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Career Profile: Audiologist

Career Profile: Audiologist

Carmen C. Brewer, Ph.D., Audiologist, Chief, Audiology, Hearing Section, Neuro-Otology Branch, Division of Intramural Research, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH)

National Institutes of Health: Office of Science Education

I chose this career because…

I chose to become an audiologist because I was intrigued by the combination of science and working with people and helping them. As an undergraduate, I majored in speech pathology. During my junior year, I had the opportunity to take my first audiology course. That is when it all clicked. The professor was inspiring, enthusiastic, and dedicated to teaching. The field of audiology seemed so interesting, especially the diagnosis part. I liked the whole process of obtaining measures of various aspects of audition, deciding which test to conduct next, determining probable cause of the hearing loss and putting it all together to achieve a complete picture of a patient’s hearing status.

Education, Certification and Licensing
• Bachelor of Arts, Speech Pathology, Douglass College, Rutgers University, New Jersey
• Master of Arts, Audiology and Hearing Science, University of Maryland, Maryland
• Doctor of Philosophy, Audiology and Hearing Science, University of Maryland, Maryland
• Certificate of Clinical Competence in Audiology, American Speech-Language-Hearing Association License, Audiology, Maryland

Career Path

While working on my Ph.D., at the University of Maryland, I also worked as a clinical fellow at the Hearing and Speech Center at Washington Hospital Center in Washington D.C. Initially, this was to fulfill the requirement for one year of supervised clinical practice to obtain my certificate of clinical competence in audiology from ASHA. After a year of working and earning a salary, I decided to continue working and complete my education simultaneously. I began at WHC in 1974 and continued there until 2002. My career path is summarized below:

• 1998-2002 Director, Hearing and Speech, Surgical Subspecialties, and Anesthesia
• 1995-1998 Director, Hearing and Speech, Oral Surgery and Otolaryngology
• 1994-1995 Director, Hearing and Speech
• 1982-1994 Assistant Director, Hearing and Speech Center
• 1979-1982 Chief Audiologist
• 1975-1979 Clinical Audiologist
• 1974-1975 Clinical Audiologist/Fellow

My typical workday involves…

My typical workday varies depending on the clinical, research, and administrative tasks I need to complete.

In the Clinic: A Collaborative Environment

I interact on a daily basis with another staff audiologist to review the clinical schedule, consult on patients, test young children, plan audiology procedures specific to various studies, and discuss new, interesting and/or challenging cases or techniques. We are very collaborative. I also interact with the otolaryngologists on a daily basis, discussing cases and topics of mutual interest, and questioning patient findings/symptoms/treatments.

On Mondays, Tuesdays, and Wednesdays I see patients. Some are subjects in studies conducted by NIDCD, others are involved in studies conducted by other NIH institutes. Still others come in for auditory testing because they have a hearing complaint.

A basic hearing test takes place in a sound isolated booth and may include the following:

• Auditory test – a basic test to determine how well a person hears and understands speech. For example, they will be asked to listen to and repeat back simple words. They may be asked to listen and respond to very faint tones. We may also measure the ability to hear complex sounds. For example, testing a person’s ability to distinguish and identify two different words uttered simultaneously in different ears.
• Ear drum mobility – a test to measure the functioning of the middle ear and how well sound in conducted into the ear.

On Thursdays and Fridays I spend time:

• Preparing research procedures
• Reviewing and analyzing data
• Researching topics of interests
• Conducting administrative duties

Clinical Research

I am currently involved in several collaborative research projects that focus on:

• Acoustic Reflectance – a new measure of the characteristics of the middle ear transmission. We are reviewing how it can contribute to our understand of various hearing states.
• Acoustic Emission – measures the sounds the inner ear makes while it works to transform mechanical activity to neural or electrically activity. This information tells us if we have normal hearing functioning, and identifies subtle differences in peoples hearing. This test is used nationwide to screen newborns.

Equipment I Use:

• Audiometer – An instrument for measuring individual hearing acuity
• Impedance Audiometer – An instrument that measures middle ear functionality
• Reflectance Measurement System (RMS) – Equipment to measure inner ear functionality such as otoacoustic emissions, and vestibular (vestibule) function
• Sound isolated booth – A small room with limited sound penetration and outside noise reduction used for sensitive auditory testing.

What I like best/least about my work…

What I like best about my work is the combination of interacting with patients, and the science of searching for a diagnosis. There is a great satisfaction in coming up with a diagnosis and offering a solution to help with a patient’s hearing. This is true whether it be as simple as giving them an understanding of their hearing loss, or guiding them through the amplification options.

I love learning about the auditory system and how it functions (or dysfunctions). I like people. I like to solve puzzles. I‘m persistent, and I’m a stickler for details. All those attributes contribute to doing well in audiology.

What I like least about my work is patient report writing and poor scheduling of patients. The hardest part of my job is keeping up with it all and learning to say “no.” There are many opportunities to participate in a variety of research projects here at NIH. Just because a topic is interesting, does not mean I should do it. Yet I love being busy and don’t like to miss deadlines.

My career goals are…

I would like to expand the audiology department here at NIH by bringing in more students, both for clinical rotations and for joint research efforts. In the coming years, I would like to:

• Develop several new research projects specific to auditory function as it related to genetic diagnosis
• Expand my role in several professional societies ( I plan to run for the Board of Directors of the American Academy of Audiology in 2005)
• Prepare and present 2-3 posters per year, and achieve 1-2 publications in professional journals per year
• Successfully complete additional courses in genetics

I really like what I am doing now at NIH. As in any health related field, my work will change as new techniques for detection, diagnosis and management of hearing loss are developed. And of course in the coming years, my work will likely be computer-based as it will for many fields.

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