Note: The Sleep Medicine Fellowship training program has filled all positions for the 2015-2016 academic year.
The Sleep Medicine Fellowship training program at Baylor College of Medicine offers a unique and comprehensive adult and pediatric clinical training and research opportunities. Our program is unique because of faculty, training sites, and diversity of pathology seen during the training year.
The program is multidisciplinary. We have a large dedicated multidisciplinary faculty, who have received local, national and international recognition, and who are committed to education in sleep medicine. Further, the program has additional non-physician faculty with extensive experience in sleep medicine. The faculty come from Internal Medicine, Pediatrics, Neurology, Psychiatry and Otolaryngology. Many of the participant faculty are well recognized within Baylor College of Medicine for their excellence in teaching and have been recipients of numerous teaching awards. The sleep medicine faculty are actively involved in clinical practice of sleep medicine, training and education in sleep medicine and research in various fields related to sleep medicine.
The program uses multiple affiliated inpatient and outpatient clinical and sleep laboratory experiences in both the public and private setting. Various sites in this fellowship program provide patient, pathology, gender, age and socio-economic diversity. The experiences are comprehensive in breadth, depth and diversity of diagnoses, allowing the trainees the experiences needed to be adept in the practice of sleep medicine.
The program has a comprehensive curriculum. The fellowship in sleep medicine addresses the full range of issues in clinical sleep research and clinical practice. The impact of normal sleep and the influence of disordered sleep on health and well-being are emphasized. Additionally, the fellowship focuses on the importance of sleep disorders and their treatment on overall health and functioning. The roles of the sleep specialist in primary, secondary and tertiary prevention and the collaboration with other health professionals are stressed. Sleep medicine is truly multidisciplinary and our program reflects that fact; content material and faculty from a broad array of specialties is incorporated into the curriculum, including internal medicine, pediatrics, pulmonary medicine, cardiology, hematology, psychology, psychiatry, neurology, neonatology, neurosurgery, otolaryngology, craniofacial surgery, plastic and reconstructive surgery, and dentistry.
The Sleep Medicine Fellowship training program provides training in four sites including Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC), Ben Taub Hospital/BCM Sleep Disorders Center, and Texas Children's Hospital (TCH).
In addition to providing exceptional patient care and performing excellent research, one of the main focuses of the Sleep Medicine Service at the Baylor College of Medicine is to lead an outstanding fellowship training program in the field of Sleep Medicine. The overall goals of the Sleep Medicine training program as determined by the program curriculum committee are as follows:
1. The goal of the program in sleep medicine is to provide multidisciplinary training in the specialty of sleep medicine such that each graduate is able to provide excellent care to patients throughout their career by way of clinical, investigative and educational efforts. The achievement of this goal is measured by program evaluations from current trainees, past graduates and faculty and by appraisal of the successful careers of all graduates and their sleep board pass rate.
2. The Sleep Medicine Fellowship training program at the Baylor College of Medicine is accredited by the Accreditation Council for Graduate Medical Education (ACGME). It is the goal of this program to ensure that all requirements established by that institution are achieved and maintained. All faculty and fellows have the responsibility of acknowledging their part in meeting this goal. The achievement of this goal is measured by the outcomes of reviews by the ACGME and the internal Institutional reviews.
3. In addition, the goal of the educational curriculum of the fellowship training program is that a trainee who successfully completes the training program will have fulfilled the requirements for eligibility for certification in Sleep Medicine by various specialty boards including the American Board of Internal Medicine (ABIM), American Board of Pediatrics (ABP), American Board of Psychiatry and Neurology (ABPN), American Board of Family Practice, and American Board of Otolaryngology. The requirements of the boards are also included in the curriculum of the fellowship program. The achievement of this goal is measured by the In-service examination results and ABIM Board pass rates and results.
The Sleep Medicine Fellowship training program consists of a two-week intensive course in laboratory assessments of sleep disorders followed by extensive clinical experiences in both outpatient and inpatient settings for the rest of the one-year training. Fellows are eligible for sleep medicine board after completion of the one-year program. There are established number of procedures that each fellow required to perform to be eligible to graduate from the program.
Clinical rotations at each hospital provide experience with the urban indigent patient (Ben Taub), the private patient adult and pediatric patients (Baylor Sleep Disorders Center and Texas Children's Hospital) and the veteran (MEDVAMC), and acquaint the fellow with different approaches to the care of patients by a number of different sleep medicine specialists.
In expanding the clinical competence in the subspecialty area, our training program encourages development of sound clinical judgment, the process by which good clinical decisions are made. This includes teaching integration of medical knowledge with clinical data; weighing alternatives; understanding the limitations of knowledge; recognizing complications of disease and side effects of treatment; instituting prompt measures to deal with serious or life-threatening clinical complications; incorporating the considerations of risks and benefits to the patient; and developing a logical plan for evaluation of both immediate and long-term management of patients. Good clinical judgment is synonymous with a physician’s ability to be able to adapt to contemporaneous scientific and technological developments.
As part of the training, fellows will acquire new medical knowledge defined as the specialized, currently accepted, and up-to-date knowledge and information required to function as a subspecialist in the evaluation and management of patients. The level of responsibility will rise and the supervision of other physicians will rise as they progress in the fellowship training. Fellows supervise upper level residents when residents are rotating in sleep disorders medicine outpatient rotations.
An integral part of the clinical experience will be enhancing their ability to gather information through thorough and problem–specific history–taking, physical examination, and review of laboratory data. The required skills include performing medical interviews that are precise, logical, thorough and reliable; conducting expert, focused physical examinations that elicit subtle findings and are directed toward the patient’s problems; and demonstrating understanding and proficiency while minimizing risk and discomfort to patients in the performance of certain diagnostic and therapeutic procedures. Fellows will be given the opportunity to develop skills in the procedures specific to Sleep Disorders Medicine, as listed in the core curriculum.
We believe that part of clinical practice should include a humanistic element, which focuses on integrity, respect and compassion demonstrated in the care of patients and their families. We also believe that an integral component of the practice includes honesty, involvement and responsiveness to patients’ wishes, respect of patients’ need for information, establishment of patients’ trust, provision for empathy, and maintaining credibility and rapport with patients and their families. Finally, we believe that it is appropriate to encourage a pleasant collegial relationship with each fellow as they develop into a subspecialist, a relationship we intend to continue far after the fellow leaves the training program. These philosophies will be practiced as an ongoing part of patient care.
Other facets of our programs in developing clinical competence include consistent application of high quality care, appropriate and responsive to patients’ needs and wishes, demonstration of cultural awareness and competency in interfacing with a wide variety of cultures, use of therapeutic modalities, laboratory tests, consultations and diagnostic procedures efficiently, effectively, and in patients’ best interest. Additionally, we aspire to maintain professionalism and will provide experiences which will develop skills in effective communication, acceptance of responsibility, writing comprehensive notes in a timely, effective and legible manner, to be available as consultants to other physicians as needed, and evaluating the critically new medical and scientific information relevant to the practice of sleep medicine. We encourage development of proper relationships with paramedical personnel, particularly nurses, sleep technicians, and respiratory therapists.
Part of the experiences will also include continuing scholarship by participating in scientific and clinical studies and conferences.
The program has a very strong research component. The key faculty in the program are involved in different aspects of sleep disorders research. These areas include insomnia and sleep-related breathing disorders. In addition, the faculty has successfully published in peer-reviewed journals and is involved in sleep-related national and international organizations.