An audiologist holds a doctoral degree, but is not a medical doctor. Since 2007, the Doctor of Audiology (Au.D.) has been the required entry-level degree for clinical practice, making audiologists doctorally trained healthcare professionals who specialize in hearing and balance. They cannot prescribe medication or perform surgery.
What the Au.D. Degree Involves
Becoming an audiologist requires a four-year undergraduate degree followed by a three-year doctoral program. The graduate curriculum covers anatomy and physiology of the ear, hearing aid technology, pediatric assessment, balance disorders, cochlear implants, tinnitus management, and electrophysiology. The final year is typically spent in full-time clinical externships across multiple settings, working with patients of all ages who have hearing and balance problems.
After graduating, audiologists must pass a national exam (the Praxis) and can earn the Certificate of Clinical Competence in Audiology (CCC-A) from the American Speech-Language-Hearing Association. State licensure is also required. All told, most audiologists complete seven to eight years of higher education before practicing independently.
Why “Doctor” Gets Confusing
The Au.D. is a clinical doctorate, similar in structure to degrees held by pharmacists (Pharm.D.), physical therapists (DPT), and psychologists (Psy.D. or Ph.D.). These professionals earn the title “doctor” through their training but are distinct from physicians who hold an M.D. or D.O. Before 2007, audiologists entered the field with a master’s degree. The shift to a doctoral standard reflected the growing complexity of the profession and aligned audiology with other healthcare fields that had already made the same transition.
In a clinical setting, an audiologist may introduce themselves as “Dr. Smith,” which is accurate but can cause confusion if you’re expecting a medical doctor. If you’re unsure, it’s perfectly reasonable to ask about their specific credentials.
What Audiologists Do
Audiologists diagnose and treat hearing and balance problems using a range of specialized tests. These include standard hearing evaluations, tympanometry (which measures how well your eardrum moves), auditory brainstem response testing (which tracks how sound signals travel from the ear to the brain), and otoacoustic emissions testing (which checks whether the inner ear is producing the faint sounds it normally does in response to stimulation).
Beyond diagnosis, audiologists fit and program hearing aids, manage tinnitus, evaluate and treat dizziness and balance disorders, and work with cochlear implant patients before and after surgery. Some specialize in pediatric hearing loss, others focus on balance rehabilitation, and some work in hospitals monitoring nerve function during surgeries. They also design hearing conservation programs for workplaces with high noise exposure.
What Audiologists Cannot Do
Audiologists do not hold prescriptive authority in any U.S. state. They cannot prescribe medications, order imaging like CT scans or MRIs on their own, or perform surgical procedures. If your hearing loss has a medical cause, such as an ear infection, a growth, or a structural problem, an audiologist will refer you to a physician for treatment.
How Audiologists Differ From ENTs
An ENT (otolaryngologist) is a medical doctor and surgeon who completed medical school, a residency, and often additional fellowship training. ENTs diagnose and treat diseases of the ear, nose, and throat using both medication and surgery. Some ENTs specialize even further as otologists or neurotologists, completing an additional two-year fellowship to handle complex ear conditions.
The key distinction is scope. An ENT can prescribe antibiotics for an ear infection, surgically repair a perforated eardrum, or implant a cochlear device. An audiologist handles the non-surgical, non-pharmaceutical side: testing your hearing, fitting devices, programming cochlear implants after the surgeon places them, and providing ongoing rehabilitation. In many cases, the two work as a team. An audiologist might identify a problem that needs medical intervention and refer you to an ENT, or an ENT might send you to an audiologist for hearing aids after ruling out a surgical fix.
Who You Should See First
If your main concern is gradual hearing loss, difficulty understanding speech, ringing in your ears, or needing hearing aids, an audiologist is the right starting point. They have the training and equipment to evaluate your hearing thoroughly and recommend appropriate technology or therapy.
If you’re experiencing ear pain, drainage, sudden hearing loss, recurring ear infections, or dizziness with other neurological symptoms, an ENT is the better first visit because those issues may require medication or surgery. Many people end up seeing both at different points, and the two specialties are designed to complement each other rather than overlap.