The SLP Clinical Fellowship: Hours, Supervision & Timeline

The clinical fellowship (CF) is the final supervised year between your master's degree and full CCC-SLP certification. It's a real, paid job — but with hour requirements, supervision rules, and paperwork that can quietly go wrong if nobody's tracking. Here's the complete rulebook.

Clinical fellowship requirements at a glance

• Minimum 1,260 hours of supervised professional experience.
• Minimum 36 weeks of full-time work (35+ hours/week).
• At least 5 hours per week — you cannot bank hours in bursts.
• 80% of your time in direct clinical contact — assessment, treatment, family/team consultation about specific clients.
• Mentor must hold a current, active CCC-SLP for the full fellowship.

Full-time vs. part-time timelines

Full-time (35+ hrs/week) gets you to 1,260 hours in about 36 weeks — roughly nine months. Part-time extends the calendar proportionally:

• 20–34 hrs/week → the fellowship must run longer than 36 weeks.
• 15–19 hrs/week → minimum 72 weeks.
• 5–14 hrs/week → minimum 144 weeks.
• Under 5 hrs/week → does not count at all.

The supervision structure people get wrong

Your mentor owes you 18 supervisory activities spread across the fellowship — not clustered at the end:

• 12 monitoring activities minimum, of which at least 6 must be direct observations (real-time, in person or via live video) of you working with clients.
• 6 indirect activities — record review, conferences, phone/video consults, evaluating written reports.
• Requirements are divided into thirds: at least 6 activities (2 direct + 2 indirect minimum) per third of the fellowship.

The trap: a mentor who's technically listed but rarely present. If the observations aren't documented, ASHA can reject the fellowship and you repeat the segment. Log every observation the day it happens.

The CF Report and Rating Form (CFRF)

This is the document that closes the fellowship. Your mentor rates you across skill areas using the Clinical Fellowship Skills Inventory (CFSI) and signs off that you met the hour and supervision requirements. Both you and the mentor sign it, and it goes to ASHA with your CCC application.

You must earn a rating of 3 or higher on every core skill in the final evaluation. If your mentor flags a deficit, the fellowship extends until it's remediated.

Can you start a CF before passing the Praxis?

ASHA does not require a passing Praxis score to begin the fellowship — but it does require one before you're awarded the CCC. States are the harder constraint: most issue a provisional/temporary CF license, and many of those require a passing 5331 score first. Check your state's board rules before assuming you can start.

Practically: pass the Praxis in your final grad semester. Starting a fellowship while still studying is how people end up retaking the exam during their most exhausting work year.

Choosing a fellowship placement

Ask about these before you sign:

• Who is my mentor, and what's their caseload? An overloaded mentor can't do 6 direct observations.
• What's the productivity expectation? 90%+ productivity in a SNF leaves no room for documentation or mentoring.
• Caseload composition. A CF that's 100% one population narrows your skills right when you need breadth.
• Is CF supervision written into the contract? Verbal promises evaporate when the schedule gets tight.
• What happens at the end? Many employers convert CFs to full positions — clarify pay after certification.

Common settings and what they teach you

• Schools: high caseloads, IEP-driven, strong for pediatric language, articulation, and legal frameworks.
• Skilled nursing facilities (SNF): dysphagia-heavy, productivity pressure, excellent medical foundation.
• Acute care hospitals: fast-paced evaluation work, swallow studies, trach/vent populations. Hardest to land as a CF.
• Outpatient/rehab: mixed adult neuro, voice, and cognitive-communication.
• Early intervention: home-based, coaching model, birth to three.

Fellowship pay

CF salaries usually run below fully certified SLP pay — commonly 10–20% lower — because the employer absorbs supervision time. Medical settings typically pay more than schools; travel and rural contracts pay the most. See salary by state for regional benchmarks.

Timeline from CF start to CCC

1. Register your fellowship intent and secure a state provisional license.
2. Work ~36 weeks full-time, logging hours and supervisory activities.
3. Mentor completes the CFRF and rating inventory.
4. Submit the ASHA CCC application with transcript, Praxis score, and CFRF.
5. Upgrade your state license from provisional to full.