Poor Student Posts: Ball and Chain

Holly Hosford-Dunn
June 18, 2013

A Shocking Picture


Residential AuD programs are a tough sell.  That’s the self-evident interpretation of  our survey analyses over the past three posts by Guest Editor Kevin Liebe, AuD, summarized in Figure 1 (below).   

Moreover, degrees that are equivalent in the marketplace in terms of authority to practice under state licensure come with widely disparate price tags:   transitional AuD degrees are economically advantageous compared to other means of achieving doctoral status in Audiology. 

Those able to matriculate through transitional programs realize thousands of dollars in savings, up to $100K in some instances.

Figure 1. Summary Tuition  Comparisons.

Figure 1. Summary Tuition Comparisons.


Allocation of an Increasingly Scarce Resource


Naturally, the economic advantage is not available to everyone.  Transitional AuDs are an option for  fewer and fewer people each year, thus qualifying as an economically scarce resource.  As intended by their name, Transitional degree programs are slowly phasing out as more in the profession achieve the doctoral level directly, without going through a Master’s program first.

If you are one of  the many audiologists who graduated prior to 2007 and were not required to attend a 4-year residential AuD program, you got the scarce resource and came out well economically. For you, the tuition figures in Figure 1 probably come as a complete shock.

I’ve encountered this shocked reaction frequently when discussing the issue of audiology education costs with ‘veteran’ audiologists. I find that most of them are horrified when they find out the amount of debt students are routinely taking on to become audiologists.  Hindsight is perfect, but here’s what I’ve heard many veteran audiologists say: 

“It’s not worth it.”


Schizophrenia, as Usual


Tuition horrors aside, transitioning those with Master’s credentials into the new doctoring profession has created a substantial group of transitional AuD degree holders  in the marketplace. That group is working and competing for jobs and salaries in parallel with the growing group of graduates from residential AuD programs.  It’s deja vu all over again as Audiologists position themselves by emphasizing the difference between themselves and other hearing health care providers — even those with the same degrees.   

Eventually, the dichotomy will disappear as the transitional-graduate group retires from practice.  But for now and the next several decades, this dichotomy poses a source of friction between workplace expectations of current students and those ‘veteran’ audiologists who graduated prior to 2007 when the AuD became the entry-level requirement for new audiologists.

Unfortunately for residential students, it’s clear that the ROI on an AuD degree is getting worse as the years go by. As annual tuition rates continue to skyrocket at rates more than double that of income growth, it seems inevitable that fewer and fewer students will pursue a clinical doctorate in audiology and instead seek degrees or licenses with a better return on investment.

This is especially true considering the growing number (>30% in a recent study) of young people who express regret at going to college altogether due to student loan debt and the unprecedented number of people who now question the value of getting a traditional college education.  Chris Diles, AuD, anticipated this reaction and transition to non-degree alternatives in our profession in a post written for HearingEconomics last year.  


What They’re Sayin’


The disconnect in Audiology is eloquently expressed by current students and recent graduates of residential programs, who seem increasingly frustrated and surprised at lower-than-expected levels of compensation relative to the amount of time and resources invested in acquiring a doctoral degree.  These comments are all the more acute because they are made in the context of high debt incurred by those student graduates in order to arrive at the marketplace as job seekers. 

 It’s definitely a big issue. I had a friend comment that he considers paying back his student loan debt as if it were a second mortgage payment. When we consider that students will have typically completed 8 years of school by the time the Au.D. is conferred, it is a significant investment. Caleb


The concern I have heard from students is one of value. Many feel that while their program may have prepared them well, they’re worried that they aren’t going to be able to pay back their student loans, or even get a job. … I have seen students from my undergraduate program decide to get their MS in speech-language pathology because it takes less time, the days off are better, and they often make more money. Chasity


For myself with a family of 4 during my education and trying to just keep the basics of life under control I ended up with over $100,000 in student debt and this is from a state university that was not expensive yet still an awesome program. It will take a while to pay these off and that is ok as I am fully aware that this is not an entitlement but a path that I have chosen to take. …I humbly submit that audiologists who have been in practice for 5 years to 50 years should take another look at what has changed in audiology since the inception of the Au.D. and embrace the possibilities rather than push out those who are working so hard on their education in their chosen career.  Cory


It [the cost of  audiology education] definitely resonates with me having been out of graduate school for only 3 years and still under mounds of student loans but wanting to practice in a rural setting! Nancy


I think bringing attention to this issue is very important! I have been greatly impacted by the cost of my education… It’s amazing how much an AuD costs and how often the pay for our profession doesn’t make up for the debt that young audiologists are required to take on. Ben 


After graduating with a Master’s (wife) and Doctorate (me), we realize we will be waiting a while before our net worth begins to actually get out of the red. Unfortunately, today’s job market keeps wanting more and more and more (education) as the entry point…. I look back at my friend who went to trade school and was making $35/hr +$6/hr for retirement at 20 years old while I was still working on my BA–I think he might have been the smartest one of us all.  anon


You better have a rich spouse or rich family is all I have to say. I am incredibly happy as an audiologist and cannot imagine doing anything else, but I just want people to understand the strain that some Au.D. students are under in order to pursue their passion as an audiologist. Shawna


Preach it Kevin.  I’m so glad someone is talking about it.  Add to it that in Seattle almost all 4th year externs are unpaid, it is easy for me to get on my soapbox. Time for some kind of nationwide educational or AuD program reform, I think. Laura


 The Economic View


We have yet to consider cost of living for students, opportunity costs that accompany the decision to pursue an AuD, or controversies such as whether 4th year students can/should be paid for their externship efforts.  These are all real factors coloring the economic analysis of whether the AuD offers a good return on investment. 

We’ll be visiting those issues in future posts, but this series is going to take a much-needed break for awhile.  


Kevin Liebe, AuD, is a clinical audiologist in private practice in Richland, WA. He currently chairs the Government Relations Committee of the Washington State Academy of Audiology. Dr Liebe has written other posts at HHTM.

  1. I think if you could add on top of the columns the cumulative interest that compounds on that tuition over the course of 10-30 years, that would REALLY open some eyes!

  2. There actually is a way to get an AuD for free; but there is one qualification: You have to be hearing impaired to a moderate-severe level yourself.

    As it turns out, Texas is the only state in the union that has a Tuition Waiver for deaf/HOH, that is good at all state institutions, for all degree programs from associates to medical school… Including the AuD at the five programs in the Lone Star State.

    The tuition waiver is no more than filling out form 3900 and submitting it to DARS/DHHS (voc rehab):
    DARS3900 Certificate of Deafness for Tuition Waiver Program:

    There’s a catch (and the reason why this is anonymous): Only 3 of the 5 programs are any good. Two are crap; and of those two, one is also very deaf-UNfriendly — They don’t like to “eat their own dog food.” I’ll leave it up to the reader to go to the US News audiology program rankings and figure it out for themselves.

    1. Holly Hosford-Dunn Author

      Thanks for the information, which is certainly interesting. Is this the only state that offers the option? As for the comments on program performance, they are data poor and derogation rich, neither of which play well at Hearing Economics. Right now, we’re talking about programs that produce a degree, not the goodness of the degree. That’s Economics for you: one thing at a time, and supporting data whenever possible!

  3. I would like to point out ( as it likely has before) this is a common issue shared accross many professions requiring some level of postgraduate training, our esteemed medical colleagues included. The issue of borrowing cost is an issue that may prevail for some time to come. I strongly believe that a necessary course of action is on the young professional to become familiar and comfortable with how their finances are most likely to be throughout their education and in the first few years of practice. Choose a comfortable standard of living within their means while planning a worst case scenerio debt repayment strategy. As a recent audiology graduate myself with a significant amount of debt, keeping these terms in my mind I have been able to live comfortably while steadily decreasing my debt load along the way.

    1. Hi Ryan — yes, it has been pointed out but not quite as you framed it. Recall that this whole series was the offspring of an earlier series that began in March 2013 (https://hearinghealthmatters.org/hearingeconomics/2013/the-battle-of-the-sexes-rages-on-in-pervasive-professional-wage-gaps/ ) prompted by an economic report that some physicians (females) would be better off foregoing medical school and following the shorter, cheaper physician’s assistant path. That report was based on ROI data, which is lacking in our field. Hence, our nascent efforts to start collecting some data and think about ROI for audiologists of either gender.

    2. Ryan,

      Thank you for your comments! You are absolutely correct, Audiology is not going through this problem in isolation–all health fields have and continue to experience this problem (especially medicine). However, what is unique is that the residential AuD was not mandatory until 2007, so this is a relatively new problem for audiology. Clearly finances can be managed appropriately in order for someone to pay off their debt while still living comfortably (such as your situation), but as tuition continues to climb at universities across the nation, the issue will unfortunately only get worse over time. The audiology community needs to realize this and brainstorm positive solutions to ensure quality of education is maintained, while also reducing the financial burden students are having to undertake in order to pursue a career in our profession.

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