I am currently placed at Worth Hearing Center, which is a private practice in Albuquerque, NM. I love it here!

A typical day for me means a variety of things. I do hearing evaluations for people scheduled to see ENT, hearing aid appointments (consultations, fittings, adjustments, problems, clean and checks, etc.), cerumen removal (my new favorite thing!), and I've recently started doing more VNG appointments a few days per week.

Something that I've learned in my externship so far is that while being knowledgeable about hearing aids and being able to answer questions that patients have is important, being able to connect with your patients have is important, being able to connect with your patients have is important, being able to connect with your patients on a personal level is really what makes the differences. Also, if you don't know the answer to a question- it's okay! Patients really appreciate transparency, especially when their clinician is a student. Your time in the AuD program goes by incredibly fast, including the externship year, so soak up everything that you can and don't be afraid to make mistakes. Feel Free to contact me anytime about anything - I'm always happy to chat! 

Email: laura.howard@colorado.edu 

I am placed at the Greater Los Angeles Veterans Affairs (VA) Medical Center.

I rotate through 3 different VA locations in the Los Angeles area. My typical day beings at 7am- I come in to prepare for my patient load that day until I see my first patient at 7:30am. I start my mornings with audiologic evaluations which are scheduled for 1-hour each (so nice!). The VA has a pretty thorough testing protocol for new patients (otoscopy, tymps,diagnostic reflexes, pure tones air and bone, tone decay or reflex decay, speech SRT & WRS, speech in noise testing (WIN or QuickSIN), performing the HHIE, then ordering hearing aids and taking earmold impressions if warranted). I also do hearing aid or BAHA fittings in the mornings. My Tuesday afternoons include vestibular evaluations, Thursday afternoons I'm leading a group Progressive Tinnitus Management (PTM) class virtually , and Friday afternoons I do Central Auditory Processing evaluations (CAPD). My day everyday finished up at 3:30pm. 

I've learned a great deal about counseling at my placement. I have such a heart for counseling and I did not realize how much room I had to grow and improve my counseling skills until I saw some of my preceptors with our veterans, they're truly amazing. I'm learning how to see patients through a more person-centered lens, modifying everything from the appointment to how I communicate and compose myself based on what the veteran or their families show me that they need. I'm beginning to learn how to steer away from "checking off" MY list of what I need to complete during the appointment to really studying the veteran, learning their learning style and learning barriers, and thinking to myself throughout the appointment what is most important to them and how can I follow up to ensure they receive the quality of service necessary to be successful or have improved quality of life through the management of their hearing loss journey. 

I am doing a hybrid externship with Rocky Mountain Ear Center and Cochlear Americas. Three days of the week I am at RMEC, which is an ENT practice in Englewood, CO that sees patients for hearing test, hearing aid appointments, Baha and Osia appointments, vestibular testing, ABR, and cochlear implant appointments. The other two days I work for Cochlear in the patient/provider support division and assist with some of their ongoing research project. 

When I am seeing patients at RMEC I am either on the clinic/hearing aid side or the CI side and my days are usually pretty busy. When working on the clinic/hearing aid side, I see patient's half of the day for hearing evaluations, fittings, and checks, plus I regularly see patients for Baha and Osia appointments as well. Some days we have patients come in for vestibular testing. The second half of the day I perform audiometric testing on patients before they see the ENT. This part of the day is usually a bit hectic as we only have 15 minutes to do pure tone audiometry, sometimes including bone conduction and tympanometry. 

I think more than anything I've learned to be graceful to myself when I don't know things, but also to be bold enough to try everything anyway. 

I am currently at Virginia Mason Medical Center in Seattle, WA. 

Everyday looks a little different but I typically see adults for audios, hearing aids, & cochlear implants. I have pediatric days about once a week and get to perform ABR's & behavioral testing. Several of my preceptors crochet, knit, and sew so I like to bring a project to work on in case someone no-shows!

Something important that I've learned at this placement is to not slack on the mental math skills! Being able to mentally calculate phonemes/words correct during CI testing helps make things run smoothly. 

I am placed at Shohet Ear Associates in Orange County, CA. I am primarily in two office locations, one in Seal Beach (which is just a couple blocks from the water so we will occasionally walk to the beach at lunch!) and one in Newport Beach, where I spend most of my time. My placement has affiliations with Hoag Hospital and Children's Hospital of Orange County, as well as other private ENT physicians and a neurologist who specializes in dizziness and vertigo. 

The patient population is probably split 80/20 adults/peds, so I mostly see adults for comprehensive hearing test and hearing aid appointments, but I do see some kids too! We see a good amount of electrophysiology as well, so I've done a number of neurologically focused ABRs for adults, as well as some ECoG and ASSR. We see cochlear implant patients weekly or every two weeks at least, mostly adults but some kids as well. I see a lot of vestibular patients, which I really love! The Seal Beach office also has a surgery center on site, so I have the opportunity to observe surgeries. 

My placement also works with some less common technology, like Lyrics (which I can now remove and insert with varying levels of independence), Earles hearing aids and middle ear implants. I've obviously learned a lot so far, but I feel like I've grown the most in doing VNGs or vestibular assessments. I didn't realize I'd be getting as much vestib as I am, and I am here for it. 

I am placed at the Rocky Mountain Regional VA Medical Center in Aurora, CO, and happy to be part of their team! Proud to be working with veterans with tinnitus and providing veteran-centered care in hearing aid, CI, and vestibular services. 

A typical day can vary from providing hearing testing and hearing aid fittings, to cochlear implant testing and mapping, full vestibular assessment, or leading Progressive Tinnitus Management or auditory rehabilitation classes. We also have one of the busier hearing aid walk-in clinics in the country, where veterans can receive hearing aid services without a scheduled appointment. Every couple of months the externs will rotate through specialty clinics so that you get a good amount of exposure and hands on learning in each. 

One unique part of my experience at RMRVAMC is that we are part of the VA Geriatric Research Education and Clinical Center, meaning I have had the chance to gain experience collaborating and communicating with geriatricians, pharmacists, social workers, nurses, and nutritionists on treatment and care strategies of older veterans. Through this program you are also required to complete a quality improvement project, which has refined my scientific process and presentation of original research (always useful in building a resume!) This is a very unique experience exclusive to the VA, and has contributed to a greater knowledge of other professions within the hospital and how audiology affects care within those professions!

Denver Health

At Denver Health we have different schedules: adult evaluations, pediatric evaluations and hearing aids, ENT, adult hearing aids, and special testing (vestibular and diagnostic ABR). Each day/week looks a little bit different for me. One day I might be doing a follow-up newborn hearing screening and the next day I'll be doing a VNG. I've also started doing intraoperative monitoring, which is super neat! All the different schedules give me a great variety and I learn something new every day.

I've learned that flexibility and willingness to ask for help are key to a great workplace. Sometimes the schedule is crazy and a patient shows up 45 minutes late, and you have to be willing to jump around and help your co-workers, as well as not be afraid to ask for help. This makes everything run more smoothly and ensures patients are getting the best care as quickly as possible. Teamwork makes the dream work!

Boys Town National Research Hospital in Omaha, Nebraska

The Boys Town externship is really amazing at making sure you, as a student, get a lot of experience doing various things. The first three months you are there, you focus on specific areas. For example the first month you do ABRs and Vestibular testing, the second month you do audiograms and hearing aids, and the third month you only do cochlear implants. After that, each week is full of all of those types of appointments! We also get the opportunity to work with a multidisciplinary craniofacial team--testing hearing for children that have craniofacial differences and hearing loss every week. Additionally, Boys Town has a multidisciplinary cochlear implant team, so you get to be apart of that as well as the team discusses candidacy and updates on patients every week. At Boys Town, you basically get to see every type of appointment--it really is a great fourth year placement! Side note: Omaha is a really fun place to live with SO much to do and lots of good food! I've really enjoyed living here :)

For the first three years of grad school, I thought I only wanted to work with children. After being at Boys Town (which is 50/50), I think I want to work at a clinic that has a good balance between the two. That is what is so great about Boys Town--you are exposed to everything and try new things all of the time.

Kaiser Permanente – Union City (East SF Bay Area)

Our clinic serves a large and diverse population in the Bay Area, so every day is unique and challenging. A typical week at Kaiser will have me on adult/pediatric audiological evaluations for 2 days, adult/pediatric hearing aids for 2 days, and 1 day of specialties which may include cochlear implant programming/assessment, vestibular assessment (VNG + vHIT), ABR diagnostics, newborn hearing screenings, and osseointegrated devices. We also have monthly meetings with the ENT team and a quarterly meeting with a multidisciplinary balance clinic. I've obtained temporary licensure in California that allows me to have my own patient schedule for audiograms, which are reviewed by my preceptors. Eventually, I will have my own hearing aid patient schedule too. I love the degree of independence this provides and the opportunity to establish patients under my care while still having support available when needed. 

As a student extern, you may have a planned schedule for the day, but what you end up doing may be very different. Cancelations, sudden SNHLs, last-minute ototoxicity monitoring, walk-in hearing aid "emergencies", and challenging pediatric patients may require your attention. I've learned that while it's important to prepare for the day, it's also important to prepare for not being prepared. Our training has given us all the tools we need to be successful, so don't be afraid to say "yes" when an opportunity presents itself even if you're not feeling prepared in that moment.

Mayo Clinic- Rochester, MN

Lack of a typical day is probably closer to the truth, ha! But- in the best way.

My rotation has been split into 4 rotations: Pediatrics, Cochlear Implants, Vestibular, and Hearing Aids. Throughout the year I work in diagnostics. Many opportunities have come from each rotation thus far, but one of the most exciting has been working with ABIs in a newly developed NF2 clinic. This past January, I worked with a team of audiologists, neurologists, and neurotologists during implantation and activation of three auditory brainstem implants. I am so grateful to be a part of this team as I begin to understand the incredible challenge brainstem implants bring.

Research is a major component to my externship as well. Primarily, I have been conducting research in the vestibular and implant realms. A few of the studies I have been involved in span topics like, fluctuating impedances, eABR use in ABIs, DHI scores for patients with multiple chronic conditions, and how a 7-Telsa MRI stimulates the vestibular system magnetically through Lorentz force.   

1. When it comes to your upcoming externships, there will be times that you will feel as if you are not ready for the next step (whatever that may be). Know that your experiences thus far have prepared you for the next step. I feel very confident in our education. When it comes to the externship (or any rotation), just go for the next step- you’ll be able to handle what comes your way.

2. Each rotation you find yourself in is a new hallway full of doors; push yourself, go the extra mile, say yes to one more thing- those doors will open.