My fourth year has definitely been an interesting ride thus far. Interesting good or interesting bad...that's debatable. I will admit it's been good to be at clinic full time unlike as a second-year student where clinic was once a week and as a third-year student where clinic was 2-3 days a week. The site that I'm at is a hospital setting where the audiology clinic sees about 50% adult patients and 50% pediatric patients. That's an excellent ratio to break things up and also to retain skills in testing children.
The mission of the hospital is to provide access to the highest quality health care regardless of ability to pay. A fact sheet for this hospital states that it cares for "the special health needs of the entire population with services ranging from trauma care to the [omitted] Poison and Drug Center, and the needs of special populations such as the poor, uninsured, mentally ill, pregnant teens, persons addicted to alcohol and other substances, victims of violence, the homeless and those with AIDS". The audiology clinic also treats prison inmates; they come cuffed and with at least one guard. Yup, it's a challenging patient population at this site. Very different from what I've encountered in private practice settings. I consider this to be both good and bad for reasons I won't get into.
There are 3 full-time audiologists and 2 fourth-year student doctors of audiology. The audiology students see the majority of the patients so clinical experience can be gained, and the full-time audiologists serve in a supervisory role. The audiology clinic sees their own patients and also Ear Nose Throat (ENT) patients. The patients range in age from newborn to 100 years old. Services provided by the audiology clinic include case history, otoscopic evaluation, audiometry (air conduction, bone conduction, speech), tympanometry, acoustic reflexes & acoustic reflex decay, otoacoustic emissions (OAE), unsedated auditory brainstem response (ABR), videonystagmography (VNG), and amplification (consult, fitting, and follow-up on hearing aids & assistive listening devices). Two of the full-time audiologists on occasion provide intraoperative neuromonitoring (aka monitoring the functional integrity of certain neural structures during surgery). About three years ago when I first learned about intraoperative neuromonitoring, I assumed audiologists only monitored the VIIth & VIIIth cranial nerves (facial & vestibulocochlear nerves respectively) during surgery. But it can be more than just that. For instance, I had the opportunity to sit in on two thyroidectomies -- one surgery was done by an ENT physician and the other was done by a general surgeon. Nothing like seeing a grapefruit-sized tumor being extracted from someone's neck after lunch.
Below is a picture of me before the 2nd surgery of the day; decked out in green scrubs minus surgical cap (nice bouffant kind ;-P), surgical mask, shoe covers, and gloves.
This is the last quarter where I am taking a class. I'm glad for that, because I'm about burnt out on academics. I can't complain - - 1 class with 5 days of clinic is better than juggling 3 classes with 3 days of clinic like I first had to when moving to this state last spring.
I'm "Hear 4 U Always"...and getting closer to being a full-fledged Doctor of Audiology. It'll be nice to start earning a paycheck for all the work. All right -- gotta prep for Monday's class session and also prep for a Grand Rounds presentation I'm giving at clinic this week (the clinic I'm at video-conferences monthly with another hospital/audiology clinic). Work is never done...c'est la vie. Work hard and play hard, readers. Oh yeah, I should take my own advice. ;-P
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