gms | German Medical Science

To date, there is no protected professional title for academically trained specialists working in the field of audiology in Germany. In general, it is not clear who is even allowed to call themselves an “audiologist” in Germany [1]. Nevertheless, there is currently a high demand for this specialized professional, as can be seen from the job advertisements published on the homepage of our German Audiological Society or in the Journal Zeitschrift für Audiologie [2].

The reason for this increased demand appears to be the efforts of the German Society for Ear, Nose and Throat Medicine (DGHNO) to introduce a certificate for cochlear implant centers (CIVE) [3]. The certification concept developed with the support of the German Society for Phoniatrics and Pedaudiology and the German Society for Audiology (DGA) is based on the AWMF S2k Guideline Cochlear Implant Care [4], in which the minimum staffing requirements of the facility were defined for the first time in addition to the description of the CI treatment process. The guideline defined the term “CI-specialized audiologist”, who should be qualified as a graduate of a technical and scientific master's degree program with additional training in the field of audiology. Examples given in the guideline include medical physicists specializing in audiology or graduates of a master's degree program with a focus on audiology. The guideline also describes that the additional qualification for the employment of the specialized audiologist in handling CI systems should be based on the advanced education guidelines for a “CI audiologist” certificate of the DGA [5].

In addition to the minimum personnel requirement of having an audiology expert with a Master’s level qualification in the CIVE, the role of a “hearing technician” was also specified. This employee should have a qualification in the field of technical hearing aids. For this purpose, a technical professional qualification, e.g., a bachelor’s degree in audiology and hearing technology/hearing aid technology or a “Meister” craftsman in hearing aid acoustics with further training in the CI field was envisaged – with the creation of the qualification profile for an Audiological CI Assistant (ACiA), the DGA is pointing the way forward for this [6].

However, the new version of the CI provision guideline presented in 2020 with an extended personnel description does not automatically imply that the requirements for the personnel structure mentioned there necessarily have to be implemented. This is due to the fact that guidelines are solely systematically developed recommendations for physicians and patients to assist them in making decisions about the appropriate treatment of a disease. They are not legally mandatory.

With the presentation of the White Paper “Cochlear Implant (CI) Care”, the recommendations outlined in the CI provision guideline on the structure, organization, equipment, qualification, and quality assurance of CI provision in Germany were further specified and the assignment of tasks within the interdisciplinary CIVE team was precisely outlined [7]. On the basis of this White Paper and with the support of a professional certification institute, the certification of clinical facilities that considered themselves to meet the requirements of the White Paper on CI care was finally launched.

In the meantime, more than 50 facilities have received the CIVE certificate, and several more applications are currently being processed. This is not only a major success for the quality management of CI provision, but also for the establishment of a professional field for audiologists with academic training and additional qualifications for the clinical-audiological workplace.

It is also becoming apparent that funding authorities are taking note of the requirements of the White Paper and expect CIVE certification for the reimbursement of CI treatment – as has already been the case in the federal state of North Rhine-Westphalia. However, this requirement was postponed for a year – there were concerns that the existing certified clinics would be overburdened with the follow-up care of CI patients.

Awareness of the importance of the role of clinically working audiologists therefore appears to have increased significantly compared to the past. However, their role extends far beyond fitting CI systems. They are also counselors in prevention, education and rehabilitation. Professional societies and the public need to understand that healthy hearing is just as important as any other facet of our health.

The training of clinical audiologists is a complex task that requires time and commitment. To address this shortage, we need to act collaboratively. Educational and healthcare institutions must work together to train more professionals in this field. Establishing and promoting degree programs in audiology and creating incentives for prospective audiologists are crucial steps to close the gap. Finally, a protected professional title should also be developed in Germany. Ultimately, the profession of audiologist deserves this protection no less than that of speech therapists, podiatrists or medical technologists – which are listed here as just a few examples of protected professional titles [8].

Finding clinically trained audiologists may be a challenge, but it is one that we can overcome together. Our hearing health should not be taken for granted, and those who choose this profession deserve our support and recognition. Let’s work together to ensure that everyone can experience the joy of hearing - a gift that enriches our lives in many ways.

With this in mind, we hope for a future in which audiologists are not only wanted, but also valued and supported.

Uwe Baumann, Frankfurt am Main