Pulmonary, Critical Care and Sleep Medicine

The Medical College of Wisconsin Affiliated Hospitals, Inc. (MCWAH) offers an excellent comprehensive benefits package. View benefits information on the Graduate Medical Education site.

This is an ACGME accredited multi-disciplinary fellowship providing training in all aspects of adult and pediatric sleep medicine. We seek to attract and train fellows from diverse backgrounds (primary discipline, previous training institution, research experience, and personal attributes).

Eligible applicants include individuals who have completed training and are board-eligible or board-certified in Otolaryngology, Internal Medicine, Family Medicine, Neurology, Pediatrics, Anesthesiology or Psychiatry.

Applications must be received to the ERAS® (Electronic Residency Application Service) associated with the National Residency Match Program before the application deadline. The prospective fellow candidate will be evaluated on leadership potential, letters of recommendation, curriculum vitae, English fluency, clinical and research experience, professional goals, and post fellowship plans.

Interviews are by invitation and securing a position in fellowship is done through the National Residency Match Program.

Prospective fellows must meet all the requirements set by Graduate Medical Education at the Medical College of Wisconsin Affiliated Hospitals, Inc. and the American Council on Graduate Medical Education.

Fellows begin with an introductory intensive lecture and laboratory sciences series during the month of July. From August through June, the fellow will participate in the Core Curriculum Lecture series on Friday afternoons and prepare journal club and multidisciplinary case review under the supervision of a faculty mentor.

Examples of some of the introductory course topics include:

• How to take a sleep history Polysomnography, scoring, and interpretation of polysomnograms
• Recognition of artifacts
• Montages with additional EEG leads for seizure detection
• Multiple sleep latency testing and maintenance of wakefulness testing
• Neuropharmacology
• Actigraphy
• Gastrointestinal physiology during sleep and pathophysiology
• Ontogeny of sleep
• Clinical manifestations of sleep disorders in children
• Clinical manifestations of sleep disorders in adults
• Portable monitoring related to sleep disorders
• Chronobiological mechanisms
• Respiratory physiology during sleep and pathophysiology
• Endocrine physiology during sleep and pathophysiology
• Basic neurological sleep mechanisms
• Cardiovascular physiology during sleep and pathophysiology
• Sleep across the life span
• CPAP and BIPAP applications and trouble shooting
• Noseology
• PFT interpretation
• Psychological and psychometric tests as they relate to sleep disorders

Research participation is strongly encouraged throughout the fellowship. Fellows are offered an opportunity to participate in ongoing research or establish projects of their own under a faculty mentor.

July: Introductory Course, PSG training, PSG practice including scoring >=25 studies, observing >=2 in-lab sleep studies

Aug-Jun: Clinical training

Aug-Jun: Research project/publication

Dec-May: QI project

Clinical Year Rotation Experiences

IP = Inpatient
OTO = Adult Otolaryngology Sleep Disorders Clinic
AN = Adult Neurology Sleep Disorders Clinic
PSG = Sleep lab
Pul = Adult Pulmonology Sleep Disorders Clinic
PedPul = Pediatric Pulmonary Sleep Disorders Clinic
RES = Research

Institutions

FH (site #1) | Froedtert Hospital
CHW (site #2) | Children’s Hospital of WI
VAMC (site #3) | Clement J. Zablocki VA Medical Center

The fellow is assigned a continuity clinic ½ day/week for 6 to 12 month blocks at one of the three sites.

Rotation 1

AN / Pul / OTO / PSG – adult & ped / RES/ PedPul
Institution / site: Sites 1 and 2
Duration: 2 months

Rotation 2

Pul / IP / RES/ PSG – adult and ped/PedPul
Institution / site: Sites 2 and 3
Duration: 2 months

Fellows will alternate between these 2 rotations throughout the year.

During rotation 1, the fellow works with board certified sleep specialists in their department clinics including adult Otolaryngology, pulmonology (adult and pediatric) and adult neurology sleep clinics. This provides the fellow experience with wide variety of patients. The fellow is responsible for reviewing sleep studies and other sleep related testing under faculty mentorship for 3 half days.

During rotation 2, the fellow works with board certified sleep specialists in adult pulmonology. In addition to sleep clinics, fellows receive experience in CPAP desensitization and cognitive behavioral therapy. The fellows also participate in inpatient sleep study. They also receive experience in electronic-consultation (telemedicine). This requires a thorough chart review to determine the first step in the patient’s care (sleep study, home study, physician clinic visit, CPAP clinic, etc.). The fellows also review sleep studies (portable monitoring studies) and their non-clinic time.

The Friday afternoon block across all three rotations is used by the fellows and faculty for education and practice development as well as research. Depending on the week during the month, there are 1-3 hours of activities that the fellow participates in with one or more faculty present.

Introductory Course Series

Sleep Faculty are assigned didactics and this faculty member will meet with all the fellows. Attendance is mandatory. Fellows are asked to provide discussion and do required reading pertinent to the topic. This assigned reading is provided by the faculty speaker. This conference schedule is set up prior to the start of the July/August rotation and the fellows are provided with the time, location, and dates for the talks. Examples of the topics are endocrine and GI physiology and pathophysiology in sleep, respiratory physiology and pathophysiology in sleep medicine, cardiovascular physiology and pathophysiology in sleep and sleep disorders, chronobiology and sleep/wake mechanisms, sleep across the life span, neurochemical physiology of sleep, portable monitoring, polysomnography, actigraphy, psychometrics in sleep evaluations, etc. In addition, all the fellows are provided time to learn sleep study scoring under supervision of sleep technicians.