Site:
VA Palo Alto Health Care System

Location:
3801 Miranda Avenue
Palo Alto, CA 94304

Description:
VA Palo Alto HCS offers a diverse learning experience for 4^th year audiology externs. Positions are full-time, not to exceed 12 months. The externs will rotate through the different divisions and clinics (Palo Alto, Menlo Park, San Jose, Livermore, and Monterey). Experience will be gained in providing comprehensive audiologic evaluations, electrophysiology testing (e.g., auditory-brainstem response (ABR) testing), video head impulse testing (vHIT), hearing conservation testing, ototoxicity monitoring, tinnitus management, aural rehabilitation, and hearing aid evaluations. Additional services include provision of auditory osseointegrated devices, hearing aid accessories, assistive listening devices, and tinnitus devices as well as device trouble shooting and repair. Rotation through the Menlo Park Division will emphasize vestibular evaluations and cochlear implants. VA Palo Alto is a CI surgical site and is affiliated with Stanford University. Externs are expected to attend monthly multidisciplinary meetings with the Geriatric Research, Education and Clinic Center (GRECC) and have involvement in quarterly Otolaryngology resident trainings. They may choose to observe Otolaryngology surgeries and to participate in activities at Western Blind Rehabilitation Center (WBRC). Patient care will also be provided through the Polytrauma Transitional Rehabilitation Program (PTRP).

Number of externship positions:
TBD

Funding is assigned by the Office of Academic Affairs and may not have been determined by the application deadline. OAA funding is announced nationally at the same time which should allow sites to know funding at approximately the same time. Funding is pending.

Clinical opportunities provided during the externship: 
Audiologic evaluation
Immittance measures
Otoacoustic emissions
Hearing aid selection
Hearing aid fitting
Assistive listening devices
Vestibular evaluation
Vestibular rehabilitation
Electrophysiology evaluation
Tinnitus evaluation
Tinnitus management
Cochlear Implant evaluation
Cochlear Implant management
Auditory Processing evaluation
Auditory Processing management
Cerumen Management
Telehealth program
ENT clinic
Industrial/hearing conservation

Clinical opportunities not listed above:
N/A

Externship site expects the extern to have mastered these skills before they begin their clinical externship: 
Pure tone audiometry (air and bone) including masking
SRT and word recognition testing
Audiogram interpretation
Basic counseling skills
Hearing aid verification measurements
Basic hearing aid repairs
Otoscopy
Clinical report writing
Participation in research
Good interpersonal skills, professionalism, and willingness to accept feedback

Externship site expects the extern to learn/demonstrate these skills during their clinical externship:

1. Veteran centered care delivery
2. Basic audiologic evaluation and hearing aid fitting
3. Emerging skills in subspecialty areas

Number of audiologists at site:
14

Number of staff at site:
39

Audiologists holding CCC-A certification:
14

Audiologists holding ABA certification:
0

What level of supervision is provided:
Graduated levels of supervision. Initially 100% with decreased direct supervision as extern masters skills.

Number of patients seen per year:
25,213

How many students per year both interns and externs:
8

Continuing Education opportunities:
Students attend on-site hearing aid manufacturer training along with staff in the spring and fall.

Travel to satellites required?:
Yes

Are there interdisciplinary opportunities? If so what:
Geriatric Research, Education and Clinic Center (GRECC) – monthly meetings
Western Blind Rehabilitation Center (WBRC)
Community Living Center (CLC)
Polytrauma Transitional Rehabilitation Program (PTRP)
Spinal Cord Injury Inpatients
Speech Pathology
Ear Nose and Throat (ENT)
Physical Therapy – vestibular rehabilitation
Psychology – Progressive Tinnitus Management (PTM)
Social Work
Domiciliary Residential Rehabilitation
Homeless Veterans Care

Are there research opportunities? If so what?:
No

Do you have a consortium or collaborative arrangements with other sites that provides additional experience?:
No

What communication or other support do you expect or require from university during externship?
Basic communication about expectations and evaluations.

Site’s application requirements:

1. Cover letter stating why you are interested in a 4th Year Externship at the VA Palo Alto HCS
2. Resume
3. Three letters of recommendation from clinical preceptors and/or University faculty (Note: Our staff encourages at least one letter from an off-campus placement.)

Please email documents to:
Rupa Ramanathan, Administrative Officer of Audiology/Speech Pathology Service
rupa.ramanathan@va.gov

Steps for the student/university to follow the application process:
Contact Rupa Ramanathan, Kelly Watts (kelly.watts@va.gov), or Sasha Allen (sasha.allen@va.gov)

Site’s application deadline:
TBD

Site’s externship contact: 
Sasha Allen- sasha.allen@va.gov

Anticipated decision date:
TBD