The MedStar Health—Georgetown University Hospital Fellowship Program in Sleep Medicine
The fellowship is a one-year program designed to develop diagnostic and clinical expertise in the field of sleep medicine. Ten of our core faculty members are board-certified in sleep disorders medicine.
The program includes clinical, didactic, and research experiences in sleep medicine with a multidisciplinary faculty from the Division of Pulmonary, Critical Care and Sleep Medicine, Neurology, Pediatrics, Psychiatry, Otolaryngology, Craniofacial and Dental Surgery, and Behavioral Psychology.
Why train here
The program provides opportunities to evaluate and manage a broad range of sleep disorders, including adult and pediatric sleep disordered breathing, insomnia, circadian rhythm disorders, narcolepsy and related disorders of excessive somnolence, parasomnias, and sleep disorders secondary to psychiatric and medical disorders and their treatment.
The MedStar Georgetown University Hospital Sleep Disorders Center performs over 1200 laboratory-based studies per year. It has been in continuous operation and fully accredited by the American Sleep Disorders Association since 1985.
Our Center was the first accredited academic sleep disorders center in the Washington area, and continues to be a referral center for the area and as part of the large multihospital Medstar Health System.
Fellows will work with attending and technical staff in the Sleep Disorders Center and learn the procedures and diagnostic tests necessary for the evaluation of sleep disorders including:
Multiple sleep latency testing
Portable sleep monitoring
PAP therapy titration and follow up
Treatment of complex sleep apnea, central sleep apnea, and hypoventilation syndromes with nocturnal ventilatory support
Adult sleep medicine clinic
Daily half-day adult sleep medicine clinics provide the bulk of the clinical experience for fellows in the program. In these core clinics, fellows perform the initial and follow up evaluations of patients assigned to them. These patients have a wide array of sleep disorders, including obstructive sleep apnea, narcolepsy, insomnia, parasomnias and sleep related breathing disorders in patients with comorbid COPD and congestive heart failure. The fellow will attend these daily clinics when not on an elective rotation. A continuity clinic will continue on all elective months as well.
The fellow will learn to assess, diagnose, and treat patients with sleep disturbances under the direct supervision of board-certified sleep medicine physicians from the Division of Pulmonary, Critical Care, and Sleep Medicine. There will also be experience with pulmonary patients and the interpretation of arterial blood gas and pulmonary function testing.
Fellows will write orders for all sleep specific and non-specific evaluation and management plans. They will also write follow-up orders for treatment, such as treatment with positive airway pressure, appropriate medications, and behavioral therapy.
Sleep laboratory rotation
Fellows will work with attending physicians in the sleep laboratory when the fellow is not attending clinic. Attending physicians will instruct fellows in the interpretation of the polysomnogram. Registered sleep technologists will teach the fellow how to properly monitor a patient during a sleep study, including proper calibration and acquisition of data signals; perform CPAP/BIPAP titrations; and set up home sleep studies.
There is no in-house or night call for sleep fellows. Fellows are expected to observe the hook-up and performance of sleep studies in the sleep laboratory 3 – 4 times throughout the year. They are given the next day off following these nights.
Adult neurology / EEG elective
The fellow will spend 2 months rotating through Adult Neurology and EEG under the supervision of board-certified attending physicians. Afternoons will be spent in the electrophysiology laboratory to familiarize fellows with the principles of electrophysiological recording.
Fellows will learn proper lead placement for EEG monitoring and how to read and interpret EEGs and video-EEG monitoring. The fellow will continue to attend continuity clinics and be required to interpret polysomnograms when not in clinic.
During these rotations, one-on-one didactic sessions on various sleep topics related to neurology will occur once a week. These will be given by the attending physicians, and are informal.
Pediatric sleep medicine / pediatric neurology
The sleep fellow will spend 2 months rotating in Pediatric Neurology and Pediatric Sleep Medicine with attendings who are board-certified in Sleep Medicine. When not in clinic, the fellow will continue to attend their continuity clinic, and interpret polysomnograms.
Emphasis will be placed on assessment and treatment of pediatric sleep apnea, sleep disturbance in patients with pulmonary disorders, pediatric narcolepsy, and behavioral sleep disorders in children.
ENT / oral maxillofacial surgery (OMFS) / dental medicine
The fellow will spend two months rotating through ENT/OMFS/dental clinics. Emphasis will be on the appropriate treatment of patients with obstructive sleep apnea. The fellow will become familiar with both the various surgical interventions and dental devices.
Psychiatry / cognitive behavioral therapy
The fellow will rotate through the Department of Psychiatry for one month, and have clinics one day per week, either 1 full day or 2 mornings per week. There will be at least one session during the month that will cover cognitive behavioral therapy.
During the month, there will be some weekly informal one-on-one didactic sessions with the supervising attendings on sleep related topics, such as interpreting psychological and psychometric testing, mental status testing, anxiety/depression as related to sleep, and effects/use of psychiatric drugs on/for sleep.
Fellows will have the opportunity to participate in research programs in sleep medicine. Ongoing faculty research interests include:
Biomarkers of oxidative stress in obstructive sleep apnea
Free testosterone levels and their response to CPAP therapy in OSA
Prevalence of sleep-disordered breathing in patients admitted to Neuro ICU with intracranial hemorrhage syndromes
Screening medical and surgical patients for sleep apnea
OSA in pregnancy
Identification of patients with obesity hypoventilation syndrome after diagnostic or split night polysomnography
Interested in applying?