How popular are the two year fellowships?
I understand they are a good launching pad to a career in Academia
What do people think about the trend to do back to back fellowships in Epilepsy and sleep?
Sleep medicine fellowships may also be two years in duration. This is sometimes an optional choice for the fellow, or applied for purposefully. The idea is that the second year is used to add time to complete a meaningful research project, which is lacking in the one year fellowships. A satisfactory clinical skill set and knowledge base can certainly be acquired in a single year for sleep medicine, though. I would argue the same for epilepsy. You are correct that the two year fellowships are often utilized by those pursuing careers in academics (hence the focus on research). But there is little point in doing a second year if you simply plan on jumping into private practice and earning a living. In fact, the extra year would practically result in lost income for you if this were the case.
On a personal note, my own attendings recommended that I complete a fellowship in either epilepsy or clinical neurophysiology prior to completing a sleep fellowship. I ultimately declined to do this. The idea is that you lay a foundation of good general neurology knowledge for academic/private practice before entering the fairly narrow scope of sleep medicine (most neuro-sleep people practice a significant amount of general neurology still, and this is operating under the assumption that you want to do this) and also that sleep studies (which usually include a truncated number of EEG leads for wake/sleep determination) sort of naturally grow from EEG studies.
I ultimately selected a private practice career over an academic one (which I considered for awhile), and chose to practice 100% sleep medicine. These two choices really made the extra fellowship year (or a research year) a bit superfluous.
So, the answer to your question of doing a single or double fellowship really depends on what and how you wish to practice.
Let's consider some of your paths here. If you want to go into academics, then a sleep or epilepsy fellowship alone is satisfactory, but the combination of epilepsy and sleep fellowships does make you more attractive and more knowledgeable than a person with a single fellowship. However, if you don't plan on practicing general neurology (in either private practice or academics), you won't be that well served by the epilepsy fellowship first and would rather benefit from applying directly for sleep medicine.
To make my answer as direct as possible, I would argue that your best course may in fact be to decide between sleep and epilepsy and then pursue a one to two year fellowship in a single area (if you wish to go into academics), or simply a one year fellowship in a single area (if you wish to go into private practice). My reasoning is that the extra research time in a dedicated single direction would probably better serve you for academic practice than a double fellowship, and that the exta time spent in training completing a second fellowship wouldn't be very useful to you in private practice no matter which direction you wish to go in PP. Now as I said above, you can make the case that doing general neurophysiology or epilepsy and sleep both helps you to become more well-rounded for neurology in private practice or academics, though.
Sleep medicine fellowships are usually very laid back. They are also as a rule more competitive to get than epilepsy fellowships. This makes it a bit wiser in my opinion to go ahead and finish your epilepsy training first (if you want to do both) so that your work progressivly becomes easier as the two years go by. But you can also make a fair argument to pursue sleep medicine as a priority (since it's harder to get) and apply for epilepsy afterwards. The idea in the second case being that the neurophysiology and/or epilepsy fellowships are "always" obtainable...somewhere. For instance, even now, I could go back and complete one if it were financially feasible and I wanted to stop practicing just sleep. I don't believe you would find sleep medicine training so easy to do on a whim as epilepsy. Of course, the quality of the program you're applying to must be taken into consideration as well. The upper tier programs which you seem to be interested in would certainly be much harder to land, generally speaking.
Anyway. Sorry for the length of the post and rambling in a slightly disorderly fashion. Good luck with your choice. I vote that you give sleep medicine a good, hard, solid look.
But then I'm biased.
Regards,
Dan
