A Toxic Debt-to-Income Ratio

The fact that many students are now taking on upward of $100,000 in student loan debt to earn their doctoral degree in audiology (AuD) is no secret (Thompson, 2016). I, unfortunately, know this reality all too well, as I graduated in August 2017 with just shy of $250,000 in student loan debt—$180,000 of which was solely from my AuD. Based upon the amount of my accumulated student loan debt and the present interest rates associated with my loans, my monthly loan payments are projected to be between $1,300 and $1,500 per month, which, if I may point out, is equal to a mortgage on a relatively sizeable home.

Truth be told, the financial burden of maintaining such an exorbitant amount of debt would seem far less daunting if the student return on investment (i.e., starting salary) were commensurate with the actual cost of the degree earned; this, sadly, is not currently the case with the AuD.

Let’s Talk Numbers

According to the U.S. Bureau of Labor Statistics, the mean annual wage for an audiologist was estimated to be $79,290 in 2016, regardless of an individual’s experience in the field (U.S. Bureau of Labor Statistics, 2016); however, as disclosed in a similar study published by the American Academy of Audiology (the Academy), which conveniently accounts for total compensation across several demographic and institutional variables (e.g., years of experience, primary work setting, geographic region, etc.), the mean annual wage for an audiologist with an AuD and one to three years of experience was only estimated to be $69,845 in 2016 (Compensation and Benefits Report, 2016).

I was shocked that in my own job search, I did not see salaries near these reported means. I did not receive a single offer, before or after negotiations, at or above the estimated salary proposed by the Academy report, even at highly reputable institutions. What’s more disappointing is that I know of students who were offered (and accepted) starting salaries as low as $48,000. Personally, I find these low salaries not only staggering, but insulting.

A Striking Realization Triggers a Necessary Call to Action

Thankfully, amidst my own negotiations for job offers, I was given insight into the hiring process, which I had not previously considered. In fact, this advice served as the very catalyst for this article. That insight was as follows,

Starting salaries, especially for newly-graduated audiologists are low because students do not negotiate; in fact, you are the first student, at least in my tenure here at the hospital, to ever negotiate salary.

This window into the hiring process left me speechless; to be frank, I simply could not believe the words that were just spoken to me. Upon doing some research of my own following this revelation, I soon came to realize that this discouraging “trend” was not unique to audiology, but occurred across several disciplines.

According to a survey of nearly 8,000 college grads by NerdWallet, a personal finance website, and Looksharp, a job site targeting new graduates, only 38 percent of new college graduates who started working in the past three years negotiated their job offers (Marte, 2015). This caused a stark realization: we have no one to blame but ourselves.

A lack of negotiation of salary constitutes a key reason we cannot earn salaries that are more commensurate with the degree we will eventually or currently hold. Without striving to negotiate higher pay, we perpetuate these low wages not only for ourselves, but for new audiologists and those professionals who will come after us. These professionals who will become our colleagues are also hampered by our unwillingness to undertake courageous discussions and demand salaries that reflect our education and expertise. This realization, which puts so much weight on the current generation of newly-graduated audiologists, also empowers these individuals to initiate the much-needed change.

I Got a Job Offer! Now What?

According to John Lees, a UK-based career strategist and author of The Success Code, “When an employer extends a job offer to you, he has, in essence ‘fallen in love’ with you…and psychologically committed to you” (Knight, 2017). Rejoice in the moments following your initial (and subsequent) job offer, as you have overcome one of—if not the—most difficult hurdle in the employment search process—getting the job.

Not only is it validating to be considered the most qualified candidate for a position, but it also greatly eases the underlying anxiety and fear of unemployment many new graduates face post-graduation. Lees goes on to say, “[Because you received the offer and the employer has determined that they want YOU]…you have more ‘leverage’ to shape your job description and improve your salary and benefits package” (Knight, 2017).

Now, however, comes the tough decision—deciding whether or not to accept the position. As you consider this decision, Jeff Weiss, president of Lesley University and author of the Harvard Business Review’s Guide to Negotiating, advises you to “think about the offer in terms of your development, your quality of life, the variety of work you do, and finally, the trade-offs you are willing to make” (Knight, 2017).

In addition to Weiss’ wisdom, I have included some helpful tips below to consider specific to negotiating salary and associated perks/benefits, particularly if you cannot reach your ideal salary. The tips offered below are certainly not “fool-proof,” as there are exceptions to every rule; however, I do hope they provide insight and perspective for new graduates to consider as they begin applying for and considering offers moving forward.

Helpful Tips to Consider When Negotiating

Know and Be Able to Articulate Your Value 

As Lees mentioned, once you receive an offer from an employer, you have been “chosen” as the individual who they feel is best-suited for the job. In essence, the employer saw something unique and is invested in you over all other candidates interviewed for the position; use this to your advantage. You are in an exceptional position as this employer has already begun to invest in you. Ensure that investment can be valuable to you both by negotiating a sustainable salary that will encourage you to stay with this employer.

Talk about what you have done, and more importantly, what you can do for the employer based upon the experience you’ve gained throughout the course of your graduate program, specifically in your internship and externship experiences. Most clinical facilities have future goals for projects/programs that will help to improve current protocols and patient flow through the clinic and/or provide some aspect of patient care that is not currently available. After asking about or looking into some of the employer’s goals, consider how you—from the experience you have gained—can help to contribute to or even lead some of these opportunities for future growth.

Note that this requires you to know your prospective employer well. Think forward toward this step in negotiations in earlier phases, such as the interview, to begin gathering these valuable insights. Not only will this make sure that you are well-prepared to negotiate a competitive and appropriate salary, it will also help you to become more intimately familiar with the organization to which you’re applying. For example, perhaps the site is looking to expand upon or develop a new specialty program due to an identified need for services that are not currently available. Conveniently, you had exposure to said specialty during your externship and, based upon that experience, could offer valuable insight into better ensuring the program’s success moving forward.

Showing interest in current and future initiatives and attempting to offer possible solutions not only demonstrates your initiative, value, and skills in problem-solving, but it also shows your willingness to collaborate with others which is inevitable and essential in thriving clinical settings, as you have likely seen during your clinical placements.

Research Salaries

In addition to using the salary information available on the U.S. Bureau of Labor Statistics and provided in the Academy Compensation and Benefits Report, also consider browsing sites like Payscale.com, Glassdoor.com, or Salary.com. As you’re researching, be mindful of the fact that salaries often vary by state (some more dramatically than others) due to costs of living, supply/demand for jobs, etc.

I recommend either saving or printing out the salary data collected, as you may be asked to present your findings during negotiations. Also, consider reaching out to and utilizing your professional networks (e.g., other students, newly-graduated professionals, seasoned professionals, faculty, friends, colleagues, acquaintances, etc.), as these individuals may be willing to offer valuable insight based upon their own experiences, particularly if they happen to be employed in a setting similar to that which you aspire to work.

Be courteous and respectful in your approach to discussions regarding salary, as some may consider this topic to be somewhat confidential. For example, instead of directly asking an individual to reveal his/her personal salary, you might ask, “What would you consider a reasonable salary for a newly graduated audiologist at (insert specific site and/or setting here)?”

Lastly, ask for a salary towards the top of the projected range based upon your experience, job setting, etc., as the employer will most certainly counter down from that value, and, if possible, ask for a very specific number. According to researchers at Columbia Business School, “when employees use a more precise number in their initial negotiation request, they are more likely to get a final offer closer to that which they initially wanted” (Muse, 2014).

It’s Not Just About the Money

Rejection is something we all struggle to accept, as it toys with our internal confidence and self-validation, all of which have been influenced by the fact that society has “trained” us to believe that the word “no” is finite. Instead, consider the word “no” to be a catalyst through which conversation can ensue, as a true negotiation does not commence until there is actually something to negotiate.

That being said, understand that most salary negotiations will involve a tennis match of counter offers between you and the employer as you work collaboratively to settle on a number that satisfies you, and is also feasible for the employer. It is important to recognize that some employers have more flexibility in negotiating salary than others. For example, private practice settings generally have more flexibility because there are less “channels” through which the negotiations have to pass through before an alternative offer can be made and/or finalized.

By contrast, large institutions, namely, major medical centers, universities, etc., typically have less room for salary negotiations due to salary “ceilings” established by executive administration and/or internal equity within the department, which is a departmental policy that essentially ensures fair pay based upon professional experience, tenure within the establishment, and contributions between employees within the same department/organization. For this reason, if you cannot attain the desired salary you initially had in mind, there are many other aspects (i.e., perks) of the position that you can negotiate to help increase the overall value of the offer being made, many of which most employers tend to exhibit more flexibility with.

With this in mind, consider inquiring about obtaining moving expenses should the position be out of the state in which you currently reside, extra vacation time/additional time-off, the option to work remotely, a sign-on bonus, preference of schedule and/or flexibility in the types of appointments added to your schedule, a different title, and/or in some cases, alternative health benefits packages.

Finally, it is equally important at the beginning of negotiations that you also consider what you are willing to walk away from, as there may be other opportunities that will be better able to accommodate your needs professionally and financially. Trust that everything that is meant to happen, will, as difficult as that may be to believe at times: with diligence, it all works out in the end.

May the Force of Negotiations Be with You

In closing, I hope you find the information provided throughout the course of this article to be insightful as you go forth and become the audiologists of the future. I also hope that it helps to instill within you a courage to hold bold conversations moving forward, particularly when they have potential to impact the future of our profession and how we, as audiologists, are viewed and respected as independent, doctoring-level professionals.

If we want to truly be seen as the primary providers of hearing and balance health care, we need to start taking ownership of our profession and helping both other professionals and the public understand the scope of our practice, the services we provide, and how those services help to positively increase patient quality of life.

Personally, I think this begins with a pointed petition to be respected and compensated for the education we earned, as we are truly, based upon the highly-specialized training we received, the expert authority of the ear. As the next generation of audiologists, the horizon is truly ours to shape as we see fit. So, I say we start thinking about what audiology could be, instead of what it presently is. Then, and only then, will our “ideal” audiology become a reality.


American Academy of Audiology: 2016 Compensation and Benefits Report(Rep.). (2016) Sector Intelligence.

Bear LB, Molinsky A, Heifetz J, Clark D. (2017) 10 Myths About Negotiating Your First Salary. Retrieved from https://hbr.org/2017/07/10-myths-about-negotiating-your-first-salary (accessed on July 13, 2017).

Editor TD. (2014) How to Negotiate Salary: 37 Tips You Need to Know. Retrieved from www.themuse.com/advice/how-to-negotiate-salary-37-tips-you-need-to-know (accessed July 13, 2017).

Knight R. (2017) How to Evaluate, Accept, Reject, or Negotiate a Job Offer. Retrieved from https://hbr.org/2017/04/how-to-evaluate-accept-reject-or-negotiate-a-job-offer (accessed July 13, 2017).

Marte J. (2015) Always negotiate pay—even on your first job out of college. Retrieved from www.washingtonpost.com/news/get-there/wp/2015/05/06/always-negotiate-pay-even-on-your-first-job-out-of-college/?utm_term=.f4359e9f0346 (accessed July 13, 2017).

Muse (2014). Editor, The Daily Muse. "How to Negotiate Salary: 37 Tips You Need to Know." Free Career Advice. August 27. Retrieved from www.themuse.com/advice/how-to-negotiate-salary-37-tips-you-need-to-know (accessed July 15, 2017)

Thompson G. (2016) The AuD Student Loan Quagmire. Audiol Today 28(5):46–51. 

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