When I began my career in 1996, I cannot say that I ever imagined audiology would become a doctorate-level profession, or that the fourth-year externship would evolve into its current level. Now that I celebrate 20-plus years as a practicing and supervising audiologist, I look back and try to assess the value of that advanced degree and what our new, bright fourth-year candidates bring to the profession. I can remember with excitement, all of the discussions and hopes for what the doctorate-level degree would bring to our practice of audiology. I know I date myself to say that. I was genuinely excited at the prospect of pushing what we were and who we are to the next level. I expected to have a much more advanced focus on tinnitus, pharmacology, rehabilitation, and amplification, and create a more medical or provider based approach to what we do every day. As a director of a large, private ENT medical group, I am fortunate enough to be exposed to many different facets of audiology—both clinically and in practice management. In accepting this role, I made the decision that we would develop externs rather than hire audio-techs or audiology assistants. I believed then and now that we needed to invest in our professional future rather than use staff who did not have extensive training in our field. We have grown our fourth-year externship program to a very competitive site in a few years’ time, and have helped to train and support some of the most phenomenal preceptors. Three-Track System We divide our externs into three tracks. The first is a rotational track with focus on cochlear implants, vestibular testing, pediatrics, and tinnitus/amplification. The second track is focused on diagnostic assessment, hearing aid fittings, and management, as well as some videonystagmography or auditory brainstem response (VNG/ABR) training. The difference in the second track is that we also spend a significant portion of time on practice management and learning how to run a business. Our newest track is a pediatric/cochlear implant (PED/CI) track. This is our first specialty track. This track is designed for the extern who is looking for the opportunity to focus on cochlear implant evaluation, initial stimulation, mapping and follow-up, pediatric diagnostics, amplification, and follow-up. The externs in this track will also have at least one day per week for clinic diagnostics and routine hearing aid patients. 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!