For the past several years, we have been developing a new class of high-power, low-noise semiconductor optical gain medium based on the slab-coupled optical waveguide (SCOW) concept. The key characteristics of the SCOW design are (i) large (> 5 x 5 μm), symmetric, fundamental-transverse-mode operation attained through a combination of coupledmode filtering and low index-contrast, (ii) very low optical confinement factor (Γ ~ 0.3-0.5%), and (iii) low excessoptical loss (αi ~ 0.5 cm-1). The large transverse mode and low confinement factor enables SCOW lasers (SCOWLs) and amplifiers (SCOWAs) having Watt-class output power. The low confinement factor also dictates that the waveguide length be very large (0.5-1 cm) to achieve useful gain, which provides the benefits of small ohmic and thermal resistance. In this paper, we review the operating principles and performance of the SCOW gain medium, and detail its use in 1550-nm single-frequency SCOW external cavity lasers (SCOWECLs). The SCOWECL consists of a doublepass, curved-channel InGaAlAs quantum-well SCOWA and a narrowband (2.5 GHz) fiber Bragg grating (FBG) external cavity. We investigate the impact of the cavity Q on SCOWECL performance by varying the FBG reflectivity. We show that a bench-top SCOWECL having a FBG reflectivity of R = 10% (R = 20%) has a maximum output power of 450 mW (400 mW), linewidth of 52 kHz (28 kHz), and RIN at 2-MHz offset frequency of -155 dB/Hz (-165 dB/Hz).