Abstract
Abstract
Rising educational costs and comparatively modest early-career wages have created a structural return-on-investment problem for the Doctor of Audiology (AuD) degree, with implications extending beyond individual finances to workforce sustainability and access to care. This article examines the economic burden of audiology training within the broader context of U.S. graduate student debt, using debt-to-income (DTI) analysis to compare early-career AuD professionals with speech-language pathology peers under otherwise identical financial assumptions. Findings indicate that AuD graduates carry substantially higher back-end DTI ratios and retain markedly less discretionary income, driven by higher average graduate debt, exclusion from favorable federal lending programs available to comparable health professions, and an uncompensated fourth-year clinical externship that concentrates the full financial burden of that year into a period with no or insufficient offsetting income. Recent federal policy changes under the One Big Beautiful Bill Act (OBBBA)–including new aggregate borrowing caps and an unsettled definition of "professional degree" programs–introduce additional uncertainty for future cohorts. The article outlines institutional, federal, and state-level reforms, with particular attention to externship compensation models, as levers to reduce debt accumulation while strengthening workforce entry, retention, and geographic distribution. Meaningful improvement requires alignment between training cost and professional earning potential, not cost containment alone.