What made you all have an interest in/choose Audiology?

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Audiology Student
Nov 25, 2022
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Hello all! Long time reader first time poster. I am a 2nd year Audiology student and desire to see increased activity within the AuD forums. Among related healthcare fields, Audiology is rather small and unknown. I have come across numerous interesting stories about how individuals were drawn to the awesome field of Audiology. For any current audiologists, AuD Students, or prospective students with an interest in the field, what is your story? What did you find attractive about Audiology?

I'll go first. When I was little, I had numerous cases of middle ear infections and ear surgeries (mainly for PE tubes). I would see the ENT physician and audiologist all the time. Even though my episodes of ear infections would cause me great discomfort and substantial temporary communicative issues, those ear experts were always able to make me feel better. I didn't really have any other health problems growing up besides my ears, so over time I came to identify medicine and healthcare in general to my ear health. If I went into healthcare, I wanted to work with ears. I thought about medical school for a while and it was for the sole purpose to eventually be an ENT physician because they were the people who helped me feel better.

However, the more I looked into the profession (both with school and lifestyle after school) there were some considerable cons that existed with going to med school. My main goal in my profession was to study ears, so I was also looking at audiology as the main competitor to going to med school. I made a list of pros and cons (for me) for being an ENT vs Audiologist:

- med school and residency afterward to specialize in otolaryngology is both extremely expensive, intense/competitive, and time consuming. Huge con. I am well aware of the horror stories of good students starting med school and just being completely overwhelmed. I myself am a good student (I think) so I was somewhat confident I could push through if I really focused, but at what cost for my health? Not being pessimistic but just realistic; if I don't get into med school or fail out of med school, don't get in the right residency program, etc, what do I do with my pre-med degree and possibly the thousands of dollars lost in the start of med school?
- Audiology school is a much MUCH more manageable program financially and in terms of intensity and time. Between in-state tuition, GA scholarships, and 4th year (hopefully) paid externship, I will likely get through my doctoral program with little to no debt. That is really cool. Additionally, Audiology is a field of hearing and balance (more focused on ears, not a lot of vestibular in my AuD program) where ENT is more broadly head and neck surgery. One would have to further specialize to become an otologist to narrow their field of practice to just ears. I get to study my passion from day 1 of grad school.
- Salary always comes up and I won't really get into that because I am more focused on my motivations from a passion and practicality standpoint. Nevertheless it is my opinion that the AuD salary is perfectly sufficient if one practices good money management skills. I have heard of several MDs and DOs practicing for 30 years and drowning in debt because of poor money management. In my opinion, it's all about living within your means.
- with the added bonuses of not being on call as an AuD and (for me) not the liability of performing surgery, I felt AuD was a better path (for me).

These are just my quick thoughts. Do any of you all share these opinions? So far I am really happy with my decision and hope to inspire others if they are thinking about this field.

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I originally was going to go to school to be an ENT. Found out how long the residency was and how little an ENT is paid for all the surgical knowledge they must learn and training they must do vs. other surgeons or specialists. I picked up a 2nd degree in Psychology because of needing to fill some openings in my course schedule in undergrad. When I came to the end of my undergrad time I had a biology pre-med degree, a psychology degree, and a minor in hearing and language sciences. I had acceptance to Psychology grad school (PhD programs only and the PsyD was a joke at that point otherwise I'd be a Psychologist right now because I sick of doing research and didn't want a PhD), and a couple medical schools. I shadowed some ENT's and decided the job wasn't for me, but the audiologist I hung out with I enjoyed what they did. It seemed like a great blend of medicine and psychology/counseling I liked. I also was in that early group of AuD students who were told once the AuD is the only degree we will be making 100k+ on average. So I jumped in an Audiology program.

So you mention you aren't going to mention money. Well money isn't everything, but when it comes to work it is a lot of it. An AuD is a poor return on investment to be quite honest. Are there lots of jobs in audiology? Of course. Are there a decent amount of good paying jobs? Depends on if you are willing to move to those areas to take those jobs. If you want to stay in a certain geographic area, then the field is too specialized and not like nursing or psychology or occupational therapy or other similar programs that have less schooling, higher pay, and more job options, and a wider scope of practice. You'll change this view if you ever get stuck working in a toxic work environment making horrible pay and can't leave because who have a home and a family rooted in the area and you have no other job prospects that pay the bills. It's a horrible feeling.

I am not saying I haven't done well for myself as an Audiologist. I make good money now and I have the schedule I want, but it took a lot of years of hard work and suffering in toxic work environments to get the PSLF to get that AuD student loan paid off since the salary doesn't match the education requirement. A simple formula should be your degree/education should never cost more than 1 year of the lower salary in your field. If it does then it's a poor return on investment. I could have done so many other career fields in medicine with far less schooling/debt with far higher salary and far more job opportunities. As long as hearing aid dispensers with a high school diploma or a GED can do our job our wages will remain stagnant. Unless we enhance our scope of practice our wages will remain stagnant. Unless we get away from being sales people selling a widget, our waged will remain stagnant.

The problem with both these issues is hearing aid dispensers have been able to dispense amplification far longer than we have as audiologists and they have a bigger lobby. Bigger lobby = more money = more power for legislation. So the hearing aid dispensers aren't going away. So our wages aren't going to go up.

Our scope of practice is not going to expand. Doctors learned from the nurse practitioner route and they will fight us tooth and nail to expand our scope if it encroaches on their turf and costs them money via competition. Also a lot of folks in this field don't want an expanded scope of practice. Go to a major conference and ask how many in attendance want to expand their scope of practice and say provide antibiotics or allergy meds for allergies or middle ear or external ear issues and you'll see most of the field doesn't want this responsibility.

We sell widgets. Those widgets are hearing aids. That is the bread and butter of any audiology practice. That is what is pushed because that is what is profit. Every hospital that was non-government I was pushed to sell hearing aids. That's how audiology stayed in the black. Our diagnostics are long in time investment, expensive in equipment costs, and low in return on investment for what we are paid for diagnostic services. Also a hearing aid dispenser doesn't need a license in audiology to do a hearing evaluation. They can do a free evaluation to sell the hearing aid/widget. That means someone is giving away your skill set for free to sell the widget you need to sell to make your profit to stay in business. The insurance companies have devalued our diagnostic abilities for years and continue to do so. How do you correct this? Well you need a strong lobbying presence to have money to throw at lawmakers to make sure legislation doesn't pass that decreases your reimbursement rates. Our field is horrible about giving any money to the lobbying groups for their states and well legislation really happens at the state level. I served on a state board for several years and it was frustrating to see how much people complained, but how little they invested whether it be time, money, or intellect to their profession in their state. You also need to be the only person who is licensed and has the ability to do a hearing exam and the only way to fit a hearing aid should have been by having an exam by an audiologist. They compared our field to the optometry model and in a lot of ways we are similar, but the defining difference and why our field suffers is in optometry yes an optician can fit and dispense glasses, but an optician cannot perform an eye exam. Only a licensed optometrist can perform an eye exam which then gives you a prescription for your eye glasses/contacts. They are the gate keeper for that service. If audiologists were the only group who could perform a hearing evaluation and you needed a prescription for hearing aids from a licensed audiologist vs a hearing aid dispenser doing the exam for free in the food court in Sams or Costco then maybe we'd have better reimbursement.

I don't mean to sound all doom and gloom because like I've said I have made a decent living in this job, but choosing this path put me financially 10-15 years behind what many other fields would have done and it made me spend several years in a toxic job I hated, but had to stay at because of my family's needs. That damaged me psychologically and it's something I don't ever want to see any of the students I supervise or anyone I know go through. Our field needs to do some major adapting and soon or else we are just setting our future students up to go too far into educational debt to work dead end jobs they could have made the same money at without ever stepping foot on a college campus.
and how little an ENT is paid for all the surgical knowledge they must learn and training they must do vs. other surgeons or specialists.
???? ENTs are one of the highest paid specialties without a fellowship
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???? ENTs are one of the highest paid specialties without a fellowship

Unless something has changed since when I looked into it I could have done a shorter residency and training and made more money as a dermatologist or general surgeon. If you're going to do all those years then plastics was still the way to go or derm.

Residency SpecialtyProgram Length
Transitional/Preliminary Year1 year
Family Practice3 years
Internal Medicine3 years
Pediatrics3 years
Anesthesiology3 years plus PGY-1 Transitional/Preliminary
Dermatology3 years plus PGY-1 Transitional/Preliminary
Neurology3 years plus PGY-1 Transitional/Preliminary
Ophthalmology3 years plus PGY-1 Transitional/Preliminary
Physical Medicine3 years plus PGY-1 Transitional/Preliminary
Emergency Medicine3-4 years
Obstetrics-Gynecology4 years
Pathology4 years
Psychiatry4 years
Diagnostic Radiology4 years plus PGY-1 Transitional/Preliminary
Radiation Oncology4 years plus PGY-1 Transitional/Preliminary
General Surgery5 years
Orthopaedic Surgery5 years (includes 1 year of general surgery)
Otolaryngology5 years (includes 1 year of general surgery)
Urology5 years (includes one year of general surgery)
Plastic Surgery5-6 years (includes 1 year of general surgery)
Neurological Surgery6 years (includes 1 year of general surgery)
Unless something has changed since when I looked into it I could have done a shorter residency and training and made more money as a dermatologist or general surgeon. If you're going to do all those years then plastics was still the way to go or derm.

Although a strong MD student has a good shot at GS, you can be perfect and not match derm (or plastics). Thus, you might still end up doing plenty of years to become a generalist.
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