Ever thought of working abroad? In this issue we hear from Caroline Hudson, International Audiologist with special interest in paediatrics and research, who took the leap to work in Canada after qualifying and working in the UK. She will provide some advice and information about the steps to consider if working abroad is on your bucket list.
You are a well-practised, experienced, and qualified audiologist in your own country; so, popping over to another country and getting a job in your field of expertise is easy right? After all, many healthcare workers do it, so why can’t you? The answer is you can, but you have to be prepared to put in the time, effort, and money to succeed.
The migration of healthcare workers is increasing in volume and growing in complexity  and audiologists are no different. However, globally there is considerable variation in entry-level educational training programmes and scope of practice for audiologists . Each country adopts different methods to assign and define roles and responsibilities, which are unique to their healthcare and education systems. Whilst this article won’t provide you with a fool-proof step-by-step guide for your country of interest, it will help to summarise considerations you may need to make and hoops you may need to jump through.
Understand your qualifications, background, and experience
A thorough understanding of your educational background and experience is the first step in preparing you to evaluate equivalency to an overseas programme. Due to international variations, the type and name of your qualification does not necessarily equate to the same level in other countries.
The better you understand your academic programme and have the evidence of it, the better prepared you will be to demonstrate equivalency to an international programme. Live and breathe your content, course and clinical practice hours.Still a student? Great! You are in the perfect position to gather all necessary documentation and to request additional course content or clinical practicum hours if needed to avoid coming up short.Already graduated? Not to worry, it can be done. Gather together detailed documentation on course content, topics, syllabi, clinical practicum, clinical placements, and as much information as you can get access to. Get in touch with your academic institution(s) to request the required documentation.
Clinical work experience and professional development
Critical evaluation of your own experience is vital in demonstrating your expertise, but also identifying areas for improvement that could be addressed before your application. Gather evidence of your roles and responsibilities through job descriptions, national and local scopes of practice. Credible and varied references are also important; think about who a good reference would be and make contact with them.
“Getting in touch with the professional and regulatory organisation is essential in ensuring you do not miss vital information relevant to your application”
Important to note: often, equivalency is measured against an entry-level practitioner. Specialisation in one area of audiology can be beneficial but also an application hindrance.
Decide where you want to go - the fun stuff and the legal stuff
Decide what you want from your move. Do you want a better (or different) work-life balance? Do you want to be close to the sea, the mountains? Do you want the big city life or are you looking for a break? Do you want to be near friends and/or relatives abroad? Consider your options for visas, work permits, sponsorship, and also salaries, taxes, cost of living, and relocation expenses. Are you eligible to work? What options are available? Are you in a financial position to move? Can you live on the expected salary? Government websites will be the main source of information for eligibility for visa requirements. Other general research should be able to help you determine working conditions, expected hours of work, entitlement to annual leave, health coverage, etc.
Mutual Recognition Agreement?
Unlike with other professions, it does not appear that a Mutual Recognition Agreement exists for audiology professionals. An agreement previously existed between the US and Canada, but it ceased to exist when the US increased its minimum education requirements to a doctoral degree in 2012 . However, some countries do recognise some international qualifications. For example, the New Zealand Audiological Society (NZAS) recognises qualifications from Australia, Canada and the United States , though there are still additional requirements for applicants from these countries.
Find the relevant professional organisations and do your research. The information is out there, you may just have to work hard to find it.
How does the country (or jurisdiction) define roles and responsibilities of audiology professionals? What professional organisations are there? Are you required to gain professional registration? With whom? Are you required to register nationally and locally? What job titles are used? Are titles legally ‘protected’? Do you have to be registered as both an audiologist and hearing instrument practitioner (for example)? Does registration depend on the type of practice you work in (public health or private)? Do you have to be registered at all? Is your qualification recognised?
“It is worth factoring in the availability of academic institution staff members; they are often unavailable between semesters”
Getting in touch with the professional and regulatory organisation is essential in ensuring you do not miss vital information relevant to your application. It can be easy to miss something you aren’t looking for.
Most regulators have pathways for international and overseas applicants. It is in your interest to fully review all requirements. Are you required to demonstrate your level of expertise, your equivalency to entry-level practitioners, or both? Do you need to have practised recently? Do you need to pass a language assessment? Do you need to have your qualifications assessed by a third party? Do you need to evidence your current registration? Do you need to provide references?
It is in your interest to demonstrate your equivalency to their requirements as clearly as possible. How can you do that? Well, that depends. Work your way through the application documents but be sure to ask the regulators if you can provide supplementary information and whether there is a desired format for it. Keep comprehensive notes about how you have come to any conclusions you have, and be sure to demonstrate this to the regulator in your supplementary information.
It could be useful to use information you have obtained from your academic institution, your work experience, your continuing professional development, and national scopes of practice, etc. Often, a significant breakdown of your course content and hours under pre-defined areas is required. It is likely your content was not designed in the same way as your destination country. It therefore may take some time to arrange in the desired format.
What happens if you don’t meet the requirements?
Don’t despair. There is always a way to make it happen if you want it enough. Are you able to provide more evidence? Can you provide supporting letters from past employers, personnel from your academic institution, etc? Is there an option for provisional membership/registration? Can you take more exams? Can you become an intern or take part in clinical supervision? Are there bridging programmes available to address any gaps in knowledge that are identified? Are there alternative pathways to follow? Do you need additional qualifications? Do you need to study in your country of interest? Can you register for an alternative position and job title? A hearing instrument dispenser or an audiometrist?
Timelines and fees
Often international applicants are viewed on a case-by-case basis. No one case or situation is the same. Do not underestimate the time it can take to pull all the information together into the application format, along with any supporting information. It could be months before the information is formatted clearly and succinctly. Regulators usually provide an estimated timeframe but consider allowing more time, just in case there are additional unexpected requirements you need to meet. It is worth factoring in the availability of academic institution staff members; they are often unavailable between semesters.
Costs will vary from one country to the next, but expect fees relating to application and assessments, examinations, membership acceptance, and annual registration in addition to immigration costs.
Finding a job that is right for you can be difficult enough in your home country, let alone a whole new part of the world. As with most job applications, use your resume and application to evidence that you meet the minimum requirements and more. Demonstrate that you are keen and willing to learn. Employers may or may not be aware that there are significant differences between countries, and some may require evidence of registration before they will consider an applicant. It is up to you to show your value.
Landed a job? What next?
Congratulations! Allow yourself some time to celebrate but be ready to really work. Do not underestimate the time it takes to learn how audiology works in this new part of the world. There is an endless list of practices and policies that are likely to work differently. These can include how services and hearing aids are funded; terminology and acronyms; appointment and follow-up care pathways; basic clinical practices (e.g. masking); and much more. Read the protocols and know them inside and out. Be engaged in supervisory requirements and use the time to learn as much as possible. Study for the exams; they are there to help you adjust and recall useful information.
The various hurdles, hoops, and obstacles may leave you feeling pretty deflated. It sounds like a lot of work, and it is. But I promise you, whatever route you have to take, whatever obstacles you have to overcome, it will be worth it. A network of audiology professionals interested in working abroad is building. If you are interested in becoming part of this community, please join the Facebook Page: Audiologist Abroad Support Group - https://m.facebook.com/groups/audiologistabroad.
1. World Health Organisation (WHO) (2017). Addressing the international migration of health workers.
Last accessed March 2022.
2. Goulios H, Patuzzi RB. Audiology education and practice from an international perspective, International Journal of Audiology 2008;47(10):647-64.
3. American Speech-Language-Hearing Association (ASHA) (2022) Mutual Recognition Agreement Frequently Asked Questions: General Information.
Last accessed March 2022.
4. New Zealand Audiological Society (NZAS) (2022) Audiologist Membership.
Last accessed March 2022.
Declaration of competing interests: The views and opinions expressed in the article are the author’s own and do not necessarily represent the views and opinions of their employer.