Sleep is fantastic!

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Psychiatry resident here going into Sleep Fellowship and can't wait. Field is changing rapidly!

Congrats!
It's a fun and dynamic field. Good luck with your fellowship.

I will be applying for 2009-2010 positions starting 05/2008; Thanks to Fruedianslip for all the great uinsights and perspectives. I will be glad to post about all the training programs as I continue my research on these programs. Currently, 59 programs have received ACGME accreditation for sleep medicine fellowships!!

"Sleep is fantastic!". "It's a fun and dynamic field"

Totally agree with the above. I have worked for many years in the field before starting my residency and I strongly consider a fellowship in sleep medicine at the end of my residency.

For a moment I thought the title of the thread was "Sleeping is fantastic"

The sleep guys in our health system our Mark Mahawold and Conrad Iber...I'm wondering if their big enough names to get letters from, or do I have to go to the University.

While we're at it, how competitive exactly is Sleep? Do you even need big name letters, etc?

Originally Posted by McLovin

Who are the big names in sleep right now? How difficult also is it to get into a sleep fellowship? thanks!

David Gozal, MD of the University of Louisville and Kosair Children's Hospital Pediatric Sleep Medicine and Apnea Center is someone I'm familiar with. More about Dr. Gozal.

And he's not a sleep specialist but his work is related, my uncle Dennis Stokes MD, MPH. He's more pediatric pulmonology, I guess.

Would anyone like to see either of these physicians profiled on the SDN front page?

I'm no sleep expert, I'm just interested in this forum since I was involved in its founding.

Originally Posted by McLovin

The sleep guys in our health system our Mark Mahawold and Conrad Iber...I'm wondering if their big enough names to get letters from, oe would pulmonary guys be ebtter.

Are you serious? Ummmm, yeah, that would be acceptable, if you could get one. Probably about one step down from getting an LOR from God . . .

I was serious in the post. Having just recently gotten interested in sleep I don't know who is big in the field etc. Of the two, who do you think is the bigger name? I know Iber well, but have actually never met Mahawald.

as an aside, the chief of Neurology here (whos sort of nutty) once referred to Iber as "god's pulmonologist"

Originally Posted by McLovin

I was serious in the post. Having just recently gotten interested in sleep I don't know who is big in the field etc. Of the two, who do you think is the bigger name? I know Iber well, but have actually never met Mahawald.

as an aside, the chief of Neurology here (whos sort of nutty) once referred to Iber as "god's pulmonologist"

I worked with them as well at Hennepin, it was my last rotation in med school and I became hooked. Mahowald is really great, and if you can do a rotation there, you will learn a lot from him. If you come from psych, try to work with Dr. Carlos Schenk, the big name in parasomnias, who is also tops in the field.

what fields are eligible to apply for sleep fellowships

Originally Posted by peduncle

what fields are eligible to apply for sleep fellowships

Well, anyone can apply . . . the bigger question is who the fellowship programs will accept . . .

Most common specialties going into sleep are:

Pulmonology/critical care
Neurology/Peds neuro
Psychiatry/Child psych

But you also have ENT, non-fellowship trained internists, and even some family medicine . . .

You should contact particular programs to get a sense of their level of interest in various specialties.

Originally Posted by peduncle

what fields are eligible to apply for sleep fellowships

You can do a sleep disorders fellowship from many primary residencies now...medicine, peds, psych, neuro, ENT, and FP. Even though anesthesiologists put patients to sleep, I do not think they are eligible for a sleep fellowship.

You also have to consider what you want to do after the fellowship - all sleep or part-time sleep, part-time primary residency. Full time sleep spots are relatively rare and you will not have your pick of location. There are a large number of Pulm/CC/sleep jobs, a fair number of neuro/sleep jobs, and very few psych/sleep jobs.

Originally Posted by Sleepygator

You can do a sleep disorders fellowship from many primary residencies now...medicine, peds, psych, neuro, ENT, and FP. Even though anesthesiologists put patients to sleep, I do not think they are eligible for a sleep fellowship.

You also have to consider what you want to do after the fellowship - all sleep or part-time sleep, part-time primary residency. Full time sleep spots are relatively rare and you will not have your pick of location. There are a large number of Pulm/CC/sleep jobs, a fair number of neuro/sleep jobs, and very few psych/sleep jobs.

What do you mean by very few psych sleep jobs? Is it just that many practices won't hire a sleep doc with a psych background? Do they do different types of work?

I know of at least one practice that is looking to hire a sleep doc with a psych background. Agree with Sleepgator that there isn't much choice of location.

Do psych docs so a different job than pulm docs in sleep med? Can't they both diagnose all disorders?

As a future psych resident interested in sleep, I'd love to know why a sleep doc with a psych background can't take any sleep job around.

Originally Posted by BobA

Do psych docs so a different job than pulm docs in sleep med? Can't they both diagnose all disorders?

.

A lot of the pulm sleep jobs, even if they are mostly sleep, involve some pulmonary call coverage.

Agree with Dr. Rack. Anyone who does a sleep fellowship, regardless of primary residency, can manage any sleep disorder. What Dr. Rack and I are saying has more to do with the reality of how most sleep medicine is practiced today. Mainly within a pulmonary practice, occasionally as a neuro practice, and rarely as a psych practice. Unless you are comfortable doing pulmonary/critical care call, you are not going to be as valuable to a pulmonary practice with a psych residency than a pulmonologist with sleep training.

I hate to keep flogging this dead horse, but basically what I'm hearing is that if I did Psych--> Sleep I'd have to be willing to move far and wide to get a Sleep Job. Is that right?

Personally, I'd really be interested in staying in Northern Climes.

Originally Posted by BobA

I hate to keep flogging this dead horse, but basically what I'm hearing is that if I did Psych--> Sleep I'd have to be willing to move far and wide to get a Sleep Job. Is that right?

Personally, I'd really be interested in staying in Northern Climes.

"Northern" like . . . Alaska?

"Sleep job" like . . . 100% sleep?

If you define northern in broad terms, I've known people doing psych/sleep in numerous states (midwest, middle atlantic, new england). You always need to think about moving if you're looking for a "perfect job" but you can probably find something just about anywhere.

If you are looking for 100% sleep, yeah, that's hard to come by anywhere, but I can tell you that not long ago I did run across someone (child psych background, sleep fellowship) who is doing 100% sleep med for a large neurology practice, so it is (remotely, perhaps) possible.

Originally Posted by neurologist

"

If you are looking for 100% sleep, yeah, that's hard to come by anywhere, but I can tell you that not long ago I did run across someone (child psych background, sleep fellowship) who is doing 100% sleep med for a large neurology practice, so it is (remotely, perhaps) possible.

Right now I am doing about 85% sleep, and could easily do 100%. Several years ago I started a sleep center in Jackson MS with several non-physician business partners. At that point, my career was about 40% sleep and 60 % psychiatry. Gradually the sleep center expanded and I decreased the psych I was doing. In addition, several small sleep labs (150-225 miles from me) contacted me over the last 2 years and I now read studies remotely for 2 as well as go out to another sleep center 2 days a month, along with reading its sleep studies remotely. I also contacted a rural hospital 50 miles from me, started going out there to do sleep consults (initially the patients were sent to my sleep lab in Jackson MS for their studies), and about 1 year ago started a 2 bed hospital-owned sleep center there.

The psych I formerly did was part-time state hospital work as well as brief locum tenens work in a prison. Now the only psych I do is some suboxone patients, a few outpts with depression, and I consult at some group homes for the mentally retarded.
I am in solo practice.

There are a few 100% sleep jobs out there for psychiatrists. You could either move to an undesirable location and take one of those or, over several years, create your own 100% sleep job.

Originally Posted by michaelrack

Right now I am doing about 85% sleep, and could easily do 100%. Several years ago I started a sleep center in Jackson MS with several non-physician business partners. At that point, my career was about 40% sleep and 60 % psychiatry. Gradually the sleep center expanded and I decreased the psych I was doing. In addition, several small sleep labs (150-225 miles from me) contacted me over the last 2 years and I now read studies remotely for 2 as well as go out to another sleep center 2 days a month, along with reading its sleep studies remotely. I also contacted a rural hospital 50 miles from me, started going out there to do sleep consults (initially the patients were sent to my sleep lab in Jackson MS for their studies), and about 1 year ago started a 2 bed hospital-owned sleep center there.

The psych I formerly did was part-time state hospital work as well as brief locum tenens work in a prison. Now the only psych I do is some suboxone patients, a few outpts with depression, and I consult at some group homes for the mentally retarded.
I am in solo practice.

There are a few 100% sleep jobs out there for psychiatrists. You could either move to an undesirable location and take one of those or, over several years, create your own 100% sleep job.

You are reading sleep studies remotely. That makes sense and it's GREAT to hear. Sounds like it wouldn't be too hard then for me to get a sleep job, eventually.

Originally Posted by BobA

Sounds like it wouldn't be too hard then for me to get a sleep job, eventually.

If by "job" you mean working 8-5 and getting a paycheck every 2 weeks, as long as you are flexible about location it isn't too difficult.

If by "job" you mean working mainly at one sleep center, but driving several times per month to other sleep centers and reading at a couple others remotely, deriving your income from your collections as well as medical director stipends and also from the profits of partial ownership of one or more sleep centers- that takes several years of hard work to build up.

Originally Posted by McLovin

The sleep guys in our health system our Mark Mahawold and Conrad Iber...I'm wondering if their big enough names to get letters from, or do I have to go to the University.

For what it's worth, it is my understand that Con Iber is one of the leading pulmonologists in the Midwest. And "that" medical center is supposed to be the 2nd in the nation in Sleep. I cannot imagine that a letter from either/or both of those folks would hurt, and perhaps even enhance your CV.

Nice. Good for you. Good Luck!

Originally Posted by Joanhabety

Nice. Good for you. Good Luck!

yep, goodluck!

I seriously thought there will be something like a cure or a method to sleep better with this threads title....

Originally Posted by giantmonster

I seriously thought there will be something like a cure or a method to sleep better with this threads title....

me too.

Hey guys! Thanks for some of the info posted on here. I am a Neuro resident and so far love General Neuro (mostly central NS stuff).l don't particularly like peripheral nervous system (its ok) so am thinking of pursuing a fellowship to a. do what I like (EEG) b. Obtain a "skill set". While I like EEG a lot, I like Sleep quite a bit and quite frankly I have heard that the reimbursements for EEG are pretty low -anyone verify if true or false? So what is your opinion on doing a Sleep fellowship and learning EEG at the same time-any thoughts on 1 year programs that do this? Any advice would be appreciated, thanks

Those of you who are in sleep practice (or know about it), what do Sleep docs generally do besides reading studies? What's clinic like? Do you order and manage CPAP? ANy other examples of what you do would be much appreciated.

Originally Posted by richardebbey

I do wanna join this field. how can I do this.

you could do a pulmonary residency, neurology residency or psychiatry residency, then do a sleep fellowship.

The field is becoming more and more competitive right now, but I think it is still less competitive than dermatology or radio oncology. Good Luck

Originally Posted by wsc2879

you could do a pulmonary residency, neurology residency or psychiatry residency, then do a sleep fellowship.

The field is becoming more and more competitive right now, but I think it is still less competitive than dermatology or radio oncology. Good Luck

pulmonary is a fellowship, not residency.

Other options are Internal medicine, family medicine, ENT, or peds- these specialties are also elgible for sleep fellowships/board certification.

Originally Posted by aaddnl

Those of you who are in sleep practice (or know about it), what do Sleep docs generally do besides reading studies? What's clinic like? Do you order and manage CPAP? ANy other examples of what you do would be much appreciated.

A typical schedule is a half day in clinic, a half day reading studies. In clinic;I do initial evaluations, see patients after sleep studies, order and manage cpap, prescribe meds for narcolepsy, treat insomnia and restless legs

Originally Posted by michaelrack

A typical schedule is a half day in clinic, a half day reading studies. In clinic;I do initial evaluations, see patients after sleep studies, order and manage cpap, prescribe meds for narcolepsy, treat insomnia and restless legs

Half a day dedicated to just reading studies? Damn, that's a sweet deal. How do I get a schedule like that? I get like an hour and many days I have a dozen studies in my box . . .

Originally Posted by neurologist

Half a day dedicated to in my just reading box .studies? Damn, that's a sweet deal. How do I get a schedule like that? . .

by working 12 hour days.

also, I am no one's employee and am either an independent contractor or part owner of the sleep labs I am associated with. At my main sleep lab, a psychiatrist trying to grandfather into the specialty sees a majority of the patients, while I read all of the sleep studies for that lab. Legally, the psychiatrist and I have separate practices, but we work closely together.

So which residency is sleep best under, neurology or psychiatry?

hey all-
Clinical Psych PhD student here, who has been interested in sleep med for about 4 years.

Got hooked up with an integrated MD/PhD sleep practice while I was working on my masters and have kept in touch with them, as recently as a week ago about this exact topic.

What I've heard from the horse's mouth: this is a field that is open to a lot of people, but typically only pulmonologists and psychologists seem interested. If you are interested regardless of your background, I'd invite you to attend the national SLEEP meeting (this year its in Minneapolis in June/July). I'm going, and glad to see anyone there.

There are a TON of things psychologists can do in a sleep clinic (sleep is so behavioral, after all) and reading sleep studies is just one of those things.

Believe me am getting sleep reading the comments of this thread