The Doctor of Audiology (Au.D.)

Since 2007, the Doctor of Audiology (Au.D.) has been the entry-level clinical degree required to practice as an audiologist in the United States. The Au.D. is a four-year professional doctoral program that combines academic coursework with supervised clinical practicum hours. It replaced the master's degree as the minimum credential for new audiologists, though audiologists who earned master's degrees before the transition are grandfathered in.

Au.D. programs are accredited by the Accreditation Commission for Audiology Education (ACAE) or the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA), a division of the American Speech-Language-Hearing Association (ASHA). Prospective students should verify accreditation status before enrolling, as graduation from an accredited program is required for licensure in most states.

Au.D. program structure

A typical Au.D. program spans four academic years and includes:

• Years 1–3: Academic coursework in auditory anatomy and physiology, audiologic assessment, hearing aid technology and fitting, cochlear implants, vestibular assessment, pediatric audiology, aural rehabilitation, and research methods. Concurrent clinical practicum placements begin in the first year.
• Year 4: A full-time, paid clinical externship (residency) at an approved site — typically a hospital, VA medical center, private practice, or school. The externship provides intensive supervised clinical experience across a range of patient populations and settings.
• Capstone or dissertation: Most programs require a clinical capstone project; some research-focused programs require a dissertation. Requirements vary by program.

Total supervised clinical hours required for graduation vary by program but typically exceed 1,800 hours, including the externship year.

Licensure and certification

After completing the Au.D., audiologists must obtain state licensure to practice. Requirements vary by state but typically include:

• Graduation from an accredited Au.D. program
• Passing the Praxis Examination in Audiology (administered by ETS)
• Completion of a supervised clinical fellowship (in some states)
• State-specific application and fee

The Certificate of Clinical Competence in Audiology (CCC-A), awarded by ASHA, is a voluntary national credential that demonstrates competency beyond minimum licensure requirements. Many employers — particularly hospitals and VA facilities — require or prefer the CCC-A. Maintenance requires 30 continuing education hours every three years.

The American Board of Audiology (ABA) offers the Board Certified in Audiology (BC-A) credential, an alternative national certification. The ABA also offers specialty certifications in cochlear implants (BC-CI) and pediatric audiology (BC-PA).

Hearing instrument specialist (HIS) credentials

Hearing instrument specialists (HIS) — also called hearing aid dispensers — are licensed to fit and dispense hearing aids but are not audiologists. HIS licensure requirements vary significantly by state but typically include:

• High school diploma or equivalent
• Apprenticeship or supervised training period (typically 1–2 years)
• Passing a state or national licensing examination
• Continuing education for license renewal

The International Hearing Society (IHS) offers the Board Certified Hearing Instrument Specialist (BC-HIS) credential, a voluntary national certification for HIS practitioners. The National Board for Certification in Hearing Instrument Sciences (NBC-HIS) offers the National Board Certified (NBC-HIS) credential.

Ph.D. in audiology and hearing science

The Ph.D. in audiology or hearing science is a research-focused doctoral degree distinct from the clinical Au.D. Ph.D. programs train audiologists for academic and research careers — faculty positions, research laboratories, and industry R&D roles. Ph.D. programs typically take 4–6 years and require original research culminating in a dissertation.

Some audiologists pursue both the Au.D. and Ph.D. (Au.D./Ph.D. combined programs exist at several universities), positioning themselves for careers that combine clinical practice with research.

Key professional organizations

• American Academy of Audiology (AAA): The largest professional organization for audiologists in the US. Publishes the Journal of the American Academy of Audiology and hosts the annual AudiologyNOW! conference.
• American Speech-Language-Hearing Association (ASHA): Accredits Au.D. programs (via CAA) and awards the CCC-A credential. Publishes ASHA journals and hosts the annual ASHA Convention.
• Academy of Doctors of Audiology (ADA): Focuses on the business and practice management aspects of audiology.
• International Hearing Society (IHS): Professional organization for hearing instrument specialists.
• American Board of Audiology (ABA): Offers board certification and specialty credentials.

Residency and fellowship programs

Beyond the Au.D. externship, several post-doctoral fellowship and residency programs provide advanced training in subspecialty areas:

• VA audiology residency: The Department of Veterans Affairs operates one of the largest audiology training programs in the country, with residency positions at VA medical centers nationwide.
• Cochlear implant fellowships: Several academic medical centers offer post-Au.D. fellowships in cochlear implant programming and management.
• Pediatric audiology fellowships: Advanced training in pediatric assessment, hearing aid fitting, and early intervention.
• Research fellowships: NIH and university-based fellowships for audiologists pursuing research careers.