CHEST Guidelines-Clarifying-Requisite-Sleep-Medicine-Content-for-th

Clarifying-Requisite-Sleep-Medicine-Content-for-th

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The article discusses the challenges and necessary steps in integrating sleep medicine education into Pulmonary Medicine (PM) and Pulmonary and Critical Care Medicine (PCCM) fellowship programs. Despite historical connections between sleep medicine, pulmonary, and neurology fields, the creation of a direct pathway into sleep medicine has unexpectedly resulted in fewer trainees choosing to specialize in this area. Factors such as the additional year of training required and limited exposure to sleep medicine during PM/PCCM fellowships have contributed to this trend.<br /><br />The Accreditation Council of Graduate Medical Education (ACGME) mandates that PM and PCCM programs ensure fellows are competent in managing sleep-disordered breathing. However, with a growing disease burden from undiagnosed conditions like obstructive sleep apnea (OSA) and a declining workforce of sleep specialists, addressing this educational gap is pressing.<br /><br />A multisociety panel has suggested developing specific curricular competencies for PM and PCCM fellowships. It emphasizes aligning program content with the broader requirements set by the ACGME and American Board of Internal Medicine (ABIM), while taking into account the evolving field of sleep and circadian medicine. The panel advocates for creative solutions, such as integrating sleep medicine content into existing pulmonary disease training to improve competency without overhauling current schedules.<br /><br />Surveys indicate discordance between program directors and graduates regarding preparedness to diagnose and manage sleep disorders, highlighting a need for curricular refinement. Initiatives like home sleep apnea testing (HSAT) exposure and understanding diurnal symptom variability in pulmonary diseases are proposed as starting points.<br /><br />Considering these recommendations requires strategic collaboration among stakeholders in pulmonary, critical care, and sleep medicine, ensuring the training aligns with patient-centered care and regional needs. Moving towards a competency-based training model, as anticipated by the ACGME, may facilitate these curricular improvements.

Keywords

sleep medicine education

Pulmonary Medicine

Critical Care Medicine

fellowship programs

obstructive sleep apnea

ACGME

curricular competencies

sleep-disordered breathing

home sleep apnea testing

competency-based training