Need advice: SLP to pre-med

[fromslptomd]

I have read through as many of these threads as I can find, but most responses seem to be based upon OP's personal stats and academic history, so I figured I'd take a shot at posting my own and gaining some advice.

I'm a 21-year old Illinois resident. I just graduated on May 9th with my B.S. in speech pathology and audiology and a minor in psychology, with a 3.846 cumulative GPA, 4.0 sGPA (biology 101 and principles of chem I, both with labs), and no debt. I got a 306 overall on the GRE without studying more than 5 hours total. I understand GRE scores aren't significant to the med school process, but I just figured I'd throw more stats in for additional information. The plan was to complete a master's in speech path, so I've already committed to starting a 2-year SLP graduate program at my same university in the fall. I have student clinical experience in the speech and audiology field, and loved working with my clients. However, probably due to some events in my life recently, I've felt a change of heart (unfulfilled and an ache or need to do more for clients and patients than just speech, language, and hearing therapy). It seems embarrassingly cliche to type out on a site full of physicians, but I do feel this immense push or draw to medicine that didn't occur when I decided on speech. I feel as if I have more to give, and think MD may be the path to take, but I'm having trouble confirming my desire to switch as I would be leaving the relative ease and security of being an SLP behind.

My family have expected me to be an SLP for the past 3 years of my being in college and are having a hard time even considering me looking at an alternative path. I'm torn between just finishing the 2-year SLP grad program and deciding how I feel then (where I could have access to a well-paying job, a more stable schedule, etc), or if I should make the jump sooner and apply to postbac programs/go the DIY route most likely at my current university, which is just a state school. I clearly have many prereqs I still need to complete and an MCAT to take either way. I'm worried about disappointing or annoying my parents and professors who I've grown close with if I do decide to move on from speech, but at the end of the day I want to be in a career I love and without regrets. I understand that given my age I would have opportunities later on in my life to continue pursuing medicine or speech path based on whichever route I take, but I'd prefer to decide sooner rather than get 2-3 years down the road and realize the path I chose was wrong.

If anyone has any advice, I would greatly appreciate it. My ability to shadow a physician/surgeon is pretty limited due to covid, but I'm working on getting in touch with physicians and surgeons once elective procedures begin to take place again in my local area. Additionally, some advice or suggestions on getting my foot in the door on volunteerism, shadowing, and clinical experience while working and/or going to school would be hugely beneficial. I am just wondering if there are other ways to solidify the choice.

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[fromslptomd]

Still hoping for some advice/words of wisdom!

 

[DadIsFat]

Hi! Current SLP starting M1 in the fall. I think you first need to decide exactly what you want to do- medicine or speech. Both are great paths and it sounds like you need more exposure to medicine. Hopefully you will be able to shadow soon. Have you had an opportunity to shadow a medical SLP? If not, I recommend doing that as well. I’ve worked on the medical side of speech for many years and there are lots of great opportunities- working with head and neck cancer patients, stroke patients, and many other interesting areas. What exactly do you feel is drawing you to medicine? What is drawing you away from speech?

Are there SLP assistants in your state? In my state, they primarily work in the schools so it does not lend much in terms of gaining clinical experience. If you aren’t committed to going to graduate school, consider getting a job and gaining volunteer experience and shadowing in the meantime. Volunteer experience can be anything you enjoy- Clinical and non-Clinical. I volunteered at a free clinic my church supports. You may have some NSSHLA hours for volunteering as well that you can list.

I recommend shadowing physicians when possible and getting exposure to the medical side of speech as well. That may help you decide if you haven’t found your interest in speech yet vs. knowing if you want to pursue medicine.

 

[DadIsFat]

One more thing @fromslptomd, we’re your science courses the ones for science majors or for non-science majors? Med schools want the ones for science majors so if your classes were for non-science majors you will have to take the others. Just FYI. Best wishes!

 

[fromslptomd]

I don't think you should enter the master's program while you feel like this, you can always go back to that if you change your mind.

Before you look at post bac coursework ($$$), definitely focus on clinical exposure. Confirm medicine is what you want. Working as an SLP is a great way to get more clinical experience, but you're right, you also need to shadow physicians. I'm assuming you'll have contact with neurologists at the very least? If not, you'll make friends with your colleagues and they will have connections as time goes on. You can also make connections with physicians through clinical volunteering.

Once you're sure medicine is your true path, look at the list of post bac programs on AAMC website (heck, you can look now! just don't stress about it). You probably will classify as a "career changer" (because you haven't completed most of your prereqs) which can open up a lot more program options. Don't take the MCAT until you've finished your prereqs.

So, if you were a loved one asking me these questions, I would recommend putting additional schoolwork on hold. Get a job as an SLP and start gaining those clinical exposure hours (I don't think patient-care time spent as part of graduation requirements during school will count on med school applications). Give yourself a few months to get adjusted to adult life, and then find a volunteering activity that will bring you outside your comfort zone, ideally something that helps people who are underserved. Eventually, work on developing connections with physicians, or cold-calling offices, to find those you can shadow. I think it would be great to shadow neurology since it's so intertwined with speech, and that may help you pinpoint why medicine. I would also encourage you to shadow in primary care since it will give you a broader perspective on what medicine looks like.

*edit - just realized becoming an SLP requires a master's, is there such a thing as a speech assistant? can you work in a rehab hospital setting?

Thank you for your reply, I truly appreciate this advice!

I began looking at post bac programs on the AAMC website a few weeks ago and familiarized myself with the terminology (career changer vs grade enhancement, etc) and found a few really good programs that I'm interested in. SLP assistants do exist and I know some grad students in my program took gap years to work in that position before beginning graduate school. However, in my area these jobs are very limited and are usually not on the medical side of speech, especially now with the covid restrictions (Illinois remains one of the most restricted states as far as covid goes). My original plan for this summer was so find a job as a speech assistant in a hospital because I loved the more medical based classes I took (neurology, A&P, acquired speech disorders, etc). I would sit in these classes and really just marvel at how fascinating I found the information that I didn't necessarily feel about other speech classes I've taken.

I know a few nurses and medical professionals that work in my local hospitals so I'm working on applying for jobs for this summer and shadowing physicians once those opportunities present themselves. I think the one thing stopping me from fully jumping in is knowing I might have to let go of that SLP graduate school seat that I worked so hard to get, but it will be worth it if it means starting a career in medicine that I'm more passionate about.

Thanks again!

 

[fromslptomd]

Hi! Current SLP starting M1 in the fall. I think you first need to decide exactly what you want to do- medicine or speech. Both are great paths and it sounds like you need more exposure to medicine. Hopefully you will be able to shadow soon. Have you had an opportunity to shadow a medical SLP? If not, I recommend doing that as well. I’ve worked on the medical side of speech for many years and there are lots of great opportunities- working with head and neck cancer patients, stroke patients, and many other interesting areas. What exactly do you feel is drawing you to medicine? What is drawing you away from speech?

Are there SLP assistants in your state? In my state, they primarily work in the schools so it does not lend much in terms of gaining clinical experience. If you aren’t committed to going to graduate school, consider getting a job and gaining volunteer experience and shadowing in the meantime. Volunteer experience can be anything you enjoy- Clinical and non-Clinical. I volunteered at a free clinic my church supports. You may have some NSSHLA hours for volunteering as well that you can list.

I recommend shadowing physicians when possible and getting exposure to the medical side of speech as well. That may help you decide if you haven’t found your interest in speech yet vs. knowing if you want to pursue medicine.

Thank you for your reply! I'm happy to see and hear from other SLPs who have been in a similar position.

Going into college, I just assumed I would want to work with children in schools, but after taking classes and learning more information I started leaning heavily towards the medical side of SLP work. I thoroughly enjoyed the more medical based classes (neurology, A&P, acquired disorders, etc), and I think the thing drawing me to medicine is I feel like I'm capable of doing more for patients than just speech and language services, but I don't want to downplay the importance of the therapy SLPs do, because I think it's amazing and I'm still passionate about it.

I was planning to work as an SLP-A this summer just to see the medical side of things and get some in-depth experience before grad school, but unfortunately hospitals in my local area aren't hiring for those positions following the covid restrictions. I think I'm going to cold-call or ask my professors if they know of any medical SLPs I can shadow, that way I still get some exposure. Luckily, I do already have some volunteer hours I can expand upon from undergrad and other personal service I've done.

The science classes I took were for science majors! My university is small enough so there's no difference between non-majors and science majors in classes, we all just take the same classes and the same labs. Obviously my A&P class was only for speech and hearing purposes, so I wouldn't count that and would need to take a complete version.

Thank you again!

 

[PedsInTraining]

Hi!

I thought about being an SLP for the longest time before just recently deciding to go to school to be a pediatrician instead. I have shadowed an SLP multiple times and also volunteer at a hospital, getting positions close to doctors, so I have an idea what both of your prospective careers look like. Something that drew me away from speech was the lack of medical application that I observed (granted I only shadowed in a school-- it may vary in other settings) It was also repetitive in how the children were treated-- I missed the variety that came with the medical route. You're going to use A&P and Neuroscience no matter what you choose-- it's up to you now to figure out how involved you want those to be in your career. Both are wonderful careers and honestly you can't go wrong either way. Do you have any idea what kind of physician you'd want to be? Just curious.

One more thing. Are you already accepted into a masters program? If so I know that it is really, really competitive. Don't give up that spot unless you're sure. You have a great GPA so I'm sure you will get accepted into either; I'm just saying don't switch unless you're sure because you're so close to the finish line. This isn't to stop you, I just wanted to give that warning. All in all, do you want intensity with all the medical knowledge you can think of, or do you want a more slow paced (not in a bad way-- changes don't need to come over night) and more relaxed environment where you can connect well with your clients/ patients? Ask yourself that, I hope it'll help you.

Also, don't rely on the hospital SLP jobs. The SLP I shadowed multiple times a week for a couple months has been in the field for years and she's still trying to get a job in the hospital. So far the only way is for her to move. Keep that in mind too.

Regardless of what you choose, I wish you the best of luck. I am more than confident that no matter what you choose, it'll be the best for you.

Good luck!

 

[fromslptomd]

Hi!

I thought about being an SLP for the longest time before just recently deciding to go to school to be a pediatrician instead. I have shadowed an SLP multiple times and also volunteer at a hospital, getting positions close to doctors, so I have an idea what both of your prospective careers look like. Something that drew me away from speech was the lack of medical application that I observed (granted I only shadowed in a school-- it may vary in other settings) It was also repetitive in how the children were treated-- I missed the variety that came with the medical route. You're going to use A&P and Neuroscience no matter what you choose-- it's up to you now to figure out how involved you want those to be in your career. Both are wonderful careers and honestly you can't go wrong either way. Do you have any idea what kind of physician you'd want to be? Just curious.

One more thing. Are you already accepted into a masters program? If so I know that it is really, really competitive. Don't give up that spot unless you're sure. You have a great GPA so I'm sure you will get accepted into either; I'm just saying don't switch unless you're sure because you're so close to the finish line. This isn't to stop you, I just wanted to give that warning. All in all, do you want intensity with all the medical knowledge you can think of, or do you want a more slow paced (not in a bad way-- changes don't need to come over night) and more relaxed environment where you can connect well with your clients/ patients? Ask yourself that, I hope it'll help you.

Also, don't rely on the hospital SLP jobs. The SLP I shadowed multiple times a week for a couple months has been in the field for years and she's still trying to get a job in the hospital. So far the only way is for her to move. Keep that in mind too.

Regardless of what you choose, I wish you the best of luck. I am more than confident that no matter what you choose, it'll be the best for you.

Good luck!

Hello! Thank you for your advice! I'm sorry for the delayed response, with the state of things in the world in the past week I have been away from my computer.

I agree and share the same opinion on all of the reasons for your switching to medicine over speech. I crave spontaneity (not sure that is the right word) in my future career, and I feel speech may be too stagnant or repetitive. I loved the more medical based classes I took and always found myself way more engaged and interested during those lectures. The material seemed to come so naturally to me and it just made sense. If I were to become a physician, I am currently thinking surgery (cardiothoracic transplant surgeon or neurosurgeon) or neurology. These areas are very close and personal to my heart and are, clearly, very different from the more laid-back speech lifestyle.

I was accepted into four graduate programs for speech, but ultimately chose to stay at my current university in order to save money in tuition/moving expenses and to continue learning under the professors I've grown very close with. I'm incredibly hesitant to give up the position I'm in now without a solid plan for the future because I know how competitive the process was and how grateful I am to even have a seat! That's mainly why I made this post, to help solidify my decision before I made any choices either way. I wish SLP undergrad programs would give students more medical SLP exposure before graduate school. It's unfortunate, students at my program may not see or discuss medical settings until the second semester of their first year in graduate studies, unless they shadow on their own time.

I truly appreciate your response, and I'm so happy to hear from someone who made a similar switch!

 

[PedsInTraining]

Hello! Thank you for your advice! I'm sorry for the delayed response, with the state of things in the world in the past week I have been away from my computer.

I agree and share the same opinion on all of the reasons for your switching to medicine over speech. I crave spontaneity (not sure that is the right word) in my future career, and I feel speech may be too stagnant or repetitive. I loved the more medical based classes I took and always found myself way more engaged and interested during those lectures. The material seemed to come so naturally to me and it just made sense. If I were to become a physician, I am currently thinking surgery (cardiothoracic transplant surgeon or neurosurgeon) or neurology. These areas are very close and personal to my heart and are, clearly, very different from the more laid-back speech lifestyle.

I was accepted into four graduate programs for speech, but ultimately chose to stay at my current university in order to save money in tuition/moving expenses and to continue learning under the professors I've grown very close with. I'm incredibly hesitant to give up the position I'm in now without a solid plan for the future because I know how competitive the process was and how grateful I am to even have a seat! That's mainly why I made this post, to help solidify my decision before I made any choices either way. I wish SLP undergrad programs would give students more medical SLP exposure before graduate school. It's unfortunate, students at my program may not see or discuss medical settings until the second semester of their first year in graduate studies, unless they shadow on their own time.

I truly appreciate your response, and I'm so happy to hear from someone who made a similar switch!

You’re welcome! And all good, I apologize for taking a while to respond too. I didn’t get a notification when you responded for some reason. I understand you there, neurology just seems so fascinating. The SLP I shadowed said that in the medical setting, it’s mostly helping patients with swallowing disorders and something with feeding training to make sure they don’t accidentally aspirate or something (I honestly can’t remember) I just know that those jobs are supposedly hard to find.
You’re right though, definitely don’t give up those spots unless you’re sure. My main piece of advice here, is if you’d rely on the hospital/SNF positions to be satisfied with your role as an SLP, it’s not the best field for you. If you’re not okay with outpatient/school settings too, you may want to either be willing to move or go the physician route. Medical SLP jobs are supposedly just really hard to come by. Keep that in mind...

 

[wanderingSLP]

Hi @fromslptomd , this is very long and a bit late, but I was wandering the internet and thought I'd give the other side -- someone who thought about what you're thinking about, but never tried for med school and became a medical SLP instead. (tl;dr the simple truth is that I thought I was too stupid to hack it as a premed, so I didn't even bother trying. Hindsight being 20/20, I probably would have done fine with premed/med school, but I didn't have the confidence to really believe that until I'd been out of school almost 10 years.)

The main thing I regret is simply Not Knowing. I'll never know if I could have made it in med school, or what kind of doctor I would have been, and I'm just going to have to live with that. Like Dear Margo says, life is choices. I'm at a point in life where I'd have to turn EVERYTHING upside down to start over again and try for med school -- not just my life, but the lives of my family members, too. I'm not willing to do that. (Even if I rethink it every time I meet a doctor who I'm pretty sure is a worse doctor than me, a non-doctor. Don't @ me, med students, I know you know who that person in your class is.)

The main thing I DO NOT regret is the amount of debt I'm missing out on, particularly since a lot of the medical specialties that appeal to me would not have been the high-dollar ones. I'll be done with my student loan debt in my late thirties. Speech pathology is also an incredibly flexible career for work-life balance. Wanna work a full-time job plus occasional nights and weekends to make a lot of money? Wanna pop down to one or two days a week for a few years while you go back to school, stay home with your kids, or do something else that takes a lot of time and attention? Wanna change specialties? Wanna work in multiple different specialties at the same time? It's all totally possible and okay in speech therapy, and you're good to go for any of it after a two year master's and a nine-month CFY.
(For med students reading: the CFY or Clinical Fellowship Year is the graduated-but-not-quite-official time for SLPs. It's not actually a whole year. It's nine months of working under the direct supervision of a fully certified SLP, after which you can apply for full certification. If you see anyone sign their name "CF-SLP" instead of "CCC-SLP," they're a brand-new SLP doing their CF.)

Things that will be the same, either way: Being in medicine. Improving people's lives. Diagnosing and treating illnesses and disorders (doctors have a lot broader scope of practice than SLPs, obviously). Analyzing an integrating a broad span of information in order to provide the best care for each of your patients.

Things you shouldn't worry about, either way: Disappointing your family or your profs. It's your life, not theirs. You're the one who has to live it, not them.

Becoming a medical SLP: Hospital jobs (in acute care and acute rehab) ARE among the hardest jobs to get in speech pathology, it's true. It's even harder if you want to be in pediatric medical speech pathology. There are a handful of specialized medical SLP programs where you will be working in medical settings almost from the beginning of your coursework -- these are helpful for getting into acute care or acute rehab as a career, but they're not required (I didn't go to one). If you really want a medical SLP career, here are my two main pieces of advice:
1) Get as much experience in hospital and health care settings as you possibly can before you graduate. If your program doesn't have much of an adult or medical focus, you will have to advocate for yourself, but it can be done. Talk to all the profs in your adult-oriented classes (they're as annoyed as you are at programs that don't acknowledge speech therapy outside kid speech and language, trust me) about experiences they think you should participate in, and ask them who among local professionals you should shadow or talk to. Get your program to place you in at least one hospital for treatment hours, preferably two. While you're doing your student work in the hospital, get as much hands-on experience as you can with video swallow studies, and with FEES if available.
2) Be prepared to move anywhere in the country to do your CFY in a hospital (or an acute rehab, if you swing that way; it's also possible to get jobs where you do both). Once you have that foundational experience, it becomes MUCH easier to get another job in the same setting. It's EXTREMELY hard to start out in another setting and then break in. My grad school (like a lot of grad schools) was mostly focused on elementary school speech therapy, and a lot of my classmates got misled into believing that they could do their CF anywhere and then "go back to" hospitals. It's just not true. For every hospital job opening, there are a handful of qualified applicants, another handful or two of applicants from other adult settings (nursing homes, home health care, adult outpatient therapy), and then dozens from therapists who have no post-graduate experience working with adults at all. Do whatever it takes to avoid being in that third group.

"Doing more": I saw this a lot in what you wrote. If you want "more" in terms of authority, responsibility, workload, multivariate analysis, problem-solving under pressure, and breadth of required background knowledge -- being a doctor will involve More of all of that, for sure. But there's not an "all they do is" statement about SLPs that's going to be true. Yes, it is the case that the majority of what you do in most acute care settings will be related to swallowing (acute rehab is more varied). Dysphagia diagnosis and treatment still involves problem-solving, evidence-based practice, consideration of the patient's history and lifestyle factors, and ongoing analysis of many aspects of a patient's present illness. You're not just the person who sticks a hand on someone's neck while they eat a bite of applesauce; that'd be like saying the doctor is just the person who puts a stethoscope on someone for two seconds and reads some labs. And, really, a lot of folks with swallowing issues have speech, language, and cognitive issues too. Swallowing is at the forefront in acute care because figuring out the safest way to get nutrition and medications into a patient is a time-sensitive, life-or-death part of their care. You will treat all the other stuff too -- you're just in a situation where swallowing HAS to come first. If you'd like a caseload that's more varied but still "medical," you might prefer acute rehab.

Some other notes:
- How blood 'n' guts you'll get depends on the hospital. No, you won't be there When Seconds Count (dramatic chord); there's no such thing as a speech emergency. But you might be the person evaluating cognition during an awake brain surgery. You might suction or change trachs (not all hospitals allow this). You'll get all the time you want with craniofacial anything, particularly head and neck cancers. You'll be in a position to contribute a huge amount with anyone who's had a stroke or a TBI (things you'll work with a LOT), anyone coming out of a coma or a lengthy period of sedation, or any developmentally disabled adults.
- In acute care, you will be spending a LOT of time working directly with hospitalists, pulmonology, GI, and palliative care. Maybe ENT if it's a large enough hospital (most hospitals do not keep ENTs on staff), and also possibly oncology or surgery if you're associated with a specialized program. You might interact with neurology, neuropsych, and psych, depending on the culture of your workplace (see next item...). In acute rehab, you and the PM&R docs will work together ALL the time.
- The respect and inclusion you get from other professionals varies tremendously, and it's usually a broad cultural thing within each hospital. I've worked in settings that were truly and happily interdisciplinary, and placed a great deal of value on our contribution to care. I've also worked in settings where nurses acted like we were there specifically to get in their way, and where doctors not only treated us like we were useless, but overtly taught as much to their students and residents. Things are slowly getting better overall, but expect to have to explain and defend your expertise at least occasionally.
- Regardless of how well your workplace regards SLPs, though, speech therapists are almost always considered last in importance after physical therapists and occupational therapists. Case in point: On this very forum, the pre-set list of professions includes physical therapy and occupational therapy... but you have to make a custom title to say you're in speech therapy.
- Because SLPs are so thoroughly versed in communication, and tend to be among the more skilled professionals in the hospital when it comes to patient/family education, patients and families often come to trust us very deeply. You can do a LOT of good working from that bond.


Whichever way you go (or, if you go a different way entirely), work hard, pay attention, and keep an open mind, and you'll be fine. Good luck