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!

Travel Therapy: Working as an “Internal Traveler”

When considering US based travel therapy careers, there are a few different options for how therapists can become employed. Most travel therapists and other traveling healthcare providers work through staffing agencies who help them to find travel jobs anywhere in the country, with any type of facility (this is what we do personally and is by far the most common route). Some travelers choose to arrange their own contracts directly with facilities, which is called being an independent contractor (you can learn more about independent contracting here). A third option would be to work directly with a particular therapy company or hospital system as an “internal traveler” who only goes between the facilities that company has. For example, you could work at any location that a certain hospital system has, an outpatient physical therapy company, or a chain of skilled nursing facilities. Below we are featuring Lesley Sheeley’s story, a physical therapist who is currently working as an internal traveler, to help you learn more about this type of employment!


Background

Hi! I’m Lesley. I am a military brat and was born in Colorado Springs, but I primarily grew up in Warner Robins, GA. I went to the University of North Georgia in Dahlonega, GA where I graduated with a Bachelor of Science in Athletic Training in 2017 and continued on to graduate with my Doctorate in Physical Therapy from UNG in 2020. 

I love to travel (duh), I also enjoy all things outdoors and CrossFit. It is not super uncommon to find me at a winery every now and then either 😉

After graduating as a Doctor of Physical Therapy in 2020, I took a position with Upstream Rehabilitation as an internal national traveler.

Upstream Rehabilitation is an outpatient orthopedic company with over 850 clinics across the United States. Some of the common clinic names you might recognize under the Upstream Rehabilitation “umbrella” are Benchmark, Drayer, and Serc Physical therapy.

My Why

I decided to take an internal traveler position as a new grad physical therapist due to it providing more stability and support than “traditional” travel positions through staffing companies.

With Upstream, I am able to remain in outpatient orthopedics, go through a 1-year mentorship program, have set documentation system, set salary, set benefits, and the opportunity to go permanent with the same company following my time as a traveler with them.

Perks to My Job

With Upstream, I make an average salary for a new grad in the Outpatient Orthopedic setting. I qualify for benefits such as loan repayment, 401k with matching, health/dental/vision insurance, and continuing education money.

Due to getting a full salary, the stipend is more of a set stipend rather than based off the area’s cost of living. So my income month to month remains the same no matter where I am working. The stipend is untaxed and follows the regulations of any other traveler stipend to help cover housing, meals and incidentals when I’m at my travel location.

Cons of Internal Travel

As an internal traveler, some cons compared with working as a traditional traveler would be:

  • I do not have as many options of locations
  • Cost of living does not always determine the amount of pay
  • I do not get to experience other settings

Logistics


Relocation: The company reimburses me for mileage to travel from one location to the next. I have been responsible for moving myself from A to B just like a traditional traveler. I pack everything in my car that I need to bring! The time moving between jobs has varied from a weekend to a week depending on the distance. If I had to take a longer time between assignments, I used my PTO through the company to cover that time and my annual salary remained unchanged.

Licensing: I do have to get licensed in each state just like a traditional travel therapist. The company pays for my licensing costs, and I take care of the licensing application process myself.

Housing: So far, I have found housing on my own for each location through people at the clinic I am going to, Furnished Finder, or Airbnb. I believe the company would help me if absolutely necessary, but I have gotten lucky with each one so far and have not needed their assistance!

Assignment Length: The time spent at each location varies based on the clinic needs. They aren’t the typical 13 weeks like for traditional travelers. My jobs have varied from 10 to 18 weeks so far.

My Experiences

So far I have lived and worked in:

  • 2 different clinics in Georgia
  • 1 clinic in Olympia, WA
  • Currently going between 2 clinics in Eugene, OR 
  • And I will be heading to Kansas City, MO next!

The locations are more limited and are determined by need. When originally hired, I gave a list of the states I was willing to go. Based off that list and the need in those states, they then offer me a position. If they offer a position I do not want, I am allowed to decline. There are not as many options, but still plenty to choose from in my opinion!

Switching clinic to clinic has been a wonderful learning opportunity as a new grad. I love to see the different ways clinics are operated, do scheduling, and treat patients. As someone who looks at going into leadership in the future, the experience is great!

I am so thankful to have had the opportunity to be an internal traveler! It has been a wonderful experience.


Thank you to Lesley for sharing her insights about being an internal traveler! If you have specific questions about internal travel therapy, please contact Lesley below. If you have questions about being a travel therapist in general, please contact us!

I am happy to answer any and all questions you may have! Feel free to email me at lesleysheeley@hotmail.com or message me on Facebook at Lesley Ashton Sheeley.