- Duration of Fellowship: One year
- Prerequisite: Completed neurology, pediatric, psychiatry, orotolaryngology, anesthesia, medicine and family medicine residency, Board eligible
- Starting Date: July 1
- Salary Level: Start depending upon which core program from the above prerequisites was completed as determined by the GME office.
We currently offer two one-year positions which include 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 13,000 square foot facility. Approximately 2, 500 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), and Dr. Heidi Roth (adult neurology). The UNC Sleep Center is an accredited full-service center and receives referrals from the state and surrounding areas.
- 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 accredited.
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 accredited 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 laboratory has the newest digital polysomnographic equipment available and offers continuous nasal pressure and CO2 monitoring 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 broad range of teaching and clinical experience in sleep medicine and offers a wide variety of interests from a variety of disciplines. We provide a multidisciplinary approach and our fellows gain experience from not only individuals in the Department of Neurology, but also 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, they are given a written examination and oral review form by each of the faculty. 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 fellow 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 an 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, learning the application of psychological and neuropsychological tests, and exploring greater detail of biofeedback and other relaxation techniques.
The sleep fellows have exposure to a variety of conferences and lecture series including 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 the orientation lecture series on topics such as physician impairment and fatigue, medical ethics, professionalism and legal issues.
We take 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 reviewed. The fellows also 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, building upon previously learned knowledge and integrating new research with the intention of identifying, evaluating, managing and developing new questions in understanding sleep and sleep disorders.
Each of our fellows is expected to participate in research, quality assurance and teaching projects, and present at a meeting. Fellows incorporate their research into their typical week with no specific research block 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 to 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 help to improve teaching techniques.