What Does a Day in Our Fellowship Look Like

Where do our Fellows train?

• Continuity clinic at New Center One
  • Each of the three Sleep fellows have ambulatory continuity clinics, where they conduct consultations and follow up care for patients assigned to their clinics. They benefit from being exposed to a large number of referred patients, who present with a wide range of sleep disorders. 
• Satellite clinics at Henry Ford Medical Center - Columbus where fellows are exposed to patients with insomnia and with more complex sleep disordered breathing and chronic respiratory failure.
• Satellite clinic at Henry Ford Medical Center - Sterling Heights, where fellows work with our neurologist to gain more insight into EEG and conditions such as RBD and RLS.
• Satellite clinic at Henry Ford Medical Center – Royal Oak, where fellows are exposed to a very mixed patient population with various sleep complaints. On some select days the fellows will also gain some insight into the basics of sleep dentistry.
• Hypoventilation/ALS clinic at the Henry Ford Hospital where fellows gain experience managing non-invasive positive pressure ventilation in patient with neuromuscular illnesses.
• Children's Hospital of Michigan for additional dedicated pediatric sleep medicine experience.
• Cognitive Behavioral Therapy for Insomnia clinic with our sleep psychologist.
• ENT/sleep medicine clinic rotation with our ENT physician. Experience with drug induced sleep endoscopy, uvulopalatopharyngoplasty, Trans Oral Robotic Surgery (TORS) for hypopharyngeal surgery, and hypoglossal nerve stimulator (Inspire therapy) can be part of the fellowship.
• Inpatient consultations at the Henry Ford Hospital, the flagship of the Henry Ford Health.

Clinics usually consist of in-person visits and some virtual visits. Virtual patient visits have helped providers to continue excellent patient care and fellow education during extraordinary times like the COVID-19 pandemic and have since remained an essential part of our day-to-day clinical practice.

How much are fellows involved in polysomnogram interpretation?

• Our 6 sleep laboratories offer plenty of polysomnograms for interpretation, including overnight and daytime studies, Multiple Sleep Latency, Maintenance of Wakefulness Test, Inspire titrations and Matrix studies.
• Our sleep labs also conduct home sleep apnea testing, and nocturnal oximetry.
• Fellows have dedicated reading time to independently review sleep studies and then discuss one-on-one with our sleep medicine physicians.
• Fellows also have weekly sessions with our sleep technologists to stage studies epoch-by-epoch and regular sessions with pediatric sleep technologists to review pediatric studies.

What are the formal didactics?

• During the first 2 weeks of the fellowship trainees take part in an intense “boot camp” focusing on learning the basics of sleep medicine, reviewing sleep studies, and seeing patients in the sleep medicine clinic.
• One morning a week is dedicated for didactics to deepen trainee's basic knowledge of sleep neurobiology and sleep medicine and includes:
  • Lectures presented by senior staff
  • Lectures led by fellows
  • Specialty guest lectures including maxillofacial surgery, ENT surgery, sleep dentistry, and others
  • Case-based learning and case presentations
  • Board preparation sessions
  • Journal club with a formal curriculum
  • Research lectures and regular research meetings
  • Sleep medicine grand rounds
  • Practice-based learning and improvement sessions including participation in Quality Improvement projects, M&Ms, and peer review
• Fellows also attend pediatric sleep medicine lectures and scoring sessions at Children’s Hospital. 
• Fellows also attend Culture of Medicine Rounds presented by the GME department.
• Fellows attend national and regional sleep conferences. 

Typical Fellow Schedule

• Clinics start at 8 am and end around 4:30 pm. Fellows are expected to arrive at 7:45 to start reviewing studies and stay until 5 pm to finish the work.
• Fellows take inpatient call for a month at a time during the day, with the other two fellows covering night and weekend coverage during that same time.
• Schedules are set up on a monthly basis.

• NCO - New Center One clinic
• St Hgts- Sterling Heights clinic
• RO- Royal Oak
• Col- Columbus clinic
• CBTI- Cognitive behavioral therapy clinic (Virtual)
• Dent: Sleep dentistry (once a month during the second half of the fellowship)
• HYPO: Hypoventilation clinic and the neurology/ALS clinic at the main hospital K11
• CHM- clinic at Children’s hospital of Michigan
• Read- dedicated time to reading sleep studies
• In Patient- hospital consultations

Our fellows are well prepared to practice on their own!

Upon completion of our program, fellows are certified as having the knowledge base and clinical skills to independently practice Sleep Medicine. They will be well prepared to sit for the Sleep Boards!