How to Become a Medical Speech Language Pathologist in California

The aging baby-boom population will create more cases of health conditions that cause speech or language impairments like strokes and hearing loss. On top of that, medical advances help more premature infants and trauma victims survive, and these patients often need speech therapy. Medical SLPs work in a field that continues to expand while making a real difference in people’s lives. Let’s explore what medical speech language pathologists do and how to become one in California.

Your path starts with a Master’s degree in speech-language pathology (60 semester units). You’ll also need to complete 300 hours of clinical practicum under supervision at an approved educational institution. The final step requires passing an exam with a score of at least 162. The process might seem daunting at first, but this piece will guide you through each step to become a qualified medical speech language pathologist in the Golden State.

Understand the Role of a Medical Speech Language Pathologist

Medical speech language pathologists (SLPs) play a key role in healthcare teams. They bring expert knowledge in communication and swallowing disorders. These professionals take a different path from those in educational settings. They focus on medical conditions that affect a patient’s communication and swallowing safety. Let’s learn about their work, workplace settings, and what makes them different from school-based SLPs.

What does a medical speech language pathologist do?

Medical SLPs help diagnose and treat various speech, language, cognitive-communication, and swallowing disorders in patients of every age. Their main duties include:

• Evaluating and diagnosing speech, language, communication, and swallowing disorders
• Creating and carrying out individual-specific treatment plans
• Teaching patients, families, and other healthcare professionals
• Working with teams of physicians, nurses, and therapists

Medical SLPs also run specialized tests like modified barium swallow studies or flexible endoscopic evaluations of swallowing. They prescribe speech-generating devices, suggest diet changes, and teach strategies to help patients communicate better.

These specialists need deep knowledge of anatomy, physiology, neuroanatomy, and brain-behavior connections. They must understand how system disruptions show up in conditions from post-stroke aphasia to Parkinson’s disease-related dysphagia.

Common settings and patient populations

The American Speech-Language-Hearing Association (ASHA) reports that much of SLPs work in healthcare settings – about 39%. The breakdown shows 16% in nonresidential healthcare facilities, 13% in hospitals, and 10% in residential healthcare facilities.

Medical SLPs work in various settings such as:

• Acute care hospitals and intensive care units
• Inpatient rehabilitation facilities
• Skilled nursing facilities
• Outpatient clinics
• Home health settings

These specialists help people of all ages—from babies with feeding issues to older adults recovering from stroke. They often treat patients with:

• Neurological conditions (stroke, traumatic brain injury, Parkinson’s disease)
• Head and neck cancers
• Voice disorders
• Respiratory conditions requiring ventilator support
• Cognitive-communication disorders
• Progressive diseases like ALS or dementia

Each setting brings its own challenges. Hospital-based SLPs handle acute care needs, while rehabilitation facility specialists help patients regain independence through better communication and swallowing skills.

How medical SLPs differ from school-based SLPs

The main difference between medical and school-based SLPs lies in their focus and qualifying criteria. Medical SLPs aim to improve quality of life and medical outcomes. School-based SLPs address educational impacts.

Medical SLPs provide services based on medical necessity through evaluation and clinical judgment. School-based services need an educational impact—students qualify through an Individualized Education Plan (IEP). Their communication disorder must affect their academic performance.

There’s another reason these roles differ in caseload and service delivery. Medical SLPs typically:

• Work one-on-one with patients instead of groups
• Handle smaller overall caseloads
• See more varied disorders
• Focus on daily living communication rather than academic success

Medical SLPs also work closely with healthcare teams, including physicians, nurses, dietitians, and other therapists. This cooperative effort creates a comprehensive approach to patient care. Such teamwork helps address complex medical conditions that affect communication and swallowing.

Meet the Educational Requirements

Getting started as a medical speech language pathologist requires the right education. California has strict rules to make sure practitioners can serve patients well. Let’s look at what you need to know about education – from college through graduate school.

Bachelor’s degree prerequisites

A bachelor’s degree comes first, before you can start graduate studies in speech-language pathology. While you can major in anything and still get into a graduate program, a bachelor’s in Communication Sciences and Disorders makes the path easier. Students with degrees in other fields need to take extra courses before graduate school.

You’ll need these basic courses:

• Anatomy and Physiology of Speech and Hearing Mechanism
• Phonetics and Phonemics of American English
• Introduction to Audiology
• Speech and Language Development in Children
• Neuroscience/Neuroanatomy (recommended)

ASHA certification needs more than just field-specific courses. You must take at least one course in statistics, behavioral/social sciences, physical science (physics or chemistry), and biological science. Many programs want students to have at least a 3.0 GPA from their undergraduate studies.

Master’s degree in speech-language pathology

California Speech-Language Pathology and Audiology Board says you need a master’s degree or equivalent from an accredited school. This rule won’t bend.

The American Speech-Language-Hearing Association (ASHA) sets specific rules for graduate programs. Master’s programs must have at least 60 semester units and include 300 hours of supervised clinical work across three different settings.

Most master’s programs take five semesters and use a group-based approach. To name just one example, California State University Long Beach runs a 58-unit program with internships in schools and medical settings. After graduation, students can get their Certificate of Clinical Competence from ASHA, the Speech-Language Pathology Services Credential from California, and state license.

Students usually study full-time since courses run once yearly in a set order. A 3.0 GPA must stay throughout graduate school.

California-approved graduate programs

California has more than 20 accredited speech-language pathology graduate programs. The California State University system runs many programs in Long Beach, Los Angeles, Northridge, Monterey Bay, and other cities.

Each program works differently with its own deadlines and start dates. CSU Monterey Bay starts new groups each summer, and applications open about 18 months early. Top programs often close applications almost a year before classes start.

Students who need flexibility can choose online options. California State University in Northridge has an online Master of Science in Communicative Disorders that takes 41 months and keeps ASHA accreditation.

Make sure your chosen program has accreditation from ASHA’s Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA). This stamp of approval means your degree will work for California certification and licensing.

Complete Clinical Practicum and Supervised Experience

Your practical experience is a vital milestone after graduate school to become a medical speech language pathologist in California. The hands-on training happens in two parts: clinical practicum during your education and Required Professional Experience after graduation.

Minimum 300 hours of clinical practicum

California license requires at least 300 hours of supervised clinical practicum in three different clinical settings. Students need exposure to patients of various age groups with communication disorders throughout their lives. Supervisors with current ASHA Certification of Clinical Competence (CCC) must verify these clinical hours.

ASHA certification has slightly different requirements. Students need 400 clinical clock hours. This includes 25 hours of guided observation and 375 hours of direct client contact. Students must complete at least 325 of these hours during their graduate program.

Most students get these hours through:

• On-campus clinical experiences (35-50 child hours and 15-25 adult hours)
• School/pediatric internships (125+ hours with children)
• Medical/adult internships (50+ hours)

Required Professional Experience (RPE)

The Required Professional Experience (RPE) comes after graduation. This supervised practice meets licensure requirements. You’ll work with a temporary RPE license under a licensed speech-language pathologist’s supervision.

The RPE needs 1,260 hours of work experience. Full-time workers must complete this in at least 36 weeks. This experience serves as your Clinical Fellowship Year. Full-time candidates can split this into three 12-week segments.

Your supervisor will provide direct supervision and tele-supervision during RPE. They’ll watch you in person and monitor you through audiovisual means. Each segment needs a minimum rating of two in all skill areas.

Full-time vs part-time supervision requirements

Your work schedule determines the supervision requirements:

For full-time RPE (30-40 hours weekly):

• Complete 36 weeks minimum
• Get 8 hours of direct monitoring monthly
• Spend at least 4 hours in screening, therapy, and evaluation

For part-time RPE (15-29 hours weekly):

• Complete 72 weeks minimum
• Get 4 hours of direct monitoring monthly
• Spend at least 2 hours in screening, therapy, and evaluation

Working less than 15 hours weekly extends the completion time. Many candidates complete their certification and licensure requirements together since these processes overlap significantly.

Pass the Praxis Exam and Submit Documentation

Becoming a medical speech language pathologist in California needs more than academic training and clinical experience. You must pass a standardized test. The Praxis examination opens the door to professional practice and shows you’re ready to help patients with communication and swallowing disorders.

Praxis exam overview and passing score

The Speech-Language Pathology Praxis Exam (5331) is a national test that ETS (Educational Testing Service) manages. This computer-based test has 132 selected-response questions that cover ASHA’s “Big Nine” practice areas:

• Articulation
• Fluency
• Voice, resonance, and motor speech
• Receptive and expressive language
• Hearing
• Swallowing
• Social aspects of communication
• Cognitive aspects of communication
• Communication modalities

California licensure requires a minimum score of 162 on a scale of 100-200. This score matches ASHA’s certification requirements. The test runs for 2.5 hours. Note that only correct answers count toward your score, so it’s better to guess than leave questions blank.

Taking the exam

ASHA suggests you take the Praxis exam after finishing your graduate coursework and clinical practicum or during your first year of practice. Most people choose to take it in their final year of study while academic knowledge stays fresh.

You can sign up on the ETS website or call 800-772-9476. The examination fee is $146. You can pick between testing at ETS centers or online through ProctorU. Tests run seven days a week from 7:00 a.m. to 10:00 p.m. Pacific Time.

If you need to retake the test, you’ll have to wait 28 days after your last attempt. Your scores must be valid within five years before you submit your certification application.

Required documents for submission

During registration, you need to pick who gets your scores from ETS. For California licensure, send your results to the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board using code R8544.

If you’re also getting ASHA certification, use code R5031 to send scores their way. It’s smart to send results to your school too.

Note that ETS must send exam results directly – you can’t submit them yourself. You can turn in your license application before taking the Praxis, but you won’t get permanent licensure until you pass.

The exam tests everything you’ve learned as a medical speech language pathologist and checks your clinical decision-making skills in a variety of practice areas.

Apply for Licensure in California

California’s Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board provides the final formal step in your experience to become a medical speech language pathologist. Getting proper licensure is a vital step that changes your academic knowledge and clinical experience into legal authority to practice.

Temporary RPE license application steps

You must apply for a Required Professional Experience (RPE) temporary license before starting supervised practice. Here’s what you need to apply:

• Complete the RPE temporary license application form
• Submit a passport-quality photo
• Pay the $35 application fee via check or money order
• Provide university recommendation for clinical practicum completion
• Submit official transcripts within 30 days of license issuance

The RPE temporary licenses cannot be renewed but extensions are possible under specific circumstances outlined in California Code of Regulations section 1399.153.10.

Live Scan fingerprinting and fees

You need fingerprint clearance through both Department of Justice (DOJ) and Federal Bureau of Investigation (FBI) criminal history background checks in California. Requirements vary based on your location:

• California residents: Must use Live Scan electronic fingerprinting
• Out-of-state applicants: Submit two completed FD-258 fingerprint cards with an additional $49 processing fee

The Board suggests completing Live Scan within thirty days before submitting your application. Results without corresponding applications are destroyed after six months.

Mailing your application and tracking progress

Send your complete application package to: 1601 Response Road, Suite 260, Sacramento, CA 95815. You can expect:

• Processing time of approximately 8-9 weeks
• Additional 4 weeks if documents are missing
• Temporary license receipt within 1-2 weeks after application review

You can track your application status on the Board’s website by entering your personal information, including your Social Security Number’s last six digits. Military spouses and veterans can get expedited processing.

Become a Medical SLP Today

Becoming a medical speech language pathologist in California definitely takes deep commitment and smart planning. Your path will include completing extensive education, getting supervised clinical experience, passing the Praxis exam, and directing yourself through state licensure. These steps take time and effort but help you build expertise to serve patients with communication and swallowing disorders.

This career path shows great promise for growth. The aging population keeps increasing, and medical advances help more people survive conditions that need speech therapy. You’ll have the chance to make real changes in patients’ lives in healthcare settings of all types.

Each step builds on what came before it. Your undergraduate work sets you up for graduate studies, which paves the way for clinical practicum and supervised experience. Once you score at least 162 on your Praxis exam, you can complete the final steps to earn your professional credentials.

The process might look tough, but many professionals have picked up on this path before you. Most find great value in the RPE period because it offers ground experience with mentorship. California has many accredited programs to help you meet all requirements quickly.

This roadmap gives you clear direction toward becoming a qualified medical speech language pathologist in California. A rewarding career lies ahead—you’ll be a key part of healthcare teams while helping patients overcome communication challenges and boost their quality of life.