and in most states, independent licensure.

Frequently Asked Questions

Once you’ve secured a clinical fellowship position, learn practical strategies and tips in our guide on how to succeed in your clinical fellowship.

2024 US Bureau of Labor Statistics salary and job market figures for Speech-Language Pathologists reflect state and national data, not school-specific information. Conditions in your area may vary. Data accessed November 2025.

Sarah Keller

Sarah M. Keller, MS, CCC-SLP, is a licensed speech-language pathologist with 15 years of experience in pediatric clinics and university training programs. She earned her master’s in speech-language pathology from a CAHPS-accredited program in the Midwest and supervised clinical practicums for online and hybrid SLP cohorts. Sarah now advises students on graduate school applications, clinical fellowships, and state licensure. She lives in Colorado with her family and golden retriever.

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