A new SLP is about to start their clinical fellowship. Across town, an experienced clinician just agreed to mentor one. Both are looking at the same ASHA pages and walking away with different questions.
And then there's the term confusion. CF, CFY, CF-SLP, CF mentor. Same year. Different labels depending on who's talking. If you've been on either side of a speech language pathology clinical fellowship and felt like the rules kept shifting under your feet, you're not alone.
This guide explains the clinical fellowship slp experience from both perspectives: what it actually is, how the year is structured, what each person is on the hook for, and the documentation traps that quietly delay a CCC-SLP at the finish line.
What the Clinical Fellowship for SLPs Actually Is
The CF is a 36-week, 1,260-hour supervised post-graduate experience required for the ASHA Certificate of Clinical Competence (CCC-SLP) and for licensure in 42 states.1 You finish your master's, you start the CF, and somewhere in the middle of it you sit for the Praxis. Once the CF and the Praxis are both done, you submit for the CCC-SLP and step into independent practice.
So what are all the different acronyms? Here's the short version. CF is the official ASHA term, standardized in 2020. CFY ("Clinical Fellowship Year") is an older synonym that still lives in job postings, program handbooks, and casual conversation. CF-SLP is a status, not a job title: it's how you refer to an SLP who's actively in their fellowship. CF mentor is the specific name ASHA uses for the supervising SLP. For a longer breakdown of the terms, our What is a CF-SLP? post has you covered.
One thing worth saying clearly: clinical fellows aren't interns or volunteers. You're a paid clinician carrying a real caseload. The CF is a structured transition, not a holding pattern.
The Structure of the SLP CF Year: Three Segments, Not One Block
Here's the single most misunderstood part of the slp cf year: the fellowship isn't one continuous block. It's divided into three segments, and most of the paperwork lives at the segment level, not the year level.
Each segment requires at least 6 hours of direct supervision (on-site, in-person observation of you evaluating, treating, or counseling clients) and at least 6 hours of indirect supervision (chart review, case conferences, documentation review, consults on clinical decisions).2 Add it up across three segments and you get a minimum of 18 direct hours, 18 indirect hours, and 36 monitoring activities total.
The Clinical Fellowship Skills Inventory (CFSI) is completed at the close of each segment, not at the end of the year.3 That distinction sounds small. It isn't. If a CFSI hasn't been filled out segment by segment, both you and your mentor are reconstructing a development arc from memory, which is hard to defend if ASHA has any follow-up questions.
A few other rules that catch people off guard:
- A given week only counts toward the 36 if you logged at least 5 hours that week.
- Full-time CFs (35+ hours/week) typically finish in about 9 months. Part-time CFs can go as low as 5 hours/week and have up to 4 years to complete the experience.1
- At least 80% of your hours must be direct clinical contact. Documentation, meetings, training, and prep all share the remaining 20%.
If you're working part-time in a school setting and four of your weeks land under that 5-hour minimum, those four weeks don't count. Better to know that in week one than in week thirty.
What the Fellow Is Responsible For
ASHA puts the burden of hour tracking on you, not your mentor.2 That's worth circling. If your records and your mentor's records disagree at certification time, ASHA looks to yours.
So set up a simple log on day one. Date, hour type (direct or indirect), one-line activity note. Some fellows use a spreadsheet. Others use a CF-specific template inside their clinic's EMR. The format doesn't matter as much as the consistency.
The 80/20 split is the other thing to watch closely. School-based CFs running a caseload of 45 to 55 students with constant IEP paperwork can watch the documentation side of their week creep past 20% before anyone notices. Medical CFs in fast-paced outpatient settings can hit the opposite problem, where chart review time gets undercounted because it feels like "real" clinical work.
You also need to submit your ASHA certification application before or during the CF, and the CF itself has to be completed within four years of that application date.3 The Praxis can be taken before, during, or after the CF. Most fellows take it during.
And then there's the part nobody puts in the ASHA standards: the transition itself is disorienting. The clinical work feels familiar from grad school. The autonomy and the pace don't. Imposter syndrome in the first segment is common, and it isn't a sign you don't belong. It's a sign you're paying attention. By the second segment most fellows describe the work as starting to settle.
What the CF Mentor Is Responsible For
If you've agreed to mentor a clinical fellow for the first time, three qualifications apply to you. All three are required.2
First, you have to hold an active CCC-SLP throughout every segment you're mentoring. Not just at the start. Throughout. If your certification lapses mid-segment, that segment doesn't count toward your fellow's experience.
Second, you need at least 9 months of full-time clinical experience after earning the CCC-SLP. Work completed before certification doesn't count toward this minimum.
Third (and this is the one most first-time mentors miss): you need at least 2 hours of continuing education specifically in clinical instruction or supervision before you start mentoring.4 It's a newer professionalization standard, and it isn't optional.
Beyond the qualifications, your job during each segment is to distribute observations across the segment, not front-load them into the first two weeks. No single observation session can exceed 6 hours, so you can't schedule one big day per segment and call it done. Keep a running log with the date, type, duration, and a one-line activity note for every observation. Complete the CFSI at the close of each segment. And give your fellow structured feedback along the way, not just at segment close.
For a deeper look at what CF mentors actually need to document, our CF supervision SLP guide walks through the full checklist.
The Documentation Trap (and How to Avoid It)
Here's the pattern that delays more CCC-SLP applications than any clinical issue: the work goes well, then the paperwork holds up certification.
A few specific risks worth naming:
- Retroactive hour tracking. Trying to reconstruct what happened in week seven during month four is a guessing game. Real-time logging takes ten seconds. Reconstruction takes an hour and produces records you can't fully defend.
- CFSI treated as a year-end form. If you haven't been completing the CFSI per segment, you're piecing together a development arc from memory at the end of the year.
- The 80/20 ratio slipping unnoticed. Documentation creeps. School-based caseloads, IEP cycles, and medical chart review all eat into the 80% direct contact threshold without anyone noticing until totals get audited.
- Lapsed mentor certification. Even a short lapse mid-segment voids that segment's hours.
Most of these problems share one root cause: two people keeping separate notes. The fellow logs hours in their spreadsheet. The mentor scribbles observation notes on whatever was nearby. At the segment close, the two logs don't match.
The fix is unglamorous and effective: set up a shared tracking system in week one. Three columns. Date, hour type (direct or indirect), one-line activity description. Both fellow and mentor reference the same log. If you want a closer look at software that supports CF hour tracking, our SLP clinical hours tracking software post compares some of the common options.
How to Set Up the CF Year So It Works for Both Sides
If you're a fellow and a mentor about to start working together, block off thirty minutes in the first two weeks for a setup meeting. Most pairs skip this and pay for it at segment close. Here's what to cover:
- Confirm mentor qualifications. Active CCC-SLP, 9 months of post-certification experience, and 2 hours of supervision CE. All three.
- Map the three segments to actual calendar dates. Write down when segment 1, 2, and 3 begin and end. Not approximately. Specifically.
- Agree on a shared tracking system. A spreadsheet, a shared doc, an EMR template. Whatever you pick, both people use the same one.
- Schedule recurring supervision time. Block it on the calendar, distributed across the segment. Not one big day. Multiple smaller ones.
- Plan your CFSI completion dates. Put them in the calendar at each segment close. Don't drift toward year-end.
If you're the mentor, here's a question worth asking yourself before segment one ends: if your fellow had to defend their CF hours to ASHA today, would your records back them up?
If the answer is "probably," fix what's missing now. Reconstructing later is harder than logging accurately in real time.
One Year, Two Roles, Better Together
The clinical fellowship slp experience is one year, three segments, two roles, and a layer of paperwork that gets easier when both sides plan for it. Most CF problems aren't clinical. They're administrative. A shared log set up in week one prevents most of them.
ClinicNote is built for university clinics and private practices that supervise SLPs, including clinical fellows. If you want to see how documentation, observation logs, and supervisor sign-off live in one place, take a look at our university and private practice pages. Or book a demo and we'll walk you through it.
Sources
- https://www.asha.org/certification/clinical-fellowship/
- https://www.asha.org/practice/supervision/supervision-of-clinical-fellows/
- https://www.asha.org/certification/certification-standards-for-slp-clinical-fellowship/
- https://www.asha.org/certification/2027-slp-certification-standards/
- https://www.speechpathologygraduateprograms.org/slp-clinical-fellowship/