Working Internationally as a Speech Language Pathologist

Since we have spent a lot of time traveling abroad, we often get questions about working internationally as travel therapists. We have actually never worked abroad and don’t have plans to. However, we do know that there are American therapists who do work abroad in different capacities. We want to share with you Noel’s story: a speech language pathologist (SLP) who has had a unique career working internationally. Noel highlights his variety of work experiences, some of which have been unconventional, and he provides insights to other American therapists who are considering trying to find work abroad. Get ready to get inspired!


Noel’s Story

My name is Noel Erik Simon and I’ve been an ASHA (American Speech-Language-Hearing Association) certified SLP since 2006. During my time as an SLP I’ve worked internationally in several different countries. If I had to point to the reason why I’ve chosen my current lifestyle, it would probably go back to my time as an ESL teacher in the Peace Corps. I was stationed about 3.5 hours south of Moscow at an experimental school in Ryazan. Since repatriating and finishing grad school, I always had the dream of living abroad again.

The opportunity came as I was completing my clinical fellowship year (CFY). I saw a posting on the ASHA website for an SLP position at an international school in Jakarta, Indonesia. Serendipitously, I had taken a linguistics course in the past couple of years and remembered my professor saying that he had grown up in Indonesia. I reached out to him and he was very excited about this possible opportunity for me. That was the first step that led me to an SLP career abroad. Ironically, I didn’t end up moving to Indonesia. I ended up moving to Cairo, Egypt in August 2007 instead. Since that time, I’ve lived in Ho Chi Minh City, Vietnam; Beijing, China; Warsaw, Poland; and I’m currently in Hong Kong.

Riding on the back of a motorcycle taxi in Kigali, Rwanda.

Even after moving abroad, I haven’t always worked in an international school setting. In Vietnam, a friend introduced me to a group of related professionals made up of special education teachers, pediatricians, a school psychologist, a play therapist, and an occupational therapist. I quickly found that I was the only practicing SLP in the country at that time. My new colleagues started sending me referrals; I made some business cards; and I built a reputation for myself in the expat and international school parent community providing private SLP services. I took my fee schedule from my OT colleague. This allowed me to make a good amount of money and make my own schedule.

Because of this flexibility and increased income, I was able to gain a lot of great experience with some side pro bono work as well. I traveled with Operation Smile on surgical missions to Cambodia, China, Uzbekistan, and Rwanda. I was able to partner with local NGOs (non-governmental organizations) and special education schools in the city to provide workshops and training for teachers and parents. One of my proudest achievements was partnering with an NGO that rescues women from human trafficking. I worked with the survivors to help them modify their accents so that they could tell their stories to a wider audience in their own voices.

The variety of work that I had done by this time convinced me that I wasn’t as pigeonholed as I thought with my profession. Typically an SLP is seen as either educational (pediatric) or medical (adult). Of course, there are many other sub-categories, but these seem to be the biggest areas. With a little bit of creativity, I was able to branch out of my mindset of what I could do with my skill set and really extend myself.

My Operation Smile team in Tashkent, Uzbekistan

Advice for Others Job Searching Abroad

I would say that there are several routes you could take if you’re looking for a job abroad as an SLP:

First: You could go the route of taking advantage of the mutual recognition if you want to work in five of the other primary English-speaking countries. This route requires a lot of research and finding a job first. After that, the job should help you with licensing and a working visa.

Second: If you’re an education-based SLP, I would suggest some search sites for international schools. Most of these have a fee (some cheap, others pretty expensive). A few examples are:

Working for an international school means you get to take advantage of school holidays: 6-10 weeks off during the summer, 2-3 weeks off around Christmas/New Year’s, a week off in the fall and spring, and depending on which part of the world you’re in, another 1-2 weeks some time in winter for Chinese New Year. All of these are what I like to call “Travel Holidays”. These are great because one of the things that can make travel prohibitive from the US is the cost of getting out of the US (unless you’re a proficient credit card hacker). Once you’re abroad, travel becomes significantly less expensive from one place to another. There are usually multiple discount airlines to choose from around the world.

Third: For pediatric and medical-based SLPs, I think there is a misconception about a large part of the world. People assume some kind of language barrier if you’re not looking at just the Anglophone countries. This is not entirely true. There are many countries that are officially another language but they use English as the lingua franca, or English is somewhat of a co-official language and it may not immediately occur to people. I would recommend checking job postings in the Middle East (specifically the Gulf States) or SE Asia (Singapore especially, but also Malaysia and Thailand). 

Fourth: I’ve talked to many people who’ve also recommended government jobs like the DOD, Veteran Affairs, Department of the Army, etc. All of these jobs have been centralized on USASjobs.com. Of course, these are more like a traditional job on a U.S. Army base (or Army base adjacent), but the people who I’ve talked to have highly recommended this lifestyle.

Almost every country has a sizable expat population. Even countries that you wouldn’t consider probably have a great need for “allied health” professionals. If there is a specific country that you have in mind, I would say to just do some research. Better yet, take a vacation and backpack around there and do some recognizance. You’d be surprised what you might find. I had no idea what the situation would be like in Vietnam. I got a job as a whole-school SLP and elementary school learning support teacher. I wouldn’t have known until I got there that there was enough of a need that I could start my own private practice.

I know that, in addition to the Anglophone countries, Europe is always big on people’s wish list. I would say these are all possible, but if you’re trying to do this for the money, then put these places out of your head (except possibly some places in Eastern Europe). If you want to make much more than you could in the US, then Asia and the Middle East are much better options. If you get a teaching job at an international school, even if your salary looks smaller than what you might be making in the states, keep in mind that housing is usually provided separately from this, and your salary will probably be tax-free. What you’re are being quoted is often (depending on the country) your net salary, without housing, flights, visa, etc. (these are provided separately). Plus, often these countries are much less expensive to live in than the US. For example, my first teaching job abroad was in Egypt. My salary was a little more than half of what I was making in the US. However, because Egypt is an extremely inexpensive country to live in (much more so than to travel through as a tourist), I found a cheaper place to live (pocketing the difference in the housing stipend), and I picked up some clients on the side, I was able to save significantly more than I was able to in the US. In fact, my two side clients paid all of my day-to-day expenses, so I was able to save all of my salary (except for what I used to travel on). I also had a 3-bedroom house, a driver, a house cleaner, a gardener, and a cook.

Another thing about working abroad is that many ‘developing’ countries don’t have the same standards as far as licensing goes. Some of our professions don’t have an equivalent in these countries, so there is no license. I was the only SLP in Vietnam when I was there. There was no need to seek out a licensing body. If you’re working at an international school, you’re often seen as a “foreign expert”. It’s more important to have a teaching certification than a license. I think that, with some major exceptions, a lot of the strategies are the same for occupational therapy and physical therapy professionals. I’ve only heard of a handful of international schools around the world that have employed occupational therapists. So, physical therapy might be the only profession out of the three that may already exist as a local profession in most countries. You would need a bit more research, but if I were trying to find a job in those fields, I would still check with clinics in the same areas (Asia and the Middle East). I would also just do a Google search on “working as a (insert job) in (insert country).” Checking LinkedIn, Glassdoor, and Indeed have also given me a lot of ideas.

In my experience, most contracts for international schools are initially two years (with school holidays) and then the option to renew yearly after that. Clinics may be just one year. I have been traveling with my wife since 2007. At least one of us has always had a job offer before we’ve moved to a country, sometimes both of us. Obviously, we both try to find jobs, but we have the added challenge that we’re both specialists (SLP and librarian), and basically, we’re both non-teachers. Out of the five countries that we’ve moved to together, we were both offered jobs at the same school for three of them. We’re not naïve going into jobs, but most of the time, when we’ve been offered jobs, it’s because we usually go by our motto “Leap and the net will appear”. Even bad job decisions aren’t permanent, and you can learn from them.

Hanging out with friends in Dahab, Egypt (one of my favorite places in the world).

Cultural Considerations

The countries where I’ve lived have been very easy to go about your daily life with little to no knowledge of the local language except niceties and “taxi language”. But, one of the reasons that I’ve chosen to live abroad is for a chance to learn a new language. I really don’t think there’s any better way to immerse yourself into the culture of another country than trying to learn as much of the language as you can. In most of the jobs abroad, you’re going to be with a mix of locals and expats, probably mostly speaking English. It can be challenging to force yourself out of your “easy” group of English-speaking friends and try to make more local friends, but the payoff is huge.

Most of the places I’ve worked have a very diverse staff. There are many international schools that are only international in that the curriculum is taught in English and most of the staff are native speakers. The student body could be 90% host country nationals. However, the average international school might look like a public school in Brooklyn or Queens, with students from 50-60 different countries. There are definitely cultural differences between colleagues and families. Sometimes it’s misunderstandings with host country people, but I’ve found most of my cultural misunderstandings have been with other “westerners”. I would say for anyone working abroad, it might be helpful to keep in mind that just because you might look like someone doesn’t mean you share the same cultural assumptions. I also think that in many ways it’s easier to live in a country in which you might not look like the majority of the people there. People look at you and assume that you’re a “foreigner”. You’re often treated as a guest. But I’ve also worked in countries in which I more or less look like I could be indigenous to that country. People assume that I must understand the language and the cultural nuances. They might have a little less understanding of my mistakes as I get acclimated to how things are done there.

For me, settling into a new country and discovering how to live, pay bills, find the best deals on groceries, learn to cook local food, etc. are the biggest pluses to living there instead of just traveling there. Most countries don’t have a Home Depot or a Costco. Most shopping is done at little shops or open-air markets. It sounds so mundane, but one of the best feelings I get is when I need to buy something that I wouldn’t think twice about in the states (e.g. a lightbulb). Finding the specific local shop that sells the lightbulb that I need and being able to conduct the entire transaction in the local language is incredible. Having a tourist stop and ask you directions is a cool feeling too. In some places I’ve lived, I’ve even had locals ask me how to get to an address because they weren’t familiar with the neighborhood. 

Color Run with my wife and friend in Beijing.

Conclusion

If it’s your dream to work abroad, there are a lot of different possibilities out there. First, suspend all of your preconceptions about licensing and language ability. Secondly, don’t be held back by your job title. There are more opportunities than you think in related fields. Do some research on a desired location to get started, and then plan a trip to get a feel for what it’s actually like on the ground. Reach out to schools, clinics, etc. Be willing to move on if things end up not fitting. Decide what’s important to you and keep at it!


Noel Erik Simon is an American-trained Speech Language Pathologist. He has worked in a variety of settings including international schools, group homes, early intervention programs, clinics, and NGOs. He has presented workshops and training to parents and other professionals on a range of topics related to speech and language. Over the past 15 years, he has lived and worked in the US, Russia, Egypt, Vietnam, China, and Poland assisting children and adults with a wide range of needs. You can find him via the following social media platforms:
Instagram: @vaguely_vagrant
Linkedin: www.linkedin.com/in/nesimon1


If you’re an SLP, PT, or OT who’s interested in working abroad, feel free to contact Noel for further insights. If you have questions about traveling for work within the US, please contact us and we can help you!

Leveraging Travel Therapy for Long Term International Travel

Whitney and I have recently started to take full advantage of our travel physical therapy careers to be able to explore the world. Last year we traveled around the world for five months, and this year we’re currently on week two of a 15 week trip all over Europe. We aren’t sure about our plans for the rest of the year once this trip is over, but it’s entirely possible that we will spend another couple of months out of the country (or road tripping around the US), and we will certainly be planning another long international trip next year! It’s a big world out there, and there’s a lot we want to see in the next few years before potentially settling down somewhere.

We feel very fortunate to be able to take these long trips each year, and they are made 100% possible by our choice to start working as Travel PTs immediately after graduation in 2015. How, you ask? The flexibility offered by travel therapy is certainly a big part of the equation. Being able to take unlimited time off of work between contracts, along with making nearly a full time permanent PT salary working just 6 months per year is a winning combination for taking months off to travel the world!

Why Long International Trips?

People with all manner of jobs choose to travel internationally, so that’s nothing unique to travel healthcare. The problem with most permanent jobs, however, is that most won’t allow more than a maximum of two weeks of vacation time to be used at once. This is especially true in the permanent therapy world, where finding short term coverage for 3-4 weeks of continuous PTO would be difficult not only for the clinic but also for the patients on caseload. You can certainly see the world in shorter 1-2 week trips each year going to new places, but there are many disadvantages to doing it that way. During our travels, we’ve met many people in both Europe and Asia traveling from the United States that are taking short trips overseas, and without exception they’re either only seeing a couple of cities or are extremely rushed trying to pack in more cities in a short time. Rushing from place to place while on an international vacation is a sure way to come back home even more tired than when you left, especially when factoring in jet lag!

More Than Just Tourist Attractions

Another big downside to short trips is less time to really interact and learn about the country from the locals in the area. With only a few days in a city, those days are almost always filled with primarily the tourist attractions, which means plenty of interaction with other tourists and store owners, but very little real interaction with locals! We’ve really enjoyed having extra days (to weeks!) on top of the few required to see the tourist sights to just walk and wander around the area, and this has led to some of our best experiences while overseas. The tourist attractions are great, but there is a lot to be missed with a rushed trip from one attraction to the next with no spontaneity involved!

Lower Cost of International Trips

The last and biggest disadvantage of short international trips in my book is the higher cost on a per day basis. The biggest costs on almost any international trip are the plane tickets to and from the country. Flights are almost never cheap, and leaving the country is generally more pricey, especially to places like Asia and Australia. Even with using credit card points, the value of the points used has to be taken into account since there’s an opportunity cost associated with using those points going to one location instead of somewhere else on a future trip. In addition to the plane tickets, booking longer stays in a location can significantly reduce accommodation costs.

These cost factors, combined with hopping from one overpriced tourist attraction to the next without the lower cost days mixed in just wandering around the city and taking in the sights, will almost always make short term international trips much more expensive on a per day basis than long term international trips. Last year on our 5 month trip, I was able to keep my total expenses to less than $37/day! There is no way that would have been possible on a 1-2 week trip to similar locations. 

The Importance of Patience

While it’s certainly possible for therapists to graduate and immediately start taking travel contracts half the year, and travel internationally the other half of the year, I wouldn’t recommend it. Even with the lower costs of longer term international travel, expenses can add up quickly, especially with no income at all coming in for half of the year. For the financial peace of mind, I always encourage other therapists with similar international travel aspirations as us to work 3-4 travel contracts per year for at least a year or two and save heavily to make some headway toward financial independence, before jumping into long stints adventuring around the world like we are currently doing! This is the path we took. We worked continuously for the first three years, working back to back travel PT contracts, then started taking off half the year (or more) after year three.

Conclusion

Travel therapy (really travel healthcare of any sort) offers the unique advantages of higher pay and unlimited time off, which form the perfect recipe for long stints of international travel. There are clear advantages to long term international travel over short term travel, which is generally impossible with full time permanent employment as a therapist. It’s always a good idea to save up a cushion of cash and investments for financial peace of mind before moving into a “semi-retirement” type lifestyle with long trips each year. We are extremely fortunate to be able to leverage our travel therapy careers to be able to spend long periods of time out of the country, experiencing the totality of what the world has to offer!

Have you taken long international trips in the past or do you plan to in the future? Let us know in the comments!

Written by: Jared Casazza, PT, DPT

jared doctor of physical therapy