Over the past 15 years since the doctor of audiology (AuD) degree was adopted nationally, it has become clear that many systemic problems with the externship model exist and need to be urgently addressed. For example, in the stakeholder survey conducted by ACAE in 2013–2014, students, faculty, and clinicians all reported large gaps between classroom and clinical training. The externship is too often inadequately supervised and lacking in quality and breadth of experiences. A survey of 64 AuD programs, undertaken by the American Academy of Audiology (Academy) Education Committee in 2009, revealed deficits in academic training to prepare students for clinical experiences. Faculty identified areas in which expertise was lacking for many areas of practice including cochlear implants, vestibular assessments and rehabilitation, business, tinnitus and hearing conservation, medical audiology, pharmacology and others. Many issues related to the fourth-year externships were identified, yet the majority of faculty advised retaining the fourth-year clinical year prior to graduation. All students of audiology need to master high levels of clinical integration and best practice during their entry-level education. Clinical education must be consistent in programs across the United States and equal in quality to its counterpart, didactic education. Now, massive changes are taking place in education, health-care models and technology, and also student tuition, that audiology must be prepared to embrace. Attempting to “catch-up” and fix the education model of the past will not work for these fundamental shifts in health-care delivery and university education. For improvements to occur, current models should be examined with regard to future needs. A critical outcome would be to determine organized steps on how to create clear pathways for future education and training needs. This content is an exclusive benefit for American Academy of Audiology members. If you're a member, log in and you'll get immediate access. Member Login If you're not yet a member, you'll be interested to know that joining not only gives you access to top-notch resources like this one, but also invitations to member-only events, inclusion in the member directory, participation in professional forums, and access to patient resources, tools, and continuing education. Join today!