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10 Things You Didn't Learn in SLP Grad School

by Jessica Schell, MS, CCC-SLP

Finally, after all the stress, anxiety, and money, it’s time to graduate. You have the enthusiasm and knowledge, and you are ready. Carpe diem! But once you start your job as a first-time speech-language pathologist, you realize the stress and anxiety are still there, and you are definitely not carpe-ing the diem. At all. To ease the stress of this transition to a new stage in your life (and help you regain your enthusiasm), I want to share with you ten things I didn’t learn in grad school.

1. Time is not a luxury you can afford

When I was in grad school I had 48 hours to create a lesson plan for my client. It was beautiful. There were themes! They were lovingly crafted to facilitate the best therapy sessions these kids had ever seen! In the real world, time is a luxury. Your caseload is not comprised of just one or two patients but a full day’s worth of cases. You have to think on your feet and learn activities that can be adapted to a multitude of disorders. You will get used to this fast pace and soon will be unable to remember that you once spent so much time preparing for one client.

2. Documentation is the bane of your existence

This goes hand in hand with the time dilemma. Less time in general means less time for documentation. When you start a full-time job, it can be very intimidating to document your (many) clients in a fraction of the time you were expected to in grad school. Plus, you have to document according to guidelines to ensure that you’re reimbursed correctly for your services. This is something that gets better with experience, but it can be frustrating and a challenging aspect of your new career that you have to adapt to in the meantime.

This can be especially true for SLPs working in home health! Luckily, we have some tips for managing it all when you're on the go!

3. Scheduling is an art form

Remember those four weeks you get off around the end of the year in grad school? That’s not a thing in the working world. If you choose to work on the medical side of speech therapy, you will most likely have to work holidays (yes, all of the holidays) and potentially some weekends. Also, getting coverage for your vacation time can be dicey in some positions, so be sure to ask about that during your interview process.

4. Insurance is the invisible influencer

In graduate school, we are essentially taught that we are the experts in speech-language pathology, and in many ways we are. However, being a patient care expert doesn’t necessarily mean you call all the shots. On the job, you have to work with insurance companies which may dictate how often you see a patient, how long your sessions are, and when you are going to discharge them. Fear not! You can use your documentation and clinical expertise to (ideally) extend the insurance coverage, and know that you are advocating for the best care for your patient.

5. Fellow SLPs are few and far between

One of the things that affected me most when I started my career was the lack of interaction with other SLPs. I missed the collaboration, friendship, and understanding found in being with my fellow SLP’s. In most cases, you will be the only SLP in your facility which is a substantial change from grad school; where you eat, sleep and breath speech. In school, you are surrounded by other people who are doing the same thing you are.

School settings can be notorious for this issue, but don't let that stop you if you're interested in the setting! Here are some pros and cons of being a school-based SLP.

In the professional environment, you will need to network to meet other SLP’s ( or SLP interns) to maintain the camaraderie that’s necessary in our field. The ability to discuss recent research, best practices, treatment strategies that work ( or don’t work), and problem solving difficult patients are only some of the things we encounter in our daily work, and it’s hard to not have an SLP nearby to bounce ideas off of.

6. Educating other professionals never ends

I did not think that I would be regularly educating other professionals about my skills, background, and the services I provide. I expected to have to provide that information to patients and family members fairly frequently, but I did not think about having to explain my work to nurses, doctors, social workers, other therapists, and even potential managers of my department. The field of speech-language pathology is still considered a newer field in healthcare, which means you will have to educate others about your services and the different diagnoses you can help to treat.

7. The pay is not commensurate with the cost of your education

With college tuition rising every single year, one would expect that pay in the real world would rise as well. That is not the case. This may have been the most shocking and frustrating thing that I learned when I started my job search There are programs that can help with student loan payback, and there are jobs out there that will pay more than others, but if you’re looking for those positions, be prepared for them to be in less than ideal areas. No matter where you go, the pay you will be offered will be much different than what you may have been told to anticipate when you were in grad school.

8. People will refuse your services

Even if they desperately need your help, people will refuse it. Your role in the working environment is to educate people about your skills and all the benefits of speech-language pathology, but at the end of the day, your patient may still refuse you. And that’s okay. As your clinical experience grows, you will find ways to promote our profession and to promote your services. Also, as you establish yourself in your setting, you will find that coworkers will see the benefit of your services and will help you with advocating the many advantages of speech therapy.

9. Productivity is an unavoidable part of your career

Productivity can be roughly calculated by dividing how much time you can bill for by how much time you are on the clock. Even though productivity is commonly associated with skilled nursing facilities, it is also tracked in hospitals, home health roles, and outpatient clinics. While measuring productivity isn’t inherently a bad business practice (businesses, after all, need to bring in more money than they are paying out to stay open), it can lead to stress, ethical issues, and burnout for their employees.

10. You'll provide more than just speech therapy

Grad school teaches you that your life will be all speech therapy, all the time, but as an SLP, you do so much more than that. You are an advocate for your clients; you’re a counselor, a mediator, a sounding board, and problem solver. No matter where you go to grad school, you can’t learn how to cope with and educate people who have a terminal illness or a lifelong diagnosis in a classroom.

I know that there are plenty of things I don’t have on my list because I’m always learning in this great field of ours. If you have something to add to our new grad readers, add a comment below!

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