Curriculum

More specifically, the fellowship training is dedicated to learning the fundamentals of scoring and interpreting polysomnograms, multiple sleep latency and maintenance of wakefulness tests, portable sleep monitor recordings, downloads from positive pressure devices, sleep diaries and standardized scales of sleepiness. The training is focused evaluating, diagnosing and comprehensively treating patients over the entire spectrum of pediatric and adult sleep and circadian rhythm disorders as well as medical, neurological and psychiatric disorders that may present with sleep related complaints. The fellows will enhance their medical knowledge regarding fundamental mechanisms of sleep and wakefulness, cardiovascular influence of sleep and sleep disorders, sleep related movement disorders, parasomnias, insomnia and other sleep disorders The fellows will also have the opportunity to pursue research projects and present at national conferences and/or prepare manuscript publications.

Core Competencies: Throughout the 12 months, fellows are trained and evaluated on the ACGME milestones in Core Competencies including:

  1. Medical Knowledge
  2. Patient Care
  3. Practice Based Learning and Improvement
  4. Interpersonal and Communication Skills
  5. Professionalism
  6. Systems Based Practice 

Increasing Levels of Responsibility and Supervision:

Throughout the year, fellows are supervised in the care of their patients by a faculty member with credentials and boards in Sleep Medicine. Each training site has a site director with overall responsibility for the fellow during his/her tenure at that site.

Fellows will gradually assume more responsibility commensurate with their skills. As they become more competent, fellows will take on the main role in caring for their patients, but in all cases an attending will be available for advice and will see each outpatient during at least part of the visit. Fellows will also become comfortable scoring and interpreting sleep studies, but will always be directly supervised with reports generated only after attending overview.

Educational Resources: There are a variety of educational resources that are available to the fellow. These include:

  1. The Levy Library with online access to standard pulmonary and critical care textbooks as well as relevant publications in pulmonary and critical care journals including UpToDate.
  2. Sleep Medicine reading lists (updated annually by the PD and associate PD).
  3. Board Review curriculum (available as a hard-copy or from the internal pulmonary fellowship website).
  4. A schedule of divisional and external weekly conferences emailed to all faculty and fellows including combined teleconferences within the Mount Sinai Health System and with National Jewish Hospital, Denver.

Clinical Competency Committee: The new accreditation system (NAS) has set up a practice whereby fellows need to meet certain milestones. These milestones correspond to six core competencies. A fellow’s performance is evaluated by a Clinical Competency Committee (CCC) made up of key clinical faculty (KCF): Dr’s Shah, Burschtin, Ayappa, Rapoport, DiFabrizio, Dua, and Powell. They meet on a semiannual basis to review each fellow’s progress and then determine if there are any deficiencies in meeting milestones. If a fellow is found to be deficient in any milestone, they meet with the Program Director (PD) to discuss strategies on improvement. Fellows meet with the PD on a monthly basis to review their performance. 

Fellow Year 1 

Rotation Name

% In-Patient

 

% Out Patient

Block 1

Sleep Studies

0%

100%

Block 2

Outpt Clinical Sleep

0%

100%

Block 3

Physio/Sleep

100%

0%

Block 4

Inpt Clinical Sleep

100%

0%

Block 5

Dentistry

0%

100%

Block 6

Beh Sleep Med

0%

100%

Block 7

Research

0%

0%

Block 8

Electives 

0%

100%

  • Journal Club
    Three Mondays a month 12 PM
    Facilitator: Dr. Wisnivesky, Dr. Mathews, Dr. Shah and Dr. Lee
    All available faculty and fellows attend Journal club. Dr. Wisnivesky, Mathews, Shah or Lee facilitate the conversation focusing on methodology and basic statistics. A designated fellow meets with one of the above attendings in advance to review either a pulmonary, critical care or sleep medicine article (chosen by the fellow or mentor) prior to this discussion.
  • Multi-Disciplinary Sleep Case Conference
    Wednesdays 3 PM
    Facilitator: Dr. Burschtin
    Three to four pre-determined sleep cases are discussed by having their clinical history presented in a multidisciplinary forum with sleep faculty, neurology, sleep laboratory staff, physician assistant and dentist.
  • Fellows Core Sleep Lecture Series
    Wednesdays 4:30 PM
    Facilitator: Program Director
    Lectures include core curriculum related sleep medicine topics.
  • Sleep Research Conference
    Thursdays 4 PM
    Facilitator: Dr. Ayappa
    This conference involves reviewing research projects, grants and manuscripts.
  • Pulmonary Grand Rounds
    Fridays 12:30 PM
    Facilitator: Dr. Allison Lee
    Fellows, faculty members, and guest speakers present various clinical and research topics in pulmonary, critical care and sleep medicine.

RotationTotal Workload
Scoring and Interpreting Sleep Studies 20%
Outpatient Clinical Sleep 30%
Physiology/Sleep 5%
Inpatient Clinical Sleep 5%
Dentistry 5%
Behavioral Sleep Medicine 5%
Research 10%
Electives 20%