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Rising Education Costs Could Decrease AuD Enrollment

Liebe, Kevin AuD

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doi: 10.1097/01.HJ.0000421127.96804.ed
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Consumer Price Index (CPI) Comparison of College Tuition, US Home Prices, and All Items From 1978 to 2012.

I am a strong proponent of the AuD degree. I believe it has had a tremendously positive effect on the profession overall. I attended a residential AuD program, and feel it prepared me well for working as an audiologist. You cannot help wondering, however, what effect rising tuitions across the country will have on audiology's future in the coming years.

New Standard in Audiology

It took years of development and lots of debate, but the AuD became the entry-level degree required to practice audiology in the United States as of 2007. Nearly all on-campus residential AuD programs today are four years. The first three years usually involve academic coursework and clinical rotations, and the fourth is typically a full-time externship off campus.

Kevin Liebe, AuD

This format was a significant departure from the previous master's degree program, which was the entry-level degree requirement to practice audiology for many years. Many clinicians had already earned their AuD degrees by the time the AuD became the official entry-level degree in 2007, primarily through distance learning programs that had become available to working professionals. (See FastLinks.)

Reimbursement Still Lacking

Improvements in reimbursement levels for audiology services have unfortunately not kept pace with the advancement and current educational requirements of our profession. Compensation has not risen to what many had expected doctoral education would provide, despite the AuD's standardization. New doctors of audiology with three or fewer years of work experience have a typical median salary of $63,000 after committing eight years to a degree, according to the most recent American Academy of Audiology salary survey. (See FastLinks.)

That number improves only slightly to $70,000 for individuals with four to nine years of experience. Few audiologists are making what the public would likely recognize as doctoral-level income, even after many years of clinical experience. Those making six Figures are typically found only in management or ownership positions. Other doctoring professions still command significantly higher median annual salaries: optometrists ($105,000), podiatrists ($120,000), dentists ($135,000), and pharmacists ($110,000), according to the US Bureau of Labor Statistics. (Occupational Outlook Handbook, 2012-2013; see FastLinks.)

The Cost of an AuD

Residential AuD programs are producing graduates with much larger debt burdens than in the past, as well as producing graduating students with more education and clinical experience than ever before. Today, some residential AuD graduates leave school with $100,000 in student loans. This could equate to as much as 20 to 30 percent of net income going toward paying student loan debt for at least a decade, if not much longer, with current interest rates and expected compensation levels for new AuD graduates. Tuition at the two major public universities in the state of Washington has increased more than 15 percent per year for the past two years. This is not an unfamiliar trend.

The cost of college tuition continues to skyrocket across the country with no end in sight, as can be seen in a comparison of the consumer price index (CPI) of college tuition, new home prices, and all items during the past 30 years. (Figure.) The CPI is often used as an economic indicator, and it measures changes in the price levels of consumer goods and services purchased by US households. It is difficult not to notice the significant upward trend of college tuition and fees.

Student Loans and Career Choice

The negative effect of massive student loan debt on doctors is already being felt. Studies during the past decade have indicated that student loan debt has a considerable influence on what specialty doctors choose. Higher debt also increases the likelihood that physicians will not practice in medically underserved areas. (Context Journal 2006[1]; see FastLinks.)

Decreasing income and increasing debt were cited as two major reasons that nearly half of doctors indicated that they would not choose a career in medicine again, according to a recent survey. (See FastLinks.) Other health professions are facing similar dilemmas. Concerns have been expressed for some time about the effect student loans and other debts are having on healthcare providers. Loan debt in optometry, for example, has been cited as a reason that more new graduates are working in retail rather than private practice, according to (See FastLinks.)

Despite relatively low levels of reimbursement and other pressing challenges we face as a profession, most of us could not imagine doing anything else. We became audiologists to help people. We are fortunate enough to have the opportunity to change people's lives positively every day. This is without a doubt the reason audiology has been ranked as one of the best professions in the United States in 2012, according to (See FastLinks.)

Audiologists are in demand across the country, and will continue to be so for the foreseeable future. The need to fill that demand with highly qualified, competent individuals is a key component to the long-term health of our profession, which is precisely the reason the AuD was originally developed.

Less Debt, More Opportunity?

Today's economic realities have led some in the audiology community to wonder whether our current AuD model is sustainable economically. Making audiology education more affordable will not be an easy task. It likely will take a multifaceted approach, including more scholarships and grants for students, but may also require us to revisit issues such as three-year versus four-year programs, paid versus unpaid externships, and other alternative methods of education.

Our profession will continue to move further away from the goal set by the Academy of Doctors of Audiology of owning the profession through a culture of private practice ownership if we do not reduce student debt. (See FastLinks.) Various audiology organizations collaborated over the years to help make the AuD a reality, and the same steps should be taken to make acquiring an AuD an affordable reality for students. We may be risking audiology's future as a profession if we continue to neglect the seriousness of this issue.


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