Sleep Medicine Fellowship - Training + Education

Tufts Medical Center has a 6-bed sleep lab that provides the whole gamut of sleep studies for both adults and pediatrics. The lab performs more than 800 overnight studies annually in addition to portable home testing. The Sleep Laboratory rotation for fellowship trainees aims to provide an extensive exposure to sleep medicine, polysomnography and related techniques via didactic teaching, polysomnogram recording and interpretation and direct patient contact. These include standard polysomnography, multiple sleep latency testing, maintenance of wakefulness testing, home sleep testing and actigraphy. Sleep study interpretations are completed by the fellow throughout the academic year and are fully reviewed using all available information, including patient sleep medicine history questionnaires, technical notes during the study, pre- and post-study patient questionnaires and direct review of scored data recordings. After an introductory period, fellows will provide the initial interpretation independently of the attending, which will then be reviewed in detail with the attending.

The Sleep Medicine Inpatient Consult Service aims to provide excellent patient care, strong teaching and broad clinical exposure to consultative inpatient sleep medicine. This includes exposure via direct patient contact through a consult service staffed by the sleep medicine fellow and sleep medicine attending. The fellow will be expected to provide the initial assessment of the consult patient, including performing a complete general and targeted sleep medicine history and physical exam. The consult will then be reviewed with the attending and a full note generated with recommendations to the requesting service.

During the Dental Sleep Medicine Rotation Fellows will rotate through the dental sleep medicine service of the Dental School of Tufts University, under the direct supervision of Drs. Malacarne, Lu, Aroni and Gurrera provide exposure to aspects of the dental clinical examination relevant to sleep medicine, the principles of oral appliance fitting and adjustment, and familiarity with the advantages and disadvantages of the different types of appliances to treat obstructive sleep apnea.

The outpatient Behavioral Sleep Medicine Rotation will provide direct patient contact in the outpatient setting and aims to provide strong teaching and broad clinical exposure in cognitive behavior therapy under the direct supervision of a certified Behavioral Sleep Medicine psychologist. This rotation allows the fellow to witness first-hand the complex management of patients with insomnia, PTSD, anxiety and depression, as they relate to the development of abnormal sleep. The sleep psychologist will be giving formal lecture training on cognitive-behavioral therapy.

The Neurology Sleep Medicine rotation for fellowship trainees in sleep medicine aims to provide an emphasis on neurology and the neurological aspects of sleep medicine. Fellows will be involved in the management of patients with Narcolepsy, Restless Leg Syndrome, and other movement disorders under the direct supervision of dual board certified Neurology and Sleep attending, Dr. Joel Oster. In addition, the sleep fellow will participate in a set of introductory sessions on the basics of EEG, conducted by the neurology department at Tufts Medical Center.

The Otolaryngology Sleep Medicine rotation provides a broad clinical exposure to sleep medicine with an emphasis on the otolaryngology assessment and management of sleep medicine disorders as it pertains to the adult as well as pediatric population. This rotation will occur at Tufts Medical Center within the Division of Otolaryngology, which is a leading center for the diagnosis and management of the complete spectrum of otolaryngology disorders, including obstructive sleep apnea. Dr. Andrew Scott will provide supervision in the pediatric clinic and Dr. Richard Wein will provide supervision in the adult clinic.

The Pediatric Sleep Medicine rotation offers broad clinical exposure to all aspects of pediatric sleep care. This includes behavioral sleep disorders, obstructive and central sleep apnea and hypoventilation syndromes. Fellows gain experience through didactic sessions, hands-on training in pediatric polysomnography and direct patient care in outpatient settings. There are also occasional opportunities to review infant sleep studies conducted in the NICU.