Pulmonary, Critical Care, Sleep & Allergy

Sleep Medicine Fellowship Program Overview & Methodology

The Sleep Medicine fellowship program at the University of Nebraska is an accredited program comprising of one year of strong clinical training with research opportunities for interested candidates. Training occurs at The Nebraska Medical Center and at Children's Hospital. The division occupies a unique discipline under the umbrella of the Pulmonary, Critical Care, Sleep Medicine and Allergy division and maintains its own clinical case conferences, core lectures, journal clubs and an introduction to the Sleep Medicine course. Trainees are expected to attend all conferences. The mixture of clinical experiences and didactics provided in this program provides excellent training for the subspecialty of Sleep Medicine. The sleep medicine faculty is made up of the divisions of Pulmonary, Neurology, Psychology, Pediatrics, Dental and Otolaryngology.  

At the completion of the one-year fellowship program, trainees are eligible to sit for Sleep Medicine boards.

1. Educational Overview
   1. Patient Care
      1. The Sleep Fellow will be assigned patients each month by the Sleep Medicine faculty on both an in-patient and an outpatient basis.
      2. The Sleep Fellow is responsible for the clinical care of the sleep disordered patient in his or her own weekly continuity clinic under the supervision of the Clinic Attending and Sleep Medicine faculty
   2. Clinical Science of Sleep Medicine
      1. The Sleep Fellow will become thorough in knowledge and sound judgment with the diagnosis, treatment and prevention of all sleep disorders
      2. The Sleep Fellow must become competent with the technical skills necessary for the performance and interpretation of the diagnostic and treatment procedures used in sleep medicine.
2. Methodology
   1. University of Nebraska Medical Center (UNMC) Sleep Medicine Fellowship schedule and Sleep Fellow responsibilities:
      1. The first four months of sleep medicine training will take place during the 1-year sleep medicine fellowship program as follows:

         Month 1	Orientation Introduction to polysomnogram interpretation Introduction to the sleep laboratory Polysomnogram scoring sessions Sleep focused H & P Differential Diagnosis of Hypersomnia & Insomnia Sleep Clinics four 1/2 days/week with mentoring
         Month 2	Sleep Medicine Research
         Month 3	Neuroscience, Clinical Neurology & EEG Interpretation
         Month 4	Otolaryngology, Dental appliances, and Allergies
         Throughout Year	Clinical Sleep Medicine, Pediatrics & Behavioral Training Occurs in Weekly Longitudinal Sessions

         The first 6 months conclude with an in-service written examination. There will be another in-service examination in the final month of the training period.

3. Responsibilities include:
   1. Interpret polysomnograms (PSG) at The Nebraska Medical Center Sleep Center. This program requires a minimum of 200 PSG interpretations for Sleep Medicine fellowship completion, although there is ample opportunity for more.
   2. Interpret MSLTs at The Nebraska Medical Center Sleep Center. (minimum 25 for the fellowship)
   3. Minimum 200 new patients and 300 follow-up patients must be documented in the fellow's log book throughout the Sleep Fellowship. At least 60 of the new patients must include a diagnosis other than sleep disordered breathing. Evaluation of at least 40 pediatric age patients is also required. Three half-day clinics at UNMC Sleep Clinic and one every week clinic at Children's Hospital should give ample exposure to required number of patients. Fellows will also attend respective clinics in other sub-specialty rotations. Overall, there are plenty of patients with a variety of sleep disorders to more than meet the minimum requirements.
   4. Take Sleep Lab call & attend Sleep business meetings
   5. Teach rotating residents & students
   6. Monthly Case Conference, monthly Journal Club, monthly EEG conference and attend Pediatric Sleep Shorts
   7. Write at least one article that is preferably a result of the fellow's sleep research project, which was ongoing throughout the sleep fellowship
   8. Must attend all scheduled sleep lecture series and complete required readings
4. All textbooks used during the fellowship training are available in the Pulmonary,Critical Care, Sleep and Allergy Division. Fellows are encouraged to be a member of the American Academy of Sleep Medicine that includes the journal Sleep.
5. Call Schedule and Vacations
   
   1. On-Call Responsibility
      There is Sleep Center on-call responsibility as assigned by the Sleep faculty, as a home pager call system. The Sleep Fellow is required to take any patient with a sleep breathing disorder on the in-patient consultation.
   2. Vacation
      1. A total of 20 working days vacation are allowed in one year.
      2. No more than one week of vacation time may be taken during each rotation (including June) with the exclusion of the orientation month at which time no vacation may be taken unless special permission is granted by the Sleep Medicine Fellowship Director.
      3. Emergency leave may be requested after discussion with the Sleep Medicine Program Director. The Program Director will notify the rotation director.
6. Evaluations
   1. At the conclusion of each Sleep Fellow's service period, a performance evaluation must be prepared by the rotation director. The assessment should be reviewed personally by the Sleep Fellow in the presence of the rotation director.
   2. At the conclusion of the Sleep Fellow's service period, he/she should complete an evaluation form assessing the quality of the rotation.
   3. Two in-service written exams are taken in December and June prior to graduation.