Career structure and pre–registration training in the UK

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Students practice attaching electrodes to the headEducation, research and clinical practice in UK audiology has experienced some fundamental, exciting and challenging changes over the past few years, and is continuing to develop.

Audiology education nationally is currently in a period of transition. The most recent development is Modernising Scientific Careers, a government initiative to enhance the training of professionals within healthcare science disciplines, including audiology. As with any change, this has presented both challenges and opportunities. We at ISVR are forward looking and will be taking advantage of the opportunities, especially to provide more flexible and clinically focussed programmes.

Updated: 4th October 2011.

Structure of audiology in the UK

There are five 'types' of audiologist (non-medical):

  • Assistant audiologist
  • Associate audiologist
  • Hearing aid dispenser (aka hearing-aid audiologist)
  • Audiologist
  • Clinical scientist (audiology)

Assistant and associate audiologists

Assistant audiologists are non-graduates that provide a useful supportive role for audiologists and clinical scientists. Associate audiologists typically have an approved foundation degree (roughly equivalent to the first two years of a Honours degree) and work more independently than assistant audiologists.

Hearing aid dispensers

Self-employed or working as part of a larger business, these professionals play a vital role in the provision of technology, support and rehabilitation to hearing-impaired adults more broadly than NHS audiology (although many also work within the NHS as 'audiologists'). New hearing aid dispensers will have an approved foundation degree. 'Hearing aid dispenser' is a protected title and dispensers are registered with the Health Professions Council (HPC).

'Audiologist'

'Audiologists'* are graduates of an approved BSc Audiology (or the Postgraduate Diploma, which is no longer running).  The new 3-year BSc Healthcare Science (Audiology) or "BSc Audiology" programme runs for the first time at our University in 2011/12, taking over from 8 successful cohorts of the NHS funded BSc Audiology programme.

Audiologists register with the Registration Council for Clinical Physiologists (RCCP). (Audiologists are in the process of moving to more formal state registration, as has already happened with clinical scientists and hearing aid dispensers.)

Once upon a time, 'audiologists' were known as audiology technicians, or medical technical officers (MTOs). You may still hear reference to grades called MTO1 (the newly qualified audiology technician) through to MTO5 (senior chief audiology technician). As the BSc Audiology has only been in existence since 2002, many audiologists (including the author of this) had the 'old style' training, which involved training on the job, a BTEC qualification and a set of professional exams ('BAAT exams', where BAAT stood for British Association of Audiology Technicians and later British Association of AudiologisTs).

'Audiologists' are higher up the professional ladder than associate audiologists. More precisely, they have a higher level of competency and therefore greater responsibility, and so command a higher salary.

*Yes, we know that having a name for a type of audiologist that is the same as the general name is a trifle confusing. History and politics!

Hearing therapist

This is a historical title that is used by a group of audiology-related professionals who trained in the pre-British Academy of Audiology days when hearing therapists, audiology technicians and audiological scientists had separate professional bodies and training routes. There is no longer specific training route for hearing therapists and the title might become obsolete in the passage of time. However, the role of the hearing therapist is more important than ever, and audiologists are able to develop the specialised counselling and rehabilitation skills of a hearing therapist.

Clinical Scientist (audiology)

Clinical Scientist is the protected name for audiologists who have a Master's degree and a specific clinical training at a higher level than graduates from the BSc. As with hearing aid dispensers, Clinical Scientists are registered with the Health Professions Council. Clinical Scientists were once called audiological scientists and some still prefer to use this title.

There are two primary paths to registration as a Clinical Scientist:

  1. Graduates from a science/engineering degree (including but not necessarily audiology) can apply for the government's new three-year training programme, called the Scientist Training Programme ('STP'). The first intake to this programme was October 2011. It consists of integrated academic and clinical training; the former consists of a Master's degree at an accredited university. Note that our MSc Audiology course is separate from the STP; the University of Southampton is not currently involved with the STP programme.
  2. Graduates from a science/engineering degree or qualified audiologists complete one of the BAA-accredited Master's programmes, such as our MSc Audiology, or by building up a portfolio of BAA-accredited Master's level modules, such as our M-level modules. This provides the bulk of the academic component of the training. This programme can be taken full-time or part-time and we are currently developing distance-learning options. After completing this, clinical training must be found - this is separately from the Master's programme and is not usually organised by universities. You would then work through the Higher Training Scheme (HTS) which provides the structure and assessment required to enable you to register.

The career ladder

Despite the different names for audiologists, there is considerable overlap in their day-to-day duties. Some departments are run by 'audiologists' and the staff include clinical scientists. In principle, competency and training largely determines duties rather than the type of audiologist per se. Things also depend on the specific job description, the values of the particular employer and the job market.

Currently, NHS audiologists of all types are employed on a career ladder consisting of 'bands'. Within each band, there are a series of levels, relating to experience, expertise and training.

Newly qualified audiologists from the BSc are typically employed on Band 5. Newly registered Clinical Scientists are typically employed on Band 7. Consultant Clinical Scientists are using emplyed in high levels of Band 8, or perhaps in Band 9.

A Bachelor's degree in Audiology is usually required for you to access Band 5. A Master's degree is usually required for you to access Band 7. A doctorate (such as the DClinP or PhD at Southampton) is becoming incresingly important in accessing higher levels of Band 8 and beyond.

There are various routes to accessing Band 7 and beyond. One is to work towards registration as a Clinical Scientist, through the Higher Training Scheme. The quickest way to obtain the academic training is to take the MSc Audiology full-time, although other options are available. Another route is to take an alternative Master's degree, such as the Master of Research (MRes) in Clinical Research at Southampton. This is particularly relevant if you aspire to a primarily clinicial research role. Another is to jump straight into a doctoral level training programme, such as the Doctorate in Clinical Practice or a PhD at Southampton.

Pre-registration training in the NHS

Let's recap. 'Audiologists' register with RCCP and Clinical Scientists register with HPC. Here are the standard pre-registration entry routes:

  • 'Audiologists'
    • BSc (Hons) Audiology: 4-years at an approvied University. No longer available and there is a national transition to...
    • BSc (Hons) Healthcare Science (Audiology): 3 years at an approvied University (from October 2011). This includes academic training (years 1, 2 and second half of year 3) and at least one clinical placement. Graduates are typically employed within Band 5. Students pay tuition fees for the normal three years but no additional fees for the clinical placements.
  • Clinical scientists

If we can be of further help in explaining how audiology, and pre-registration training, works in the UK, please do not hesitate to contact us.

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