Of course I had practicums in the school clinic, as well as having one in the schools. Since, at that time, you could work in the schools with a Bachelor's, that was what the program was geared toward.
Fast forward 3 years later. During my grad school program, my practicums were again at the school clinic, and a private clinic. I never did a hospital rotation since I was already working in the schools, and
How do you determine which setting is right for you?
You get out there & try them until you fall in love. I worked for a company that contracted to nursing homes for a couple of years. At first, I like the "newness" of it; the "medical" side of it. I liked having to research how to help my patients and how to look in their file at their blood work to make sure they were getting adequate nutrition, and if they weren't, making sure that it wasn't due to their swallowing ability. Then, I had another SLP (who was just out of grad school) tell other team members that I wasn't as good as her because I had worked in the schools, and I have an "M.Ed." (instead of an "M.S." or "M.A.") after my name. This person, for some reason, really looked down on School SLPs. Of course, not having ever been in the schools, she had no clue what it took to be successful in the schools. OOPS. I got a little off-track....Sorry!
I actually loved working with the patients there, and the nurses. I learned an awful lot about "CYA" in that setting, especially as far as paperwork is concerned. There were definite benefits to working for a company (like being sent to training and having everything paid for), but there were also drawbacks...like losing contracts and having to travel to another facility, as well as worrying about your productivity.
The wonderful thing about our profession is that we have a choice. My parents' next-door-neighbors (who I went to school with; I graduated from high school with the woman) have a daughter who is working at a local hospital with stroke patients. I talked to her the other day, and she said she couldn't imagine doing anything else.
I did some Home Health work on the side at one point in my career. For some people, that is their calling. It just wasn't mine. I felt very uncomfortable going into other peoples' homes, especially after I was told at one house not to come in if a patient's son was there by himself. Or, the house that had 2 Great Danes & 1 of them almost took a chunk out of me!
Some people think that the schools are "easy". Oh, if that were only true! The farther along in my career I get, it seems that it gets harder. We're getting more "different" cases, and are expected to know how to "treat" them. We have to be able to work with teachers, TAs, administration, and parents. We have to juggle writing IEPs, IEP Meetings, Medicaid paperwork (some of us, anyway!), as well as seeing our students. In the system I'm now working in, we also have to be able to work with contract SLPs/SLPAs. We are part of a faculty, so some of us have the same responsibilities as the teachers: bus duty & faculty meetings. And, we're expected to keep up with CEUs on our own time.
I wish I had the answers to help someone just starting out in our field with what to do. For me, it was easy, although I did have to try out a couple of different settings to know without a doubt where I belonged. I had to see if the grass really was greener on the other side. The money I made working in the private sector with a company was great, but I realized that money isn't everything. I valued my time with my family over working long hours and not seeing my kids as much as I had.
Some people prefer adults over children, and vice versa. Some people like the idea of 1:1 therapy over seeing children in a group. As I previously said, you just have to get out there & try different settings and see where you fit in. If you start in one setting, don't think you're "stuck". That's the beauty of being a Speech Pathologist!