The CFY Experience: A New Grad's Perspective
week's post is an interview with Christine Costello about her Clinical
Fellowship Year (CFY) experiences. Last year I had the privilege of supervising
Christine for a few months in the skilled nursing facility (SNF) setting. Although
Christine decided to explore an opportunity in the public education system while still in her CFY, I
know she will excel there just as she did in geriatrics.
wonder sometimes if our graduate school experiences truly prepare us for the day-to-day
logistics of working in the field. I know that when I was in school I was eager
to graduate and put all of that knowledge to good use. I could not wait to
enter the professional world, work with patients and, of course, earn a living
doing it. All settings - public schools, private practice, home health, acute
care, long-term care, and outpatient clinics - have their unique challenges,
advantages and disadvantages. I encourage all graduate students (and
undergraduate students!) to seek out a variety of experiences. Contact some local
speech-language pathologists and ask them for their take on their profession
and the environments in which they work. Observe them at work whenever you can.
Additionally, try to find a mentor who can guide you and answer the real-life,
nitty-gritty questions about case loads, salaries, work environments,
expectations that are not always presented during clinical practicums and
love our field because it encompasses so many settings. A clinician can choose between a number of settings, which
can provide new professional experiences, new learning challenges, and a variety
of options in workday schedules. From the flexibility of PRN work, to the
salaried field of the school systems, to the hourly wages earned in long-term
and acute care settings, there are many opportunities that we can take
advantage of over the course of our careers.
to thank Christine for taking the time to answer these questions for me. I
truly enjoyed supervising her, and I know that she will bring her
professionalism, love for the field, and caring heart to her school-based
clients. I hope to check in with her later in her career.
interview with Christine is below.
did you decide to start your career in the SNF setting?
that I wanted to work in the medical setting. After a few different experiences
in acute care I knew I didn't feel ready for that type of setting. It was just
too fast-paced for me. I thought the SNF would be a good setting to help grow
my confidence in the medical setting with a slower pace.
you have any experience in this setting or in geriatrics while in school?
didn't have any experience in this setting while in school. Before applying to
grad school I did do some observation hours at a geriatric hospital in Atlanta, GA.
However, that was quite different than the SNF I work in now. I know some of my
classmates were placed in a SNF, but I was never placed in one.
many of your fellow graduates choose or consider a SNF setting?
not positive, but I'm pretty sure it was only me and one other person who went
into the SNF setting. Everyone else went into the school system.
(if any) worries did you have about working in a SNF? Did you have any ideas
about working in a SNF that you found to be untrue?
biggest worry I had was I thought it would be really depressing. It can be
really sad sometimes, but I also think it's a wonderful place to work. The
reality is there are people there who don't have any family or there are people
who won't remember you from one minute to the next, but I love being able to
bring positivity into their day and make them feel, if even only for a few
moments, that somebody does care about them.
is the biggest challenge for you as a CFY clinician in this setting?
the confidence I need to stand up to the individuals who doubt that I know what
I'm talking about. What I mean by this is there are people who have been in the
facility I work in for years and there are people who have been working with
them for years. I came in and started telling people to do things differently,
which didn't go over very well. Since then people have warmed up to me, but
it's still a challenge I face on a daily basis.
do you think of the CFY process so far? Can we do anything differently to
better support new graduates?
I don't have any major issues with the CF process. I think that the six hours of
indirect/direct supervision every three months is too much, especially when the
CF and supervisor are not in the same building. I think the process would be
just as effective with fewer hours.
is you favorite part of the CFY process so far? Least favorite?
best part has been getting great feedback from my supervisor. I am the only SLP
in my building so she is really the only person I have to go to who can answer
SLP questions. She gives me great ideas for how to improve my skills. As for my
least favorite aspects, please see my answer to the previous question.
advice would you give to graduate students about geriatrics and long-term care
based on your experience so far?
would say it's definitely not for everyone, but it can be a very positive
experience. You have to get the nurses and certified nursing assistants (CNA)
on your team if you really want them to follow through with what you tell them.
However, be prepared for some people to continue to disregard you completely.
When that is the case, don't be afraid to go to the director of nursing. Be
prepared to have to be creative and try a variety of therapy techniques to
obtain your goal.
graduate school prepare you to work in this setting?
and no. As far as evaluations and therapy planning I would say yes. I didn't
learn anything regarding Medicare in school. I still feel like I don't know
what I need to know really. School also didn't prepare me for the business side
of things. In school we learn it's all about helping individuals and we never
talk about the fact that there are also businesses that need to make money.
is the most important thing you've learned from working in a SNF?
with any setting, it's important to be as productive as you can be and to make
sure every therapy session is as effective as possible.
continual growth and progress, such words as improvement, achievement and
success have no meaning. - Benjamin Franklin