Compare on-campus clinic, externship, supervision, and cost models before you choose a program
A university speech and hearing clinic asks students to learn on real clients while the community expects dependable care, and the model works only when supervision is close enough to protect both. Most SLP master's programs require at least 400 clinical hours, including 375 in direct client contact, and AuD students finish with a full-time externship in the fourth year, a difference covered in Speech Pathology vs. Audiology.
At UNCG's Speech and Hearing Center, audiology externs have worked full-time for a year since 2006, paid as temporary employees under a temporary North Carolina license. The program grew after UNCG graduated its last master's-level audiology class in 2005.
The real question for applicants is where a program's hours are earned, and who watches them, a key question when weighing School vs Medical SLP Grad Programs.
What happens inside a university speech and hearing clinic, and who is actually treating the clients? It is a working clinic with two jobs: it offers speech, language, and hearing services to the surrounding community, often at lower cost than private practice, and it gives graduate students a place to practice under licensed supervision during their SLP clinical placements. UNCG's Speech and Hearing Center, for example, serves clients across three states, which shows how far a campus clinic's reach can extend.
Clinics usually see a broad mix of ages and needs. Common services include:
Exact offerings differ by clinic, so check each program's website for the services it runs.
A typical session involves three roles. The student clinician plans the session, delivers therapy or testing, and documents progress. The clinical supervisor is a certified, licensed professional who observes, steps in when needed, and gives feedback. The client, or a parent or caregiver for younger clients, participates in goals and carryover practice at home. Many clinics use observation rooms or live video so supervisors can watch without interrupting.
Most graduate students start with a small caseload, sometimes one or two clients, in the first SLP grad school semester or the second semester. Some programs begin with shadowing and co-treating before students lead sessions. Timing varies by program, so ask admissions staff exactly when students take on their first client and how quickly the caseload grows.
Both professions require supervised clinical work, but the two paths are built differently. SLP training is organized around a clear hour count. Audiology training is organized around a sequence of settings that ends in a full-time final year.
ASHA's current certification standards include clear SLP clinical hours requirements, calling for 400 supervised clinical hours: 25 guided observation hours and 375 direct client or patient contact hours. Observation can be completed at the undergraduate or graduate level, and it generally comes before direct contact. Most of the 375 hours accumulate across graduate practicum terms, typically in the university clinic first and then in off-site settings such as schools and hospitals.
Audiology degree programs are doctoral, and the sources reviewed here do not establish a single national hour total comparable to the SLP formula. Instead, students usually move through three stages:
When comparing programs on speechpathology.org or elsewhere, use what to look for in an SLP graduate program: exact hour breakdown, placement list, and externship pay and licensing history rather than relying on general descriptions.
Most SLP students move through clinical training in the same order, even though each program schedules hours and placements a little differently. At every stage, supervision gradually loosens and the caseload grows more realistic.
SLP master's programs now publish the 400-hour requirement prominently but rarely say where those hours are earned. That gap matters, because the on-campus clinic and SLP externships are very different training environments.
Few programs publish an exact on-campus versus off-site breakdown, so treat any split as a pattern rather than a rule. DePaul University describes four quarters in its Lincoln Park clinic followed by two external externships. The University of South Florida lists two externships of roughly 85 to 100+ clock hours each, at a minimum of 16 hours a week for 12 weeks. That puts about 170 to 200+ hours off-site. MSU Denver and the University of Akron typically schedule externships in the final two semesters.
The common shape looks like this:
Ask each program you're considering for its actual numbers.
In the university clinic, you usually carry a small caseload and work around a class schedule. Supervisors are often just down the hall.
Externships flip that. The University of St. Augustine for Health Sciences notes that sites set the schedule, typically 3 to 5 days a week of standard clinical hours. Your supervisor is a working clinician with their own caseload. You also take patients as the site receives them rather than choosing cases. Ohio University externships, for example, run 13 to 14 weeks.
SLP externships are generally unpaid. That's a key contrast with audiology, where some fourth-year AuD externships pay students as temporary employees.
Assignment models and slp clinical placement criteria vary more than students expect. None of the programs described here promises a first-choice site.
By the time you leave the campus clinic, sites generally expect you to run a session from start to finish. That usually means you can:
You should also act on feedback without needing it repeated and manage your own schedule. SLP Clinical Supervision continues, but it shifts from coaching toward verifying your work.
A well-run final-year clinical placement should look less like observation and more like a job with real patient responsibility, structured feedback, and a clear path to employment. UNCG's Speech and Hearing Center offers exactly that model, and its audiology externship data shows what students can expect from a strong university clinic with immersive SLP clinical training.
UNCG has hosted audiology externs since 2006, welcoming 31 externs from 18 universities by 2026, according to UNCG News.1 Externs work full-time for one year as paid temporary employees, and each must obtain a temporary North Carolina audiology license before starting. The clinic typically supervises two externs at a time with three preceptors, allowing direct patient contact under close guidance. That staffing ratio is one of the first things prospective SLP and AuD students should look for, because it determines how much individual feedback you will actually receive.
The daily work goes far beyond shadowing. Externs see patients, provide rehabilitation services, service hearing aids and equipment, use diagnostic equipment, handle inventory, and call manufacturers. In other words, they operate as functioning clinicians rather than classroom observers. For SLP students, the parallel is a graduate practicum that moves you from structured observation into direct treatment, documentation, and care planning with real clients.
UNCG reports that 41% of its externs have stayed to work in the Triad region or elsewhere in North Carolina afterward.1 Program leaders describe the goal as helping externs smooth out the rough edges so they can get jobs and filling clinical gaps where experience may be thin. That placement-to-hire signal matters because it suggests the clinic is training clinicians for the local workforce, not just rotating students through.
If you are evaluating an SLP program, use this externship as a checklist. Ask how many clinical hours you will log before the final placement, whether off-site externships are paid or unpaid, how many supervisors are assigned per student, and whether graduates stay in the region. A placement that mirrors a real job, not just a resume line, is the strongest sign you will be ready for your CCC-SLP clinical fellowship.
UNCG's Speech and Hearing Center offers a useful benchmark for what a mature, university-based externship can look like. These figures show the scale of the program, its staffing, and how often its externs stay in North Carolina after graduation.
Supervision in speech-language pathology and audiology training has shifted from hours-based checklists toward ongoing, competency-based coaching.
SLP supervisor responsibilities begin with holding the Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP), having at least nine months of full-time clinical experience after certification, and completing two hours of professional development in supervision before taking students. ASHA supervision requirements for graduate students mandate that at least 25% of the total contact time for each client be supervised in real time by the clinical educator, though many university clinics set higher percentages for first placements or complex cases. This 25% applies across the practicum, not each individual session. Overall, students must accrue 400 clinical hours, including 25 observation hours and 375 direct client contact hours.
For AuD students, the supervising audiologist must hold CCC-A and meet the same nine-month experience and two-hour professional development benchmarks. There is no single national preceptor-to-student ratio, but strong clinics pair each student with a designated licensed preceptor who is available consistently. Ohio University, for example, states its audiology preceptor is available 100% of the time and provides at least 25% direct supervision of patient contact for ASHA certification; the University of North Texas requires 50% direct supervision during diagnostic sessions. As students demonstrate safe, independent skills, preceptors step back and shift to periodic observation and feedback.
Supervision typically follows a three-part cycle: pre-session planning, live observation, and a post-session debrief. The student reviews the client, goals, and proposed activities; the supervisor watches in real time or via recording; then they discuss what worked, what to adjust, and what to practice next. Written midterm and final evaluations capture progress on specific clinical skills and provide constructive feedback to SLP students.
Competency is assessed through structured rubrics rather than supervision time alone. University clinics often rate students on screening and prevention, evaluation, treatment, interaction, and personal qualities, using a four-point scale. Supervisors document observation, guidance, and feedback at formative and summative checkpoints. A student is "ready for independence" when they can plan, execute, and justify clinical decisions with minimal prompting across a range of clients.
University clinics are often where students first work alongside audiologists, physical and occupational therapists, nursing students, social workers, and psychology trainees on shared cases. Telepractice has also become a regular part of many on-campus caseloads. Both topics come with rules attached, and the rules are the part students most often get wrong by relying on hearsay from a forum or an upperclassman.
Interprofessional education requirements and telepractice hour policies are set by accrediting and certifying bodies, not by individual clinics, and they are revised periodically. Rather than trusting a summary (including this one), go to the primary sources before you commit to a program or a placement, so you know what to look for in an SLP graduate program.
ASHA and the CAA answer accreditation and certification questions. ASHA's Practice Portal and Action Center are the place for telepractice hour counting and supervisor requirements. Program websites and clinic handbooks answer program-specific policy. BLS.gov is useful for broader career and wage context, but it is not a certification authority, so do not use it to settle an hours question.
When you talk to a program, ask plainly: Do telepractice hours count toward my clinical hours here? Under what supervisor ratios? Does my state board treat them the same way? Which interprofessional experiences are built into the curriculum, and which are optional? Get the answers in writing or save the email. Policies shift, so verify against the current year's documents rather than an older handbook, and re-check before your final placement year.
Most AuD students are paid during their full-time final-year externship, though the amount is modest.
University clinics sit in an odd spot: they need to charge enough to keep the doors open, but their teaching mission depends on a steady stream of clients who may not be able to pay market rates. The result is a patchwork of fee models that varies clinic to clinic, which matters to you twice over, once as a student weighing a program's client volume and once as someone who may pay small clinical fees of your own.
There is no national price list. Published examples span a wide range:
So the honest answer to "is it free?" is: sometimes, often low-cost, and it depends on the service, your income, and whether insurance is involved. Several clinics do not bill third-party payers at all. Auburn's audiology clinic states no one is denied services because of financial limits, with a sliding schedule applied when relevant.8 Waivers can require documentation, and deductibles, copays, and noncovered services may still fall to the client. Students, faculty, staff, and dependents sometimes get discounted or waived rates: Oklahoma State lists $250 per semester for students and $450 for faculty and staff.6
Your own clinical costs are separate from tuition and usually modest but real. Auburn's audiology program notes roughly $40 for liability insurance.8 The University of Washington lists SLP grad school background checks from about $42.75 to $51.95, with education placements running $50 to $100.9 Alabama A&M's handbook cites a roughly $46.90 background analysis plus Simucase ($110) and CALIPSO ($99) platform fees.10 Budget separately for immunizations and travel to off-site placements, which programs rarely subsidize.
Low client fees are typically propped up by SLP program funding, donations, and grant support, though most clinics do not publish which funder covers what.
What should you ask a program about clinical training before you apply? Start with the slp grad school interview questions below, because the answers tell you more about your daily experience than a brochure will.
For AuD programs, ask whether the fourth-year externship is paid and whether the program helps with licensure, details to confirm as you learn how to become an audiologist. Some externships pay as temporary employment and require a temporary state license before you begin, so find out who handles that paperwork and how early it needs to start. Ask which externship sites graduates have used recently and whether those sites typically hire their externs.
Ask whether students get supervised telepractice experience and whether the clinic works alongside other professions, such as audiology, education, social work, or occupational therapy. Both are increasingly part of real-world practice, and programs that build them in tend to graduate more adaptable clinicians.
Compare answers side by side in a simple spreadsheet, and notice where a program is vague. Vague answers about placements or supervision are worth following up on with these slp clinical placement tips for grad students. For more on weighing the rest of your options, see our guides on choosing a graduate program and on how SLP clinical hours work. Together with a clear picture of each clinic, they will help you pick a program that fits how you learn.
