Clinical Rotations
The Sleep Medicine Fellowship training program consists of a two-week intensive "boot camp" in Sleep Medicine followed by extensive clinical experiences in both outpatient and inpatient settings for the rest of the one-year program. Fellows are eligible for sleep medicine board after completion of the one-year program. Each fellow is required to perform an established number of procedures to be eligible to graduate.
Clinical rotations at each setting provide experience with various patient populations to acquaint the trainee with different approaches to the care of patients by a number of different sleep medicine specialists.
In expanding the clinical competence in the subspecialty area, our training program encourages the development of sound clinical judgment. This includes teaching integration of medical knowledge with clinical data, weighing alternatives, understanding the limitations of knowledge, recognizing complications of disease and side effects of treatment, instituting prompt measures to deal with serious or life-threatening clinical complications, incorporating the considerations of risks and benefits to the patient and developing a logical plan for the evaluation of both immediate and long-term management of patients. Good clinical judgment is synonymous with a physician’s ability to be able to adapt to current scientific and technological developments.
An integral part of the clinical experience will be enhancing their ability to gather information through problem–specific history–taking, physical examination and review of laboratory data. These skills include performing medical interviews that are precise, thorough and reliable; conducting expert, focused physical examinations that elicit subtle findings and are directed toward the patient’s problems; and demonstrating understanding and proficiency while minimizing risk and discomfort to patients in the performance of certain diagnostic and therapeutic procedures. Fellows are given the opportunity to develop skills in the procedures specific to Sleep Disorders Medicine, as listed in the core curriculum.
We believe that our clinical practice should include a humanistic element that focuses on integrity, respect and compassion demonstrated in the care of patients and their families. We also believe that an integral component of the practice includes involvement and responsiveness to patients’ wishes, respect of patients’ need for information, establishment of patients’ trust, provision for empathy and maintaining credibility and rapport with patients and their families. Finally, we foster a pleasant, collegial relationship with each fellow as they develop into a subspecialist, a relationship we intend to continue far after the fellow leaves the training program. These philosophies will be practiced as an ongoing part of patient care.
Michael E DeBakey Veterans Affairs Medical Center Sleep Center
The Michael E DeBakey Veterans Affairs Medical Center Sleep Center—including a sleep laboratory and sleep medicine clinic—serves as a hub of one of the largest sleep medicine clinical care centers in the United States. Fellows attend weekly clinics at this facility.
Texas Children’s Sleep Center
The Texas Children’s Sleep Center is one of the largest pediatric sleep medicine clinical care centers in the United States, with a total of 18 pediatric sleep laboratory beds and a home sleep testing system. Behavioral sleep medicine and otolaryngology services are part of the clinical experience. Fellows attend weekly clinics apart from their home base rotations.
Harris Health Sleep Medicine Clinic
The Harris Health System Sleep Medicine clinic is located at Smith Clinic, a large multi-specialty and primary care clinic. Fellows attend weekly clinics apart from their home base rotations.
Baylor Medicine Sleep Medicine Clinic and Sleep Center at Baylor St. Luke's Medical Center
Multi-specialty sleep medicine clinics, including behavioral sleep medicine, otolaryngology and neuromuscular disease, are part of the clinical experience.
Clinical Competency
Fellows will acquire new medical knowledge defined as the specialized, currently accepted, and up-to-date knowledge and information required to function as a subspecialist in the evaluation and management of patients with suspected sleep disorders. The level of responsibility will rise and the supervision of other physicians will rise as fellows progress in the fellowship training. Fellows supervise residents, medical students and respiratory therapy and sleep technology students throughout their training.
Clinical competence is viewed as demonstrated by consistent application of high-quality care—appropriate and responsive to patients’ needs and wishes, demonstration of cultural awareness and competency in interfacing with a wide variety of cultures and the use of therapeutic modalities, laboratory tests, consultations and diagnostic procedures efficiently, effectively and in patients’ best interests. Additionally, we provide experiences to develop skills in effective communication, acceptance of responsibility, and writing comprehensive notes in a timely, effective and legible manner. Good interpersonal and communication skills are emphasized to work with paramedical personnel, particularly nurses, sleep technologists and respiratory therapists.
Research
Our training program includes a research component. Faculty in the program are involved in different aspects of sleep disorders research, including insomnia and sleep-related breathing disorders. The faculty has published regularly in peer-reviewed journals and is involved in sleep-related national and international organizations.
Quality Improvement
The program requires the implementation and completion of a quality improvement project.