Job Performance and Worker Health Implications of Unpaid Health Care Field Training: The Case of the Final-Year...

In the United States, final-year externs in clinical audiology play an important role in clinical practices, yet many are unpaid for their work. This article evaluates cross-discipline research to place the high prevalence of unpaid externships in a larger trend toward precarious work arrangements that shift risk from employers to workers. Concerns about the cost of paying externs are understandable, and this article discusses how the benefits outweigh the challenges. Audiology program directors and precepting audiologists have a responsibility to challenge this status quo that undervalues audiology externs and advocate for paid externships. Compelling reasons to compensate externs include attracting higher quality trainees, reducing medical errors, improving extern learning outcomes and health, and addressing the shortage of audiologists to meet rising demands for audiologic services. Establishing paid externships as the expected standard will require changes at both the organizational and individual practice levels. Precepting audiologists are ideally positioned to model equitable labor practices and invest in the future of the profession.

This article argues that fair monetary compensation for the work that externs perform is essential for the well-being of trainees and for the quality of the clinical services they provide. By fairly compensating externs for their important work, audiologists can create a fairer, more equitable pipeline of diverse audiologists to meet rising hearing health care needs. It is time to recognize the value of audiology externs' work and commit to providing them the compensation they deserve.