Graduates or soon to be new graduates- whether applying for an internship, a residency, a fellowship, or a new job- should do all of the following:
Consider the work setting.
- A clinic or hospital with a higher staff:doctor ratio would allow for more staff availability to you (ie to assist with client communication where needed).
- A clinic or hospital that has a quieter environment might work better as compared to one that is constantly very noisy.
- If the caseload is very high, people may not have the time to slow down for you. Yet if the caseload is too low, you will not get as much valuable experience.
Decide whether or not to disclose your hearing loss.
Pros:
-If the selection committee finds out from someone else that you have a hearing loss that you did not disclose to them nor discuss, it could be a negative reflection on you that you were not direct with them and were unwilling to address the issue.
-The selection committee may not recognize that you have to work harder than many of your hearing peers and thus fail to give you credit for your work ethic and discipline.
Cons:
-The selection committee may wonder if you will succeed in a demanding clinical environment.
-The selection committee may feel threatened by the effort and expense of the accomodations that you may require.
-There is no legal requirement to disclose at the interview stage.If one discloses, the focus of the interview may tend to focus on the hearing loss rather than the person’s capabilities and credentials and once the hearing loss is disclosed, questions can be freely asked about it by the interviewer at that point.
-Discrimination does happen and it can be hard to prove. The committee may simply rank you lower on the list and rank other candidates as being more attractive.
Get your name out there.
- Spend significant time at the programs, clinics, or hospitals that you are most interested in. Do a one month externship or out rotation there when possible. At the very least, spend a day with them. Direct observation of you goes way further than letters of recommendation when it comes to allaying doubts about your abilities.
- Have an advisor or mentor call your top 3 programs, clinics, or hospitals and advocate for you.
Check into special accomodations:
- If you will need sign language interpreters, oral interpreters, and/or real time captioning, consider discussing this with potential employers.
- Remember that quality of service is variable amongst interpreters and real time captioners. Some of them have more training and certification than others. Some have experience with medical terminology while others do not. Ask for referrals from interpreter and CART national organizations, other D/HOH colleagues, and local D/HOH groups.
By now, you should be aware of common obstacles encountered in clinics/hosptials and how you can deal with them, but here is a review:
Stethoscopes:
- The AMPHL website’s stethoscope section contains a wealth of information on stethoscope use by the D/HOH.
- Borrow a stethoscope or buy one that has a 30 day trial period during which you can return it. This way you can be sure you are making an investment in a stethoscope that is going to work for you, before you make a final non-refundable purchase.
- Spend some time with internal medicine specialists or cardiologists at clinics and hospitals. Practice using the stethoscope with their assistance. Ask what sounds you are supposed to identify. Remember that it takes years for a hearing medical professional to learn to distinguish and identify subtle sounds.
Patient rounds and sit-down conferences:
- Be assertive. Tell people to speak up, to face you as much as possible, and to slow down when necessary.
- Ask colleagues to write some notes for you or repeat pertinent points to you if you are unable to follow what is being said.
- An FM/microphone system may be helpful in selectively amplifying the conversation of interest over the incessant background noise. Choose an FM system that has the option of "zoom" amplification which focuses on just one or a few speaker(s).
- Read patient's charts before and/or after rounds and ask questions about things you do not understand.
- Utilize sign language interpreters or oral interpreters if needed. Real time captioning is also an option for sit-down conferences, but not for walk-around rounds.
Telephones/pagers:
- Today’s technology makes telephone/pager use much easier than it was 15+ years ago! Most D/HOH people now have mobile phones that allow them to use the relay system of their choice to make/receive phone calls, and to send/receive text messages and emails. Such devices can be set to vibrate with incoming messages/calls.
- If amplified phones work for you, ask for them to be installed in areas where you will be working. You may also need to request telephones compatible with assistive devices such as HATIS or cochlear implant telephone jacks.
The Operating room:
- Review/study ahead of time so that you are familiar with the surgical procedure(s) being performed. This will make it easier to understand what is going on and what is being said.
- All individuals (other than the patient) wear a surgical mask in the operating room. This causes problems for those who rely on lipreading. See-through surgical masks (handmade ones until they become commercially available), sign language or oral interpreters, real time captioning, writing notes (ie with sterile skin marking pens on sterile drape material), and FM systems worn under surgical attire are all options that can be used for effective OR communication.
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