A Sleep Medicine Curriculum for Pulmonary and Pulmonary/Critical Care Fellowship Programs

Abstract

BACKGROUND: Pulmonary medicine specialists find themselves responsible for the diagnosis and management of patients with sleep disorders. Despite the increasing prevalence of many of these conditions, many sleep medicine fellowship training slots go unfilled, leading to a growing gap between the volume of patients seeking care for sleep abnormalities and the number of physicians formally trained to manage them. To address this need, we convened a multisociety panel to develop a list of curricular recommendations related to sleep medicine for pulmonary fellowship training programs. METHODS: Surveys of pulmonary and pulmonary/critical care fellowship program directors and recent graduates of these programs were performed to assess the current state of sleep medicine education in pulmonary training, as well as the current scope of practice of pulmonary specialists. These data were used to inform a modified Delphi process focused on developing curricular recommendations relevant to sleep medicine. RESULTS: Surveys confirmed that pulmonary medicine specialists are often responsible for the diagnosis and treatment of a number of sleep conditions, including several that are not traditionally considered related to respiratory medicine. Through five rounds of voting, the panel crafted a list of 52 curricular competencies relevant to sleep medicine for recommended inclusion in pulmonary training programs. CONCLUSIONS: Practicing pulmonary specialists require a broad knowledge of sleep medicine to provide appropriate care to patients they will be expected to manage. Training program directors may use the list of competencies as a framework to ensure adequate mastery of important content by graduating fellows.

Curriculum development for the Saudi sleep medicine fellowship program

“…Additionally, the Specialty Curriculum Development Committee reviewed the local and international sleep medicine fellowship programme curricula in countries that already provide training and certification in sleep medicine. 20 , 21 , 22 , 23 , 24 , 25 , 26 Moreover, the committee contacted experts in sleep medicine training locally and in other countries to obtain information when needed.…”

An Integrated Interdisciplinary Sleep Care Model—The Ultimate Dream Team

“…Inspiring the pipeline to commit to additional training in sleep will be critical to the health of our specialty, particularly because fellowship training has been required for board certification in sleep medicine since 2013. 3…”

“…A multispecialty sleep medicine approach that embraces a diversity of specialty perspectives may also increase the number of specialists who select sleep medicine fellowship training. Inspiring the pipeline to commit to additional training in sleep will be critical to the health of our specialty, particularly because fellowship training has been required for board certification in sleep medicine since 2013 …”

Clarifying Requisite Sleep Medicine Content for the Pulmonary and Critical Care Medicine Fellow

“…The graduate perspective therefore is one in which sleep medicine expertise has been developed or was present in the program. 8 Results indicated that most PM and PCCM PDs reported that their graduates could diagnose pulmonaryspecific sleep disorders such as OSA and central sleep apnea, sleep-related hypoventilation, and narcolepsy and insomnia; however, they indicate less confidence in ability to treat these disorders. Contrary to the PD survey, graduates for the most part felt comfortable managing sleep disorders and less comfortable diagnosing sleep disorders, particularly hypersomnias, parasomnias, and circadian rhythm disorders.…”

“…Data from a 2014 survey of PCCM Fellowship PDs and graduates were collated to inform the construction of the roadmap to integrate sleep medicine education in the PCCM fellowship curriculum. 8 Of 162 programs, 44 completed the survey (ie, a 27% response rate with lower participation of Northwest and Southwest programs as well as sole PM vs PCCM programs). Smaller programs (ie, those with one to two fellows per year) appear to be underrepresented; therefore, generalizability and interpretation of the data presented should be placed into appropriate context.…”