How to Become an Audiologist: Education, Training, and Requirements
What to know about an audiologist’s training and expertise and how it differs from a Ph.D. in audiology.
The 3 key takeaways
- Audiologists are highly trained clinicians — Becoming an audiologist typically requires about eight years of education, including a clinical doctorate (Au.D.), hands-on training, and licensure.
- Training goes far beyond the classroom — Audiologists complete extensive supervised clinical experience, including a full-time externship where they treat real patients before practicing independently.
- Their expertise directly impacts your care — This level of training ensures audiologists can accurately diagnose hearing and balance conditions, explain results clearly, and recommend evidence-based treatment—not just quick fixes.
Have you ever had your hearing tested, and wondered: how does an audiologist know all of this?
The answer involves considerably more than most people expect. Today, audiologists are doctoral-level clinicians who complete years of advanced education to understand hearing, balance, and how to help those with hearing loss.
This typically includes a four-year undergraduate degree, followed by a four-year clinical doctorate (Au.D.), with the final year spent in a supervised externship, and a state licensure exam — not counting any specialty certifications a practitioner may choose to pursue beyond that baseline. However, some audiologists entered the field before the doctoral standard was established in 2007 and were allowed to continue practicing with a master’s degree under “grandfather” provisions.
That training extensive matters. It’s what separates a full in-depth hearing evaluation from a quick online hearing test or in-store retail screening. In this article, we’ll walk you through what it takes to become an audiologist, and why that level of training can make a real difference in your care or your loved one’s care.
An audiologist’s perspective on training and career path
Jessica Hinson, Au.D., who is part of our medical review team, shares about her training and career path:
In order to become a candidate for the doctorate of audiology program, I changed my major to speech and hearing sciences. Most doctor of audiology candidates have some sort of hearing related undergraduate degree, such as speech and hearing or deaf education. While on the undergraduate audiology track, I took the Graduate Record Exam (GRE), and submitted my scores, transcripts, required observation hours, and multiple letters of recommendations to the Audiology Department of my choosing.
In the doctorate program, I completed rigorous training in the organs of hearing, psychoacoustics, vestibular and balance disorders, neurophysiology, occupational hazards, tinnitus and tinnitus therapies, educational audiology, and amplification systems, all while observing audiologists in a number of settings.
For the year afterwards, a residency is required, during which I was mandated to achieve over 1,800 hours of supervised audiology work with patients. Following graduation, a national licensing exam was administered and a passing score granted me the ability to become state licensed.
Her tips for finding a qualified audiologist
When looking for a local audiologist or hearing professional, I would look not for the accolades of the school itself, but what specialty experience they have. Do you have severe tinnitus? Find a provider that specializes in tinnitus therapies. Do you have a particularly hard time listening to live music with your hearing loss? Find a provider who loves visiting their local symphonies and can relate to your struggles. Do you have a complex hearing loss that fluctuates over time? Select a provider who has dealt with similar pathologies.
Step 1: earn a bachelor’s degree
Every audiologist starts with a college degree. While there is no one required major for admission to a Doctor of Audiology (Au.D.) program, most begin with a strong background in science— including biology, anatomy and physiology, physics (particularly acoustics), statistics, and psychology.
Many audiologists-in-training major in communication sciences and disorders speech-language pathology, while others enter the field through biology, neuroscience, or pre-health tracks.
This early training helps audiologists understand how the ear and brain work together — which is essential for accurately diagnosing and treating hearing loss.
Step 2: complete a Doctor of Audiology (Au.D.) program
The Doctor of Audiology (Au.D.) is the required degree for audiologists who provide hearing and balance care in the United States. This clinical doctorate is focused on real-world patient care, ensuring your audiologist is trained to evaluate hearing loss, explain results clearly, and recommend the right treatment options.
The Au.D. is a professional doctorate, meaning it emphasizes hands-on clinical training rather than research — which is what sets it apart from a Ph.D. in audiology.
The transition to this doctoral standard was completed in 2007. Before that, some audiologists entered the field with a master’s degree, and were allowed to continue practicing under grandfathered provisions. Today, entering the profession must earn an Au.D. from an accredited program to become licensed.
Most Au.D. programs take four years to complete. The first three years combine classroom instruction with supervised clinical experience, while the fourth year is a full-time, off-campus clinical externship, similar to a medical residency. A small number of accelerated three-year programs also exist, though they are less common.
This means that by the time your audiologist begins practicing independently, they’ve already spent a full year treating patients in real-world settings.
What you study in an Au.D. program
Au.D. programs are designed to give students a strong foundation in both the science of hearing and real-world patient care. Across accredited programs, students can expect to cover:
- Anatomy and physiology. How the ear and balance systems are structured and how they function.
- Acoustics and psychoacoustics. How sound travels in different conditions and how hearing works.
- Hearing tests. Tools like pure-tone audiometry, speech audiometry, and immittance testing.
- Electrophysiology. Objective tests such as auditory brainstem response (ABR), electrocochleography (ECochG), and vestibular-evoked myogenic potentials (cVEMP and cVEMP), which help evaluate complex hearing and balance disorders.
- Otoacoustic emissions (OAE). Tests that measure inner ear (cochlear) function and are commonly used in newborn hearing screening and diagnostic evaluations.
- Hearing aids. How to select, fit, and program devices for different types of hearing loss.
- Cochlear implants and bone-anchored devices. Candidacy evaluation, device programming, and habilitation
- Balance (vestibular) care. Testing and treatment for balance disorders, dizziness and vertigo.
- Tinnitus management. Strategies to evaluate and reduce ringing in the ears.
- Pediatric audiology. Hearing care for infants, children, and teens.
- Auditory rehabilitation. Communication strategies, group rehabilitation programming, and assistive technology.
- Research and evidence-based care. How audiologists use research to guide treatment decisions.
- Professional ethics and practice management. The business, legal, and ethical dimensions of running or working within a clinical practice.
This training goes beyond the classroom.
From the first year, students begin working with patients in supervised clinical settings. Over time, they build skills by working with different age groups, hearing conditions, and real-life situations.
Clinical training: hands-on experience with patients
One of the most important parts of Au.D. training is hands-on clinical experience. Au.D. students complete supervised clinical hours as part of their degree training, building experience with a wide range of patients, age groups, and hearing and balance conditions.
These hours are a core part of clinical preparation and help ensure students develop real-world diagnostic, counseling, and treatment skills before entering independent practice.
They may train in:
- Hospitals
- ENT (ear, nose, and throat) clinics
- Veterans Affairs (VA) facilities
- Schools
- Hearing aid clinics
Clinical training is not just about logging hours. This is where students learn how to work with real people.
They learn how to:
- Explain hearing test results in simple terms
- Help older adults adjust to hearing aids
- Test young children who won’t wear headphones
- Support patients who feel unsure or overwhelmed
It is also important to distinguish clinical training from optional professional credentials. Some audiologists choose to earn the Certificate of Clinical Competence in Audiology (CCC-A) through ASHA, but this certification is not required for licensure in most states or by most employers. It can, however, be helpful in some professional situations, such as license transfer between states.
Step 3: complete a full-time clinical externship
The fourth year of the Au.D. is a full-time clinical externship — typically 12 months at a single site or across two rotations. By this point, students are working with patients daily under supervision. During this year, students act as supervised clinicians. They manage patient care while being guided by licensed audiologists.
Externship sites span the full spectrum of audiology settings: academic medical centers, private practices, Veterans Affairs facilities, children’s hospitals, cochlear implant programs, school systems, and research institutions.
Students typically apply for extern positions through a matching process, and the site selection can meaningfully shape early career direction. After completing the externship and all program requirements, students earn their Au.D. and can move forward with licensure and certification.
Step 4: get licensed to practice audiology
An Au.D. degree alone is not enough to practice audiology. Independent clinical practice requires state licensure, and every U.S. state has its own licensing board with its own requirements, though the structure is broadly similar across states.
In most states, licensure requires:
- An Au.D. degree from an accredited program
- Passing the Praxis Exam, a national test of audiology knowledge
- Clinical experience, which may include a supervised fellowship in some states
- Application and background check through the state licensing board
- Ongoing education to maintain licensure over time
Licensure requirements vary by state and can change over time. Audiologists must meet the rules in each state where they practice.
Au.D. vs. Ph.D. in audiology: what’s the difference?
You may come across both the Au.D. and the Ph.D. in audiology and wonder what the difference is. Understanding the difference can help you better understand your provider’s training.
The Au.D. (Doctor of Audiology) is a clinical degree. Audiologists with an Au.D. are trained to:
- Perform hearing tests
- Diagnose hearing loss
- Fit and manage hearing aids and other devices
- Provide ongoing care and support
It is the required degree for clinical practice in the U.S., and the vast majority of people who become audiologists pursue it.
The Ph.D. in audiology is a research-focused degree. Audiologists with a Ph.D. usually do not provide routine patient care. Instead, they focus on:
- Studying how hearing works
- Researching hearing loss and treatments
- Developing new technologies and tests
- Teaching future audiologists
Ph.D. graduates typically pursue careers in academic research, university faculty positions, or research-intensive medical centers.
Some audiologists earn both degrees through a combined Au.D./Ph.D. program. These professionals may provide patient care while also contributing to research and advancing the field.
Advanced certifications and continuing education
Some audiologists choose to pursue additional certifications to build advanced expertise in specific areas of care, such as pediatric audiology or cochlear implants.
Specialty certification is not required for practice, but signals a level of focused expertise that can be meaningful for patients, employers, and referral networks. For example, an audiologist with pediatric certification has advanced training in working with children — which can be especially helpful for parents navigating a new hearing diagnosis.
Continuing education is a required part of being an audiologist. Hearing technology and treatment options are always evolving. Ongoing training helps ensure your provider is using the most up-to-date approaches.
Optional certification: the CCC-A credential
In addition to state licensure, many audiologists earn the Certificate of Clinical Competence in Audiology (CCC-A) from ASHA. The CCC-A is not required for licensure in most states or by most employers. However, some audiologists choose to maintain it as an additional professional credential, and it may be helpful in certain situations, such as transferring a license between states.
To obtain the CCC-A, audiologists must submit proof of supervised clinical practicum hours under a CCC-A certificate holder, submit their doctoral college transcripts, pass the national Praxis exam, and pay ASHA’s certification fee.
To maintain the CCC-A, audiologists must pay the annual fee, abide by ASHA’s code of conduct, and complete continuing education — currently 30 hours every three years.
Why an audiologist’s training matters for your care
All of this matters for one simple reason: when you sit across from a licensed audiologist, you’re working with someone who has invested the better part of a decade preparing to evaluate and treat hearing and balance conditions.
They understand how your ears and brain work together to process sound. They know how to interpret your test results based on your health history, lifestyle, and hearing needs.
They have been trained — by supervised clinical practice across hundreds of real patient encounters — to communicate findings clearly, to counsel thoughtfully, and to recommend treatment options grounded in evidence, not sales pressure.
That level of training is not incidental. It’s why a full hearing evaluation provides more insight than a quick screening or online hearing test. It’s also why building a long-term relationship with an audiologist can be one of the most valuable steps you take for your hearing health.
The bottom line
The path to becoming an audiologist is a long and rigorous one. It includes years of education, clinical training, an externship, licensure, and optional professional certification. Each step is designed to prepare audiologists to care for patients safely and effectively.
For patients and families, that training provides peace of mind.
When you work with a qualified audiologist, you’re not just getting a hearing test, you’re getting expert guidance to help you hear and communicate better over time.
Frequently Asked Questions
How long does it take to become an audiologist?
Becoming an audiologist typically takes about eight years: four years for a bachelor’s degree and four years for the Au.D., which includes the full-time clinical externship in the final year. Some students complete their undergraduate degree in less than four years, and program timelines vary— especially since a small number of accelerated three-year Au.D. programs exist — but eight years is a reasonable planning baseline.
What undergraduate major is best for getting into an Au.D. program?
There is no single required major, but communication sciences and disorders is the most common pathway and provides the most direct preparation. Biology, neuroscience, psychology, and pre-health tracks are also well-represented in Au.D. applicant pools. What matters most is completing the prerequisite science coursework, maintaining a competitive GPA, and gaining clinical observation hours in audiology settings before applying.
Is the Au.D. required to practice audiology everywhere in the United States?
Yes. The Au.D. is required for anyone entering the profession today. The Au.D. has been the required entry-level degree for clinical audiology practice in the United States since 2007. Some audiologists who earned master’s degrees before that transition are still in practice under grandfather provisions, but anyone entering the field today must complete the Au.D. from a CAA-accredited program and obtain state licensure to practice independently.
Do audiologists have to do a residency like medical doctors?
No, though the final year of the Au.D. is a full-time clinical externship that functions as a supervised immersion in real-world practice. An audiology externship is similar to a residency in that it involves full-time, supervised patient care, but it is completed during the doctoral program rather than after graduation.
Medical residencies are longer and broader in scope, while audiology externships are typically one year and focused on hearing and balance care — often within a specific area of interest. For example, a student interested in cochlear implants may choose an externship in a hospital that performs implant surgeries, while someone interested in private practice may train in a clinic setting.
Can audiologists prescribe medication or perform surgery?
No. Audiologists are not medical doctors and do not have prescribing authority or surgical scope of practice. When a patient’s hearing or balance condition requires medical or surgical management — such as treatment for ear infections, cochlear implant surgery, or removal of acoustic tumors — audiologists refer to otolaryngologists (ENTs) or other appropriate medical specialists. The two professions frequently work in close collaboration, with audiologists handling the diagnostic and rehabilitative dimensions and ENTs managing the medical and surgical ones.