Audiology is one of healthcare science's best kept secrets, according to Angela King, senior audiology specialist for the Royal National Institute for Deaf people (RNID). While a lot of people have never heard of it (pardon the pun), there's a lot happening in audiology at the moment, making it a cutting edge, exciting and stimulating career option. "There are new technologies, new ways of working, a new career structure and a strong network of audiologists across the UK," she explains.
The UK desperately needs more audiologists, she adds, urging careers advisers to promote it as a career option to young people.
Audiologists - sometimes called audiological scientists - develop ways to investigate, assess and rehabilitate patients with hearing and balance problems and tinnitus. They ensure that reliable test techniques are used and develop and assess new techniques. For many people, the biggest appeal of all is that audiologists have a direct clinical role, working with patients.
"There are many types of, and causes of, the problems that audiologists deal with - some temporary and some permanent," explains King. " For example, permanent deafness from damage to the cochlea can be caused by serious infections, head injuries and occasionally as a side effect of some powerful life-saving drugs."
Meanwhile, problems can occur in the middle ear, stopping sound vibrations from passing freely thorough to the cochlea - but these can quite often be treated.
Much of audiologists' work can be with children or elderly people. About one in every 1,000 babies is born deaf, whilst others get hearing or balance problems after they're born. Most of us will start to lose our hearing in later life, adds Marion Hoyle, programme director for the audiology undergraduate degree at the University of Bristol. "By the time you get to 60, one in three have hearing loss and by the time you get to 70, it's one in four."
Because hearing loss doesn't just affect the person themselves, but their families, their learning and their social life, audiologists have a hugely important role in improving lives, regardless of the age of the person, she says.
As an audiologist, you may find yourself working with an Ear, Nose and Throat consultant to discover exactly what is causing someone's hearing or balance problem - or you could be using special techniques to test the hearing of small babies. You might get really skilled at programming modern, digital hearing aids to suit each person individually, helping them hear and communicate better or you might enjoy helping people to manage balance problems. You could work with a team giving cochlear implants to severely deaf babies or adults, or if research is your thing, there is still much to be found out about exactly how the ears and brain work together when we hear, what can go wrong, and how new technologies and techniques can help.
You might work in a hospital or a community centre or both. Alternatively, you might choose to work privately, perhaps running your own clinic. You can specialise in working with children or adults or see people of all ages.
The audiological profession has recently undergone major changes and restructuring, with the creation of new career, training and funding structures. The introduction of a tailored four-year degree course (BSc Hons audiology) in 2002 is a significant development in the process. This degree forms the basic professional training of audiologists in the future.
The BSc (Hons) audiology is currently offered at the Universities of Manchester, Southampton, Leeds, Swansea, Aston, Bristol, University College London (UCL), and De Montfort University, Leicester. Further courses are being developed in Scotland and Northern Ireland.
The first two years of the four-year BSc are spent at university, with some work experience opportunities. The third year is spent gaining practical/clinical experience and expertise through a full-time placement in an audiology clinic. Salaries for this placement are funded by the NHS. The final year is spent back at university, learning about the most advanced aspects of audiology and writing a dissertation.
Pre-entry experience is not needed, although Dr Gary Farrell, audiology course co-ordinator at Southampton University, says it will help your application process to have gained some work experience. "We look for people to have had at least a couple of days gaining some understanding about what the discipline actually involves," he says.
Potential candidates will also need to show evidence of good interpersonal skills, technical ability, time management skills, patience, problem-solving ability and the ability to interact with patients of all ages.
Dr Farrell says that because the course is so new, they are very open to making amendments where necessary. "Every year, we have a mop up meeting with the students and they recommend changes. For example, we used to have all the exams at once and they felt that was too much of a cognitive load, so we now split the exams up. Students also pointed out that some people aren't very good at sitting exams so now, in the second year, we have made the assessment 70 per cent exam based and 30 per cent written assignments - to give those who excel in coursework a chance to show how good they are."
He says audiology is a hugely rewarding career, not least because it is a small profession where everyone tends to know each other. "This makes it a little more friendly than other professions."
Dr Farrell adds that you're never quite sure what you'll see - whether it's hearing disorders or dizziness, which makes it a stimulating and challenging career. "But perhaps most important of all, you're giving someone back one of their senses. We have a cochlea implant centre based at our university and we get our first year students to go and see some situations where the implant is turned on for the first time among children, and they find that very emotive."
Leah Wannell, who has just finished the first year of the course, says she particularly enjoys the balance between practical work and theory. " It's made me feel more motivated than ever before because the theory helps me understand what is going on with all the tests, and the work shadowing and work placements help me see the rewards of actually working with patients, making a difference to their lives."
Ted Killan, lecturer in audiology at the University of Leeds, says that the appeal of audiology for him was that you get to work in a clinical science, but directly with patients, rather than behind the scenes. He adds, " Other allied health sciences often involve seeing a patient only once. With audiology, you might detect a young infant with a permanent hearing loss, then see that child regularly until they're 18 or more. You can build a real bond with patients and their families. With audiology you also get to deal with lots of different kinds of people and professions; teachers, speech and language therapists, social services, for instance."
Killan's message to careers advisers is to promote audiology as a career suitable for a "people person" who is also interested in physical science and behavioural science and in making a difference. "I'd also like to stress that whilst audiology should be viewed as a caring health profession, it has substantial science elements - in particular, biology, physics and psychology."
Ben Mann spends half the week working as an audiology manager at St John's Hospital in Chelmsford, Essex. The other half is spent running his own private practice, Click Hearing. He has worked in audiology for 10 years.
I came into audiology quite late, when I was 20. I knew I wanted to work in health, but never really had much idea beyond that. I saw an advert in a local paper looking for a student audiologist at a hospital and it said they'd support you to study for a degree on a block release basis over four years. I liked the idea of very practical training where someone else would finance the studying side. By the time I graduated during which time I moved around doing different jobs I got a senior post. Unfortunately, that route in isn't available now, but I keep pushing for it to be made an option again.
As head of a department in my NHS role, I do less clinical work than I used to. I spend a lot of time in the office. But although it's not a hands-on role, I enjoy making the decisions and changes that make a difference. It's still helping people. This work is almost exclusively paediatric pretty much from birth up until the children leave school.
I moved into private work where I work almost exclusively with adults four years ago in response to my perception that people in the private sector were paying too much and not always getting the service they should. I'm not saying that happens everywhere, but the benchmarking doesn't really exist in the private world. I read about people going to Denmark to buy better hearing products and I felt that shouldn't be the case. I took the necessary exams and started up my own practice.
The best thing about private work is that you don't feel you have to compromise on treatment for people, whereas funding issues in the NHS mean that patients often wind up with a choice of maybe two things to help them or no choice at all. The pay is also better and you get more continuity with private clients. I get to do some consultancy work on the private side too, where I advise on the private market.
The best thing about the NHS is that you get to work in teams. Also, since the Royal National Institute for the Deaf (RNID) has managed the modernisation of hearing services in the NHS, everything is much more protocol driven and the aids are much better. That makes the job much more rewarding.