Sleep

• DURATION OF FELLOWSHIP: One year. A 2 year program is available with emphasis on advanced techniques and research applications
• PREREQUISITE: Completed neurology, pediatric, psychiatry, orotolaryngology or medicine residency, Board eligible
• STARTING DATE: July 1
• SALARY LEVEL: PG5 or PG6 Level, based on educational experience

We currently offer two positions for one year which includes broad training in sleep disorders.Fellows also participate in the Sleep Clinic, work with the neurologist, pulmonologists, psychiatrist, otolaryngologist, dentist, and oral surgeons during their training. The fellowship provides exposure to a wide variety of sleep disorders.

The Sleep Laboratory of the UNC Hospitals is located within a 13000 square foot facility. Approximately 2500 overnight sleep studies and 300 multiple sleep latency studies are performed annually.

The UNC Department of Neurology includes an active child neurology training program and approximately 20 percent of the sleep studies performed are in the pediatric age group.The Laboratory is staffed by three board certified sleep specialists.The Medical Directors in the Laboratory include Dr. Bradley V. Vaughn (adult neurology), Dr. Leslie Boyce (pediatric neurology), and Dr. Heidi Roth (Adult Neurology).The UNC Sleep Center receives referrals from the state and surrounding areas.

Services include:

• new patient evaluation and follow up
• experimental drug trial
• evaluation for differential diagnosis, and treatment

The fellowship will provide training in sleep disorders management and sophisticated neurophysiologic diagnostic techniques.Opportunities for additional specialized training in basic and clinical research activities are available if desired.The fellowship is designed to provide the basis for board eligibility and is ACGME approved.

Summary Of Fellowship
The UNC Sleep Fellowship faculty provide top notch training and supervision for fellows in sleep medicine with the goal that the training encompass all areas of sleep medicine and that physicians will become leaders in the field.

The Department of Neurology at The University of North Carolina has supported an unaccredited fellowship in sleep medicine since 1992. During this time frame, the sleep program has grown from a two bed facility to its current sixteen bed facility. All of our fellows have passed the American Board of Sleep Medicine.

The facilities at the University of North Carolina Sleep center offer one of the best opportunities for learning state of the art care in sleep medicine. Our new 16 bed laboratory opened in June 2006 and has the newest digital polysomnographic equipment available. This state of the art lab offers continuous nasal pressure and end tidal CO2 measurements as standard practice along with the 23 other parameters measured. The laboratory facility supports study of neonatal patients, children, adults, and geriatrics in a comfortable and visually pleasing setting. Additionally, the laboratory has a library as well as Internet access and a teaching computer complete with a computer based learning module for sleep medicine. The laboratory contains a conference room that is capable of projecting polysomnographic data from any of the patient recording rooms or access from the network of previous studies and web conferencing.

Our fellows receive a board range of teaching and clinical experience in sleep medicine. Our fellowship also offers a wide variety of interests from a variety of disciplines. We have worked hard to have a multidisciplinary approach and our fellows gain experience from not only individuals in the Department of Neurology but Pediatrics, Otolaryngology, Psychiatry, Pulmonary, Prosthodontics, Oral Maxillary Surgery, and Cardiology. Fellows have a graduated experience within the sleep center. Spending the first months learning basic polysomnographgy, identifying normal and recognizing the more obvious polysomnographic abnormalities for both adult and pediatric patients, the fellows also gain adult and pediatric sleep clinical experience. They will learn how to take a sleep history and perform specific aspects of the physical, and neurological exam important in the evaluation and management of patients with sleep related complaints. By three months into the fellowship the fellows are expected to expand their knowledge on pathophysiology of common sleep disorders and apply their understanding of normal sleep physiology to clinical situations. The fellows should feel comfortable in utilizing the technical sleep equipment and are proficient in formulating basic treatment plans for common sleep disorders. After six months, the are given an oral examination by each of the faculty and the results are compiled. The fellow meets with the program director on a quarterly basis to review progress and map out the next quarter’s goals. Over the last six months of the residency the fellow gains experience in several specialty areas within the sleep center. The fellows will spend part of their time with Otolaryngology, Oral Surgery, Dentistry and Psychiatry sleep colleagues. These specialty rotations are to enhance the clinical experience, understand the examination and concerns related to each of these disciplines in relationship to the area of sleep. The Otolaryngology and Oral Surgery rotation provide experience in examination of the oral airway and understanding the upper airway dynamics as well as the concerns related to surgery. The dental rotation, provides the fellows with a experience in oral appliances and dental examination. The rotation in Psychiatry is held at our Biofeedback Clinic-Medwell Center, which performs the biofeedback for the insomnia program. Fellows gain experience expanding their psychiatric interviewing skills, application of psychological and neuropsychological tests and learn greater detail of biofeedback and other relaxation techniques.

The sleep fellows have exposure to a variety of conferences and lecture series. We have a weekly multidisciplinary case conference and journal club. The fellows also are invited to the daily Neurology conference series on a variety of clinical and basic science topics. This series includes lectures on neuroanatomy, neuropharmacology, neurophysiology, clinical neurology, pain management, and neuropsychometrics. Fellows are also expected to attend the weekly clinical neurophysiology lecture series and are expected to attend the orientation lecture series that includes lectures regarding, physician impairment and fatigue, medical ethics, professionalism and legal issues.

We have taken extreme pride in teaching our fellows to be the best in sleep medicine. Each week, the fellow meets with one of the attendings and systematically covers basic sleep physiology, pharmacology, approach to sleep disorders, and a review of specific sleep disorders, pathophysiology and treatment. In addition, review of basic electronics, polysomnographic and other sleep recording techniques, electroencephalographic, brain imaging, psychological, and pulmonary testing are also reviewed. In addition, the fellows are instructed in the basic management, administration, and financing of a sleep disorders center. Fellows are given a reading list to coincide with the review. As the year progresses, the discussions are noted to become more intricate pulling on previous learned knowledge and integrating new research with the clear idea of developing a clear understanding of the process of identifying, evaluating, managing and developing new questions in understanding of sleep and sleep disorders.

Each of our fellows is expected to participate in research and teaching. Each of our fellows is expected to participate in a research project and present at a meeting. Fellows incorporate their research into their typical week and no specific research block is granted. We believe it is important for our fellows to understand this process and its effects on our understanding of sleep disorders. Fellows must perform a teaching project during their fellowship year. This project enhances the education of others in sleep medicine. The fellows also gain experience in teaching especially medical students, residents, allied health and other fellows throughout the year. The fellows also aid in teaching the sleep technologist and are expected to present at our Sleep Technologist Teaching Conference. The faculty advise the fellows on their teaching and presentation skills and work to improve the fellows teaching techniques.

Applications can be made by sending a letter of interest, a curriculum vitae and three letters of recommendation to Bradley V. Vaughn, M.D.

CONTACT: Bradley V. Vaughn, M.D.

Department of Neurology
3114 Bioinformatics Bldg, CB #7025
University of North Carolina at Chapel Hill
Chapel Hill, NC 27599-7025
919-966-3707 (Office)
919-966-2922 (FAX)