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Career structure and pre-registration training in the UK

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Education, research and clinical practice in audiology in the UK have experienced some fundamental, exciting and challenging changes over the past few years, and continue to develop. On this page, we aim to provide a summary of pre-registration training and the structure of the profession.

Audiology nationally is currently in a period of transition. One important development is Modernising Scientific Careers, a government initiative to enhance the training of professionals within healthcare science disciplines, including audiology. A second development is Any Qualified Provider, a government policy whereby most adult hearing-aid-related audiology services are put out to tender giving the opportunity for independent companies to become NHS service providers. As with any changes, these have presented both challenges and opportunities. We at Southampton are forward looking and will be doing our very best to equip our students to be able to take advantage of the opportunities.

Structure of audiology in the UK

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

The latter three ‘types' are names that can only be used by people who are registered with certain bodies, and each type is dependent on having specific qualifications. (The details of this, below, may seem a bit confusing.) The particular type also affects what work the individual is allowed to do (‘scope of practice'). Importantly, it is possible to be registered as more than one type and there is much overlap in the work of the three types. 

We are working towards all students of our BSc Healthcare Science (Audiology) programme being able to register as both Hearing Aid Dispenser and Audiologist soon after graduating. We are working on similar arrangements for UK students of our MSc Audiology (with Clinical Placement) - more information to follow on this. See below for more information on opportunities for graduates of the MSc Audiology in terms of pre-registration training.

Assistant and associate audiologists

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

Hearing Aid Dispensers (HADs)

Hearing aid dispenser (HAD) is a protected title and HADs are registered with the Health & Care Professions Council (HCPC; formerly known as Health Professions Council, HPC). The professional body that looks after HADs is called the British Society of Hearing Aid Audiologists (BSHAA).

Traditionally, HADs were known only for providing private hearing-aid-related services on the high street and directly to the home, being self-employed or working as part of a larger business. Only with this specific registration can one sell hearing aids, and many Audiologists and Clinical Scientists are also HADs. It is important to recognise that HADs don't just sell hearing aids: they provide a wide variety of technology, support and rehabilitation to hearing-impaired adults, and this can be indistinguishable from, and more extensive than, services available on the NHS.

Traditionally, people registered only as HADs tended not to be employed in NHS audiology departments, largely because of limits in their scope of practice.

These traditions are changing with ‘Any Qualified Provider' as independent companies acquire tenders to provide certain NHS adult hearing-aid-related services, which fit within the scope of practice of HADs. HADs will be alongside the traditional role of providing services privately.

The minimum academic requirement for new HADs is an accredited foundation degree. BSc and MSc programmes can also be approved and we are seeking approval for both our BSc and MSc programmes. This will provide graduates with greater flexibility for career development. 

Audiologist

Audiologists* register with the Registration Council for Clinical Physiologists (RCCP). This registration is currently voluntary although it is in the public interest to be registered. The RCCP is lobbying the government for this to be enhanced to state registration as with Hearing Aid Dispensers and Clinical Scientists. The professional body that looks after Audiologists is the British Academy of Audiology (BAA).

The requirement for registration as an Audiologist is an approved BSc in audiology. As with other universities currently running the three-year BSc Healthcare Science (Audiology) programme, ours has been approved by the government Department of Health (whose initiative led to these programmes) and accreditation by RCCP is pending. There is also an avenue for students from an appropriate (soon accredited) MSc Audiology to register with RCCP as Audiologists, following further clinical training. We are currently working on exploiting this opportunity for UK students on the MSc Audiology. 

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 audiology degrees have 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, a larger scope of practice, 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

Historically, this is a title that was used by audiology-related professionals who had separate training from other types of audiologist and particular counselling and rehabilitation skills, although many were also registered as other types too. While this particular training route no longer exists, the title hearing therapist continues to be used, for example by people who are already Audiologists, Hearing Aid Dispensers or Clinical Scientists and undertake additional training in that area. Consider it a short-hand for an audiologists with particular expertise in the psychological aspects of rehabilitation (including various forms of counselling). The professional body that looks after Audiologists is the British Academy of Audiology (BAA). 

Clinical Scientist (Audiology)

Clinical Scientist (CS) is a protected name and CSs are registered with the Health & Care Professions Council (HCPC; formerly known as Health Professions Council, HPC). Clinical Scientists were once called audiological scientists and some still prefer to use this title. The professional body that looks after Audiologists is the British Academy of Audiology (BAA).

Clinical Scientists are required to have a Master's degree and a specific clinical training at a higher level than is required for registration as an Audiologist. There are three paths to registration as a Clinical Scientist: 

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 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 etc. 

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 usually employed in high levels of Band 8 or perhaps in Band 9. 

An 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; note that registration as a Clinical Scientists is not in itself essential to access Band 7 or higher although it is a practical advantage in most cases. A doctorate (such as the DClinP or PhD at Southampton) is becoming increasingly important for 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. Another route is to take an alternative Master's degree, such as the Master of Research (MRes) in Clinical Research here at the University of Southampton. This is particularly relevant if you aspire to a primarily clinical research role. Another is to jump straight into a doctoral training programme, such as the Doctorate in Clinical Practice (a professional doctorate) or a PhD here at the University of Southampton.

Summary of pre-registration training in the UK

Let's recap. Hearing Aid Dispensers and Clinical Scientists register with the Health & Care Professions Council (HCPC), and Audiologists register with Registration Council for Clinical Physiologists (RCCP). Here are the standard pre-registration entry routes:

Hearing Aid Dispenser (HAD): accredited foundation degree, BSc or MSc including or plus appropriate clinical training.

Audiologist: accredited BSc or MSc; clinical training is an integral part of the former and is required in addition to the latter.

Clinical Scientist, one of the following three options:

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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