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). 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. 

Pulmonary, Critical Care, and Sleep Medicine Journal Club
Monthly, Monday at 4pm
All available faculty and fellows attend Journal club. Journal Club Faculty and Preceptors focus the conversation on methodology and basic statistics. A designated fellow meets with one of their assigned preceptor/ attending in advance to review either a pulmonary, critical care or sleep medicine article (chosen by the fellow or mentor) prior to this discussion.

Sleep Research Data Club
Weekly / Bi-monthly, Tuesdays at 4pm
Facilitator: Dr. Ayappa
This conference involves reviewing research projects, grants and manuscripts.

Sleep Medicine Bootcamp:
July-September, Wednesdays at 3pm and 4pm
Facilitator: Dr. Vaishnavi Kundel and Dr. Jay Guevarra
We will include all the ACGME core curriculum topics given by our sleep faculty for a comprehensive understanding of sleep medicine as the fellows begin their fellowship.

Multidisciplinary Sleep Case Conferences
Weekly, Wednesdays at 4pm
Facilitator: Dr. Vaishnavi Kundel and Dr. Jay Guevarra
One to two pre-determined sleep cases are discussed and reviewed by having their clinical history and corresponding polysomnograms presented in a multidisciplinary forum with all sleep faculty (neurology, ENT, PCCM), dental sleep specialists, pulmonary fellows, and sleep laboratory staff.

Sleep Grand Rounds: Core Sleep Lecture Series
Weekly, Wednesdays at 4pm
Facilitator: Dr. Vaishnavi Kundel and Dr. Jay Guevarra
Lectures include cutting edge elite research topics given by institutional Sleep Faculty, as well as invited lectures from regional and nationally recognized faculty.

Pulmonary Grand Rounds
Weekly, Fridays at 12:30pm
Fellows, faculty members, and invited 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%