Sleep fellowship as psychiatrist?!

[EDlover23]

Hi all, unfortunately my faculty didn't help with majority of these questions so hoping the hive here can help with some viewpoints.

1. How hard is it for psychiatry residents to match sleep? I unfortunately don't have any sleep research and just have a rotation that I did and loved.

2. How difficult is the learning curve for a psych resident to learn about CPAP titrations and such?

3. What is the average sleep income looking like these days and hours worked. My attendings didn't feel comfortable sharing these numbers.

Thanks in advance!

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[splik]

sleep is not very competitive these days, mostly IMGs, as the compensation plummeted some years ago. Per NRMP for 2023, 89% of fellowships positions filled. There were 201 positions offered, 231 applicants and 16 programs went unfilled. That said it's not uncompetitive either - it's not like CAP or C-L where there are many more positions than applicants.

Per MGMA 2021 numbers, out west sleep medicine median was $313,073 75th %ile was $357,798 and 90th%ile $487,821. In the south it was $271,362 $443,361 $625,219 for 50th, 75th and 90th %iles respectively. By comparison psychiatry in the west was $260,189 $316,123 $425,273 and in the south was $285,309 $349,279 $461,449 for 50th, 75th and 90th %iles respectively.

 

[EDlover23]

sleep is not very competitive these days, mostly IMGs, as the compensation plummeted some years ago. Per NRMP for 2023, 89% of fellowships positions filled. There were 201 positions offered, 231 applicants and 16 programs went unfilled. That said it's not uncompetitive either - it's not like CAP or C-L where there are many more positions than applicants.

Per MGMA 2021 numbers, out west sleep medicine median was $313,073 75th %ile was $357,798 and 90th%ile $487,821. In the south it was $271,362 $443,361 $625,219 for 50th, 75th and 90th %iles respectively. By comparison psychiatry in the west was $260,189 $316,123 $425,273 and in the south was $285,309 $349,279 $461,449 for 50th, 75th and 90th %iles respectively.

I appreciate your very detailed response. In your experience has sleep been difficult to get as a psychiatrist without any specific sleep research? Trying to see if the year is worth it from a practical and financial perspective as I really liked my rotation.

 

[comp1]

I seriously doubt it's worth it from a financial perspective (maybe only forensics is worth an additional year of training financially), but if you liked it, go for it. Happiness should be most important. You'll more likely than not match.

 

[clausewitz2]

It is still a work in progress and hasn't been implemented anywhere, but AASM is piloting the idea of a part-time sleep fellowship, so something to keep an eye out for in the next couple years.

 

[Attending1985]

I always thought sleep seemed like a really good gig with minimal stress.

 

[nexus73]

Is higher pay in sleep due to interpreting sleep studies?

 

[michaelrack]

Is higher pay in sleep due to interpreting sleep studies?

The reimbursement for sleep study interpretation has gone down. Home sleep studies have destroyed sleep medicine financially. There are few pure sleep medicine jobs out there. Basically sleep medicine does not add much financially to what one could earn with their underlying specialty.

 

[TexasPhysician]

I appreciate your very detailed response. In your experience has sleep been difficult to get as a psychiatrist without any specific sleep research? Trying to see if the year is worth it from a practical and financial perspective as I really liked my rotation.

It is becoming much easier to get this fellowship as reimbursement is declining. CAP, forensics, and pain are the only options that may increase financials in my opinion.

 

[Celexa]

I actually think a fully sleep trained psychiatrist could carve out a very nice niche for themselves in private practice capitalizing on the sleep expertise. I don't know if that would end up being more money than just doing cash pay general psych work but it might with some hustle. It would also possibly give you an edge in academic hiring--in a psych dept, they might be willing to let you set up a specialized clinic, and in the sleep dept they'd probably want to send you all the most challenging patients. But as a standard employed gig, I agree, I haven't seen anything to indicate the fellowship would be worth it.

 

[michaelrack]

Agree with Celexa. Sleep fellowship training would be a big plus for a psychiatrist going into academia.

 

[Sushirolls]

The sleep doc who used to sublease from me, would get a slightly higher offer of pay at same Big Box Shop than I would.
Full sleep jobs exist.
Psychiatry trained are perfect to also do CBTi and bill for the 90833 with patients.
Income rise in Sleep is related to number of HST/PSG studies they read, or how fast they churn through patients.

Overall ... overall ... sleep will earn more income for garden variety Big Box shop jobs than Psychiatry.

Sleep is like Psychiatry. you have to like the field. Man, I couldn't read sleep studies every day. That would be too numbing. That sleep doc was frequently urging me to go do a fellowship. I just can't.

 

[Prehealth1011]

Can sleep med docs work from home?

 

[Sushirolls]

In theory yes.
But vast majority of jobs, no.
Some jobs might allow reading of PSG/HST from home though.

 

[FlowRate]

Can sleep med docs work from home?

Like sushi said, maybe part time.

Mostly because they generally do a focused physical exam on patients, especially new patients.