Every year, audiology graduate students from across the country come to the UNCG Speech and Hearing Center (SHC) for an immersive experience that serves as the final step between the classroom and professional practice. While the clinic provides essential speech, language, and hearing services to clients in three states, it also plays a vital role in training the next generation of audiologists.
Since 2006, the SHC has welcomed 31 externs from 18 universities, giving them the opportunity to work directly with clients, learn from experienced clinicians, and gain firsthand insight into the daily operations of a clinic. Many of these externs come from the top Doctor of Audiology (AuD) programs in the country.
“This is their final year [of school]. They are still students and are still learning. They’ve already had two to three years of clinical experience. The goal is to help them smooth out the rough edges so they can get jobs,” said Dr. Lisa Fox-Thomas, assistant director of the SHC and one of three preceptors who oversees the externs. “We also train them in clinical areas with which they may not have had much experience, which also can be helpful when they are job-seeking.”
Externship Program Grows as Audiology Students Find Placements
Externs are paid as temporary employees and work full-time for a year. The majority of that time is spent with patients in the clinic, while the remainder is devoted to clinic-related activities and education.
In 2005, UNCG’s Department of Communication Sciences and Disorders graduated its last students in the master’s of audiology program as the profession transitioned to a doctoral degree in audiology (AuD). The following year, the externship program was created.
“20 years ago, Dr. Celia Hooper was the department chair of CSD and had a good relationship with Vanderbilt University, which had an AuD student who needed a placement,” Fox-Thomas said. “We benefited by getting help in the clinic and could continue to train students, which is the mission of UNCG. Celia was forward-thinking by helping us continue to educate students in audiology.”
The externship program has expanded since then. Initially enrolling just one student at a time, it has grown to three preceptors and usually two externs a year. This summer, however, due to students’ overlapping schedules, there were four students in the clinic at once.
Fox-Thomas said the program prides itself on taking students from a wide variety of schools, ensuring a good match for the students and the SHC. Externs have come from The Ohio State University, Texas Tech University, University of North Carolina-Chapel Hill, Louisiana Tech University, Indiana University, Iowa University, University of Tennessee, and Pacific University, to name a few.
“We try to expand our network and take students from other schools. The students have been in school more recently than I’ve been, and are learning from faculty across the country,” Fox-Thomas said. “They are bringing knowledge with them. I’ll ask them, ‘What did you learn about this?’”
Once at the SHC, the externs learn everything they would typically do at a clinic. This includes seeing patients, doing rehab services, servicing equipment and hearing aids, working with diagnostic equipment, doing inventory, and calling manufacturers.
Each extern obtains a temporary North Carolina audiology license prior to beginning at the SHC, enabling them to work directly with clients. Clinic audiologists Fox-Thomas, Dr. Jennifer Burkey, and Dr. Amy Myers serve as preceptors, supervising the externs and providing continuity of care for clients.
Maintaining a North Carolina Connection
Forty-one percent of the externs who come to UNCG get jobs in the Triad or North Carolina afterward, including Dr. Sarah Stalnaker. She grew up in Charlotte and got her AuD from Northwestern University, doing her externship at UNCG in 2018. Although she initially took a job in Mooresville upon graduation, she soon returned to Cone Health in Greensboro to be one of its two full-time audiologists.
“I came to UNCG in the winter and toured the Speech and Hearing Center. I liked that it was small, and they treated me like I was still learning, and I wasn’t seen as an employee. They were willing to support and teach me,” Stalnaker said. “Being at UNCG, I had a lot of independence, which I appreciated, and there was a wide variety of patients. I also had some kids, which I am appreciating now because I mainly have pediatric clients. And the faculty had so much experience. Dr. Fox-Thomas and Dr. Myers were really great advocates for us and audiology.”
Stalnaker said when she applied for the position with Cone, the healthcare system contacted UNCG for a reference.
“Cone said that was a large part of why they hired me,” she said. “I appreciate how well UNCG set me up for my career.”
The SHC and Cone Health maintain a partnership, with Burkey planning to work at Cone Health Outpatient Audiology one day per week when Stalnaker is on maternity leave this fall.
“The Speech and Hearing Center has agreed to see patients who have auditory processing disorders while I’m out, so they don’t have to wait until January when I come back,” Stalnaker said. “We refer patients back and forth. We work together.”
Creating Career Paths
Trenton Barnett, an East Carolina University (ECU) doctoral student, began his externship at the SHC in May. He was interested in working with patients with tinnitus — people who hear ringing, buzzing, or humming in their ears — and his preceptors told him that UNCG specialized in it.
“This is my first placement seeing patients five days a week. I like that there’s a lot of teamwork and cooperation, which is what I was hoping for,” Barnett said.
He previously interned at ECU’s clinic and at a Veterans Affairs clinic. Barnett said he preferred his experience at ECU to the VA because it gave him more time with patients. He’s glad to have a similar experience at UNCG.
While at the SHC, Barnett worked with sound-sensitivity patients and cochlear implants, something he’s never done before.
“I’m glad I’ve been introduced to it, but it hasn’t changed my goal, which is to learn as much as I can from Dr. Fox-Thomas and provide as much care as she does for tinnitus patients,” he said. “I’m interested in working with them because it’s a population a lot of audiologists tend to shy away from. I want to be available for those patients. I don’t think they’re as easily seen. They require a lot of patience and listening, which is more my style. There’s not always a quick fix. I like following up with them.”
Dr. Kaitlin Fisher completed her year-long SHC externship in August while a student at Northwestern University. In mid-September, she was hired as an audiologist at the clinic.
Fisher describes it as the perfect match, saying UNCG was the only place she wanted to extern.
“I knew I wanted to be somewhere with tinnitus and sound-sensitivity patients. During my externship, I shadowed all preceptors equally, but I found that Dr. Fox-Thomas and I worked well together. I felt like we had the same brain sometimes.”
Students Find Freedom to PUsh Past Their Comfort Zones
Fisher said that, as an extern, she had the freedom to explore other treatments, learn about different hearing aid manufacturers, and complete educational training. She was also encouraged to try new things that were less familiar to her.
“I had never even touched a cochlear implant before here. It was great, but terrifying. I was definitely out of my comfort zone,” she said. “I loved the Speech and Hearing Center because I got to do everything I wanted to do. I wasn’t sure how much freedom I would have before I started. Others in my cohort didn’t have the same experience I did.”
Fisher said she asked Fox-Thomas in May if there would be any open positions at the SHC, and there weren’t. By August, however, that changed, and she applied.
“I have just fallen in love with my patients and the process. I didn’t want to lose them,” Fisher said. “It’s so rare that everyone you work with is who you want to be as a future clinician. We all respect each other and goof around and have so much fun.”
Fox-Thomas said Fisher fit in with the team perfectly and is the type of clinician they want serving patients.
“Kaitlin quickly embraced UNCG’s person-centered approach to patient care. She is a warm, outgoing person with a wonderful sense of humor who immediately puts patients at ease,” Fox-Thomas said. “Kaitlin also showed initiative, going above and beyond expectations to improve the daily operations of the clinic. She is dependable, often being the first to arrive in the morning, and is a true team player.”
Story by Sarah Newell, University Communications
Photography by Sean Norona and Sarah Newell, University Communications, and courtesy of Kaitlin Fisher and Dr. Lisa Fox-Thomas
