Colleagues, join our movement to add Sleep Medicine as a subspecialty of EM- survey attached [Sticky Until 1/22/25]

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miacomet

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Greetings-

I have been working hard with a small (and growing) group of EM docs to add Sleep as a subspecialty of EM. We have a ton to offer the field and AASM seems very interested in having us join. ABEM needs numbers- they want to know how many docs support this and more importantly how many are interested in applying for fellowship.

I believe our skill set and training would make us good candidates for this one year fellowship. The American Board of Sleep Medicine and American Academy of Sleep Medicine are both supportive of EM applicants, but ABEM has not yet approved of this. At ABEM's request we are conducting a survey. The survey is to gauge both support for this being an available option and also interest in the fellowship. Even if this doesn't interest you personally, but you believe it should be available for other EM colleagues, please take just one minute to fill out the survey.

Thank you and please share the link with as many EM colleagues as you can! Link below:

Sleep Medicine Fellowship Survey for EM physicians

Please share as widely as you can!
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GatorCHOMPions said:
Congrats on getting some traction on this
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Thanks! It was a challenge to get an audience with ABEM, but the meeting I had was very informative. They seem willing to petition AASM (who wants us, they have been super helpful) but it's purely a numbers issue to them. If we get enough interest, they will apply to be a sponsoring board.
But the survey is key- no numbers, no go. So please everyone fill it out, it should take less than a minute. So far the response has been overwhelmingly positive!

Mods, is there any way you can pin this post for a few weeks?
 
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Awesome job.

If you haven't already, consider contacting CORD so that they can distribute this widely to all residency programs. This seems like the sort of thing they'd be interested in.
 
BoardingDoc said:
I temporarily stickied this and edited the title to reflect that.
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Thank you!
We need about 50 more responses to present our preliminary results to ABEM, the survey takes less than a minute, share far and wide, we can do this!

Thank you to everyone who filled out the survey already, we are receiving tremendous support and are optimistic about petitioning ABEM to add Sleep as a subspecialty of EM.
 
Unclear as of yet. ENT, psychiatry, pediatrics, family medicine, and IM are eligible for Sleep. While it's true Pulm/CC "owns" Sleep at some centers, I doubt if that's universally true. In my area there are several PP sleep docs. They are all CC/Pulm, but I think that's mainly who is into it. There are always turf wars in medicine, and EM doesn't own much turf, sadly.

Edit: I forgot neurology and anesthesiology. I do know that at some academic centers Sleep is "owned" by neuro.

But if all these fields are eligible, why not us?
 
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miacomet said:
Unclear as of yet. ENT, psychiatry, pediatrics, family medicine, and IM are eligible for Sleep. While it's true Pulm/CC "owns" Sleep at some centers, I doubt if that's universally true. In my area there are several PP sleep docs. They are all CC/Pulm, but I think that's mainly who is into it. There are always turf wars in medicine, and EM doesn't own much turf, sadly.

Edit: I forgot neurology and anesthesiology. I do know that at some academic centers Sleep is "owned" by neuro.

But if all these fields are eligible, why not us?
Click to expand...

I agree we should be eligible and I thank you for your efforts. But if no one will hire us what's the point of doing the fellowship?
 
miacomet said:
Unclear as of yet. ENT, psychiatry, pediatrics, family medicine, and IM are eligible for Sleep. While it's true Pulm/CC "owns" Sleep at some centers, I doubt if that's universally true. In my area there are several PP sleep docs. They are all CC/Pulm, but I think that's mainly who is into it. There are always turf wars in medicine, and EM doesn't own much turf, sadly.

Edit: I forgot neurology and anesthesiology. I do know that at some academic centers Sleep is "owned" by neuro.

But if all these fields are eligible, why not us?
Click to expand...
It could be like sports medicine where it's incredibly hard to just do sports medicine. The usual fit is a little sports medicine plus a lot of XYZ specialty. The couple EM docs I know doing SM are still like 50% or more EM. My bet is it will take some grind to carve out part time sleep medicine that isn't integrated into a larger neuro, primary care, pulm, etc. clinic. It still is better than nothing for the right person.
 
GatorCHOMPions said:
It could be like sports medicine where it's incredibly hard to just do sports medicine. The usual fit is a little sports medicine plus a lot of XYZ specialty. The couple EM docs I know doing SM are still like 50% or more EM. My bet is it will take some grind to carve out part time sleep medicine that isn't integrated into a larger neuro, primary care, pulm, etc. clinic. It still is better than nothing for the right person.
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Or the flip side, as @Birdstrike did with pain; as attributed to Hannibal, "we will find a way, or we will make one". Bird made his own way; I don't know if he was the first, but he was the first one of which I heard. Alternately, "by hook or by crook"!
 
WhatJobDoIPick said:
I agree we should be eligible and I thank you for your efforts. But if no one will hire us what's the point of doing the fellowship?
Click to expand...
There are plenty of private practice Sleep docs, at least where I live. Since there are plenty of docs boarded in neuro and medicine doing sleep full-time, why not us?

EM-Sleep has the possibility of a specific niche in an academic medical center, particularly in regards to circadian rhythm research, which is growing , and also altitude medicine/altitude sleep research. Sleep research is a growing field IMO. My initial interest in pushing for this was that I thought EM docs would have a critical perspective for Sleep research.

EM is still a new field; twenty years ago people thought EM-CC docs wouldn't be employable. I won't say the field is level, but there are certainly plenty of EM docs out there doing CC full time, more than a few EM docs doing Pain, and, and some doing Sports, Palli, Occ Med, and Addiction.

Let's remember this is a field open to ENT, FP, IM, Peds, Psych, and anesthesia (I'm sure I missed a sponsoring board in there) with practicing docs from each of those fields. We can do it, do it well, and be both employable and leaders in the field.

Edit: As we prepare to present to ABEM, if anyone has any particular research-y thoughts regarding Sleep, let me know. I actually think we have a lot to offer. I was inspired by these articles, and I think EM really deserves the research funding for this, like no specialty is more deserving of funding to do research in a high mountain hut in the Swiss Alps than us:


Edit 2: I do agree there has been a ton of midlevel encroachment (and they are not universally doing a particularly great job, they are just CPAP dispensers IMO). There are some old school places where Sleep is owned by pulm-cc, but that's fading with Sleep open as standalone fellowship. There are jobs that want a sleep neurologist or a sleep-pulm doc. I'm not promising employment. But it will happen, and the field should be open to us!
 
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miacomet said:
There are plenty of private practice Sleep docs, at least where I live. Since there are plenty of docs boarded in neuro and medicine doing sleep full-time, why not us?

EM-Sleep has the possibility of a specific niche in an academic medical center, particularly in regards to circadian rhythm research, which is growing , and also altitude medicine/altitude sleep research. Sleep research is a growing field IMO. My initial interest in pushing for this was that I thought EM docs would have a critical perspective for Sleep research.

EM is still a new field; twenty years ago people thought EM-CC docs wouldn't be employable. I won't say the field is level, but there are certainly plenty of EM docs out there doing CC full time, more than a few EM docs doing Pain, and, and some doing Sports, Palli, Occ Med, and Addiction.

Let's remember this is a field open to ENT, FP, IM, Peds, Psych, and anesthesia (I'm sure I missed a sponsoring board in there) with practicing docs from each of those fields. We can do it, do it well, and be both employable and leaders in the field.

Edit: As we prepare to present to ABEM, if anyone has any particular research-y thoughts regarding Sleep, let me know. I actually think we have a lot to offer. I was inspired by these articles, and I think EM really deserves the research funding for this, like no specialty is more deserving of funding to do research in a high mountain hut in the Swiss Alps than us:


Edit 2: I do agree there has been a ton of midlevel encroachment (and they are not universally doing a particularly great job, they are just CPAP dispensers IMO). There are some old school places where Sleep is owned by pulm-cc, but that's fading with Sleep open as standalone fellowship. There are jobs that want a sleep neurologist or a sleep-pulm doc. I'm not promising employment. But it will happen, and the field should be open to us!
Click to expand...
Dude, thanks for all you are doing in regards to pushing for our inclusion into this fellowship. This is the kind of thing we need moving forward. Most of us complain about not being allowed into certain fellowships but are too lazy to do anything about it. Let us know if there's anything we can do to assist.
 
Groove said:
Dude, thanks for all you are doing in regards to pushing for our inclusion into this fellowship. This is the kind of thing we need moving forward. Most of us complain about not being allowed into certain fellowships but are too lazy to do anything about it. Let us know if there's anything we can do to assist.
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Yeah, we need more options. A lot of our talent is wasted.

There is really no reason an EM doc can't do a GI, cardiology, or many other IM/Peds/FP fellowships. There is no reason that medicine can't come up with fast track pathways to retrain in different fields (eg an 18 month primary care fellowship for EM etc). It's simply tradition and turf wars.

I'm still learning about the process of getting ABEM to petition ACGME to be added as a primary board for other fellowships; @Birdstrike has done this successfully with Pain and can shed more light. BUT the one thing I have learned is that ABEM wants, above all, numbers and a survey to even consider. Now, I'm sure that IM is unlikely to give up GI (I'm not sure how that works on their end- Bird would be able to explain a bit more I think).

If you want to add options for EM, the first thing to do is send out a surveymonkey asking three really basic questions and if you get a positive response, then ask for a meeting with ABEM subspecialty section.

If anyone has a fellowship they want added, DM me and I can tell you how to start the process and how to request a meeting with ABEM so you are not reinventing the wheel.

It's actually been a fun project so far and I'm looking forward to seeing it to completion, super empowering.
 
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