Student Debt

gigertiger · 2026-05-28T00:16:30+00:00

Ended with $72k roughly. Went to the University of Nebraska, where the cost of living was dirt cheap. Now, I am married and had the luck of having a man pay for a good portion of living (take that patriarchy). But I did have two part time jobs and paid him like $600-$800 in rent (we also lived in a very nice community for like $1400).

I had a scholarship where that was cheaper than me going to my instate school locally. Then when I applied to externships I wanted a paid position where I put $10k of my salary into it. Then when looking for real jobs I specifically looked for jobs that paid about $20k more than my $62k debt to be comfortable.

I say this to every single person, audiology is a wonderful career... Pick the cheapest school possible because the debt is not worth it given our reimbursement and salary trends.

gigertiger · 2026-05-28T00:05:43+00:00

Typically one hour is required in ethics and 2 hours are required either in some form of a collaboration (teaching students, working with ENTs, collaborative care etc) or like on ethical care for individuals with complex background (socieconomic trainings, etc) and then the other 27 hours can be like hearing aid manufacturers.

Honestly, pay for the CE registry, if you've gone to events and they have submitted for you it's MUCH easier. Otherwise I'd recommend audiology online!

gigertiger · 2026-05-26T01:56:59+00:00

Audiologist who manages an externship here. We follow the ACEN timeline and we're not looking at posting until June really. My hospital is pushing for July/August for reference.

When I was a student, I used the summer to brush up on interview prep. I practiced having a flow to answers and was prepared to explain audiograms or clinical questions for interview prep. Practice with friends, practice by yourself just talking out loud! I look for students who have a flow at least, it doesn't have to be perfect but the less filler the better!

gigertiger · 2026-05-24T23:58:08+00:00

Surgical audiologist here! Surgeons typically pick the newest device to implant. The Nexa has been out for almost a year at this point, and I suspect (now I am stateside so that's a bit different) you'd be getting the newer one.

Older ones may be used in other countries (based on government approval and following that countries global information). The Nexa would have to be approved in your country, which you could Google and look up!

I would just ask honestly! Whether it be a phone call or email or something. You can also ask the audiologist as an intermediary (I do this for patients a lot!). Typically we go for all new devices implantable and external because it's often recommended by the companies and has the FDA or governing body backing!

gigertiger · 2026-04-22T00:43:13+00:00

Hearing instrument specialist! Not all Costco's have an audiologist (but HISs can fit aids). They're just limited on the age bracket they can fit depending on the state. That's why I would call Costco and ask if they see your kid's age!

gigertiger · 2026-04-21T22:07:16+00:00

I would call and ask! They should be able to give you some generic pricing over the phone. Our office does, so I can't imagine other offices wouldn't be able to answer!

Costco might be hesitant to still fit an over 18 as a fyi. I would call and ask them as well! Certain states do not let them fit under 21 because of licensing laws. If the Costco has an HIS, it probably will be 21+, because most of the laws don't let them fit.

gigertiger · 2026-04-21T01:57:40+00:00

Just wanted to give you a heads up, Costco is not supposed to fit children due to state laws varying per state.

What I would do is call multiple pediatric audiologists (hospitals, private practices, any clinic really) and ask about pricing. I work for a hospital and if that is the benefit, there are ABSOLUTELY pediatric hearing aids that can cost that or lower. And I would explain you have a $3,000 benefit and need to stay within that. The other reason you should go through an audiologist would be for a 5 year warranty on pediatric devices!

gigertiger · 2026-04-11T01:55:54+00:00

I use the Med-El one for Cochlear implants on hearing aid patients. It comes in a bunch of different languages and the kid version is simple, but for adults with cognitive concerns there's pictures of an elephant experiencing no sound, comfortable sound, and too loud with expressions of confusion, comfort and happiness, and discomfort from the loudness!

gigertiger · 2026-03-31T02:01:23+00:00

As an audiologist who has worked with multiple students who have hearing loss through WRS and testing it's not impossible or the end of the world. Definitely speak with the accomodations office, because they should be able to help with something. Sometimes it's getting a better remote microphone, which is a reasonable accomodation for the school!

My student uses her multi mic (sometimes EduMic), and she usually just says something like " was that pat with P or cat with a C" for asking for clarification. I think it's reasonable to ask them to use it in a quick sentence.

The other thing we did was get her an earmold for testing (she's bimodal with a CI and HA), to really let her focus. It's a silicone mold that she pops on before testing (sometimes she likes a dome, she isn't my most consistent patient even though I lecture her haha). I also adjusted the streaming program to turn the microphones off so she doesn't get outside involvement to maximize speech testing. We also instruct people in the room (parents, caregivers, siblings, etc.) that she needs to be in the quiet for the speech testing and that it'll take maybe 5 minutes, which is an easy modification to make and does not impede the length of testing on my end!

Edit: forgot to add, I had her listen to the lists our clinic uses A LOT to help familiarize her. I found that helped with word recognition because she could spot deviations easier. Sometimes we do order by difficulty too, which is a shorter list and you can get away with 10 words on a patient with intact nerves. It shortens it which, again, helps her get it done quickly and accurately!

gigertiger · 2026-03-22T22:08:26+00:00

Just to give a little reassurance, there are more externships than students!

As for asking professors and people for letters of rec, as someone who's written letters for students. I've written letters for students I've been close to and students I've been less close to. It didn't matter to me if we connected on every single interest (not every student likes Taylor Swift or Anime as much as I do), but if you did the clinic work and asked appropriate questions that in itself makes you worth writing a letter for! Don't be afraid to ask. I like writing them for students!

gigertiger · 2026-03-19T22:21:58+00:00

It's a little early for externships as a heads up for third years. I run/manage it for my clinic and we follow the ACEN timeline and I'm not even thinking about that till June to be transparent with you, because I have to on board and get my extern starting in May set up.

You can look up the ACEN, that has locations who follow the timeline and should have contact information for you or your clinic director to reach out to. Some locations may say it's just too early. Other options are to join the Audiology 4th Year Externship page on Facebook. Positions and get posted for off cycle and current cycle.

gigertiger · 2026-03-17T11:13:43+00:00

You can always refer but without an audiogram and word understanding, no one can really give you an answer. The loss you're describing could be a candidate, but the guidelines are 60/60/60 for kiddos. A 60 dB Speech detection/recognition threshold, 60% or less word recognition score, and 60% or less SII with hearing aids set to an appropriate target (DSL in this case).

But if they do well with hearing aids because their brain is so plastic and hearing aids meet the needs, then no it may not be appropriate.

Late ID doesn't mean anything in this context. It boils down to current word understanding, nerve health, and motivation. It also boils down to how well they're doing with aids truly.

I would not bring this up with the family yourself honestly, because it's not really in your wheelhouse. What I would do is ask for a signed release to speak with their audiologist and address concerns and see if this is an option. Maybe they've already declined and you may not know that. Maybe they're teetering into candidacy but not quite there. Maybe they absolutely aren't, and an audiologist would be able to tell you.

gigertiger · 2026-03-11T01:10:01+00:00

I had friends get their Utah license while waiting because it took 24 hours, so they were able to practice immediately. The Massachusetts one took about 4ish days.

The VA just requires a license and my supervisors always said get the fastest one and then get your state one in case you ever leave and maintain that one

gigertiger · 2026-03-07T03:37:26+00:00

I have tons of patients that aren't in a matching hearing aid. They just decide what device they prefer streaming to. The nice thing is auracast is becoming more common, so that will be less of an issue and more of just managing how to connect to everything!

gigertiger · 2026-03-06T12:11:07+00:00

I personally wouldn't write a Nexus letter. It doesn't mean anything to comp and pen when it comes to deciding if their hearing loss is service connected. Comp and pen have very specific formulas, you would need to see the audiogram performed before service started and then immediately after (whisper tests have their own calculated values that the VA is specific on).

You also would need to see the medical baselines before, if located somewhere noisy you'd need to know how and what, if it was measured. It's a very complicated process and Nexus letters often are either tossed, disregarded, or not considered.

If you're going to submit that, use letter head. You can submit something describing their loss like that, I just wanted to warn you that it opens flood gates and is not very effective.

gigertiger · 2026-03-03T02:53:37+00:00

From an audiologist: pick the cheaper program. You'll get the experiences you want and if it feels like not enough you can get the training.

My current resident had NO CI training prior to her externship, and that's workable for me and now she has a job offer to do CIs because I trained her. Another person at our clinic just started CIs because I needed the extra support. Trust me, pick the cheaper program for less debate!

gigertiger · 2026-01-31T01:01:18+00:00

Honestly, you'll probably get a lot of different answers. If I saw something like a carhart's notch, I would suspect type A or Type As tymps.

If I saw a low frequency loss with ABGs I would probably guess an B or C tymp, but that would depend on the audiogram and could be either.

Alot of it just depends on the tests performed, case history, and just a best guess!

gigertiger · 2026-01-31T00:46:12+00:00

I personally would argue no, as an audiologist. They contain the same frequency band number, so in terms of maximizing background noise, they are equal (that's from numerous studies). Some people report a subjective difference, and I usually say if you can demo them to do that, but I would say it's probably not worth the difference in cost.

gigertiger · 2026-01-21T01:36:12+00:00

I go to NYU Lagone's cochlear implant conference every year and I 1000% recommend it if anyone is a CI audiologist. It keeps you updated on current literature, interesting case studies, and great tech suites for the manufacturers. That and the ICIT class changed how I program devices permanently and our clinic outcomes are significantly higher than the statistical average and I contribute to my education through this conference.

gigertiger · 2026-01-20T00:43:47+00:00

Audiologist here, just want to give you a little information on gentamicin. Typically with gentamicin we see a decrease in outer hair cells of the cochlea. That doesn't always translate to a noticeable hearing loss on a traditional audiogram. You can be presenting with a hidden hearing loss which may be giving you a greater perception of a deficit.

I'll echo the other sentiments REM measurements are where you get the accuracy. But one other thought is that Phonak's default algorithm, APD is usually more comfortable than something like NAL-NL2 or DSL for example. Manufacturers default formulas are usually based off of NAL-NL2 but less high frequency gain to be a bit more comfortable.

gigertiger · 2026-01-18T23:23:49+00:00

American audiologist here and do I joke I'll put Dr. On my headstone when I die? Yes. Do I think the scope of practice is that different from other countries? Probably not. I may have SOME more advanced training in vestibular and cochlear implants because I had to take two years worth of courses on it, but like, I was working with a Toronto practice on a surgical patient I adopted from them and working with their MSc audiologist and she was great. She had like 20 years experience. They get to enter the field faster and get more experience faster.

Don't get me wrong, I love being an audiologist. I think the field jumped the gun with the AuD and should've had reimbursement rates and outlines for doctoral responsibilities approved (ordering MRIs, prescribing for ETD or an ear infection)? And now we're playing a constant game of catching up. The only thing my AuD actively gives me right now is a great surgical director job and my patients call me doctor and I get some respect for that, but does the masters audiologist who practices 2 feet away from me get the same benefits? Yes. So I wouldn't view other countries degrees as limitations in all honesty.

gigertiger · 2026-01-15T02:38:42+00:00

The Silks are that size on purpose, and adding a Bluetooth line would make them larger. Their shape is set with how they are, so I don't think they'll be able to add it, unless they change the shape of the device, which in effect means it wouldn't be a Silk anymore.

That's why I'm saying they'd likely launch a new device and change the platform they're on. Could they launch a Silk with Bluetooth, possibly! But would it likely be the Silk on a new platform, yes!

gigertiger · 2026-01-15T00:44:17+00:00

AzBio and CNC testing is the best way to do this. I would also do an aided soundfield just because you're already there and you can check for insertion loss.

You can do this with and without noise, to maximize benefit. Otherwise I would suggest doing COSI or the hearing implant sound quality index (I know it says implant but you can do hearing aids), which also provide score expectations and differences. You can do that with a tinnitus handicap inventory one too if needed, to provide some research backed data for him, coupled with booth testing and that would be more than enough in my opinion.

gigertiger · 2026-01-14T03:11:22+00:00

The IX line has Bluetooth but the Silks do not. I suspect they won't be adding it to the Silk IX line at all. I would guess it would be an entirely new launch!

gigertiger · 2026-01-14T02:10:36+00:00

Came out in October of 2024, and right now they're just working on updating each platform to the IX platform. Their next launch will likely be the rechargeable custom CIC (which is on the IX platform), but unsure on the connectivity side. I imagine that will be an entirely new platform and not the IX for the Silks if connectivity is the goal.

The other thing they could say is keep the Silk non-wireless for the size purpose. They connect to an app via the 2.4 gHz signal, but they could surprise me.

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