Rotation and Conference Details

Sleep Disorders Fellowship Program

Rotations and Conferences

Sleep Fellow Rotations:

Weekly activities common to all rotations:
1) Didactic Lecture series – weekly
2) Case Conference weekly
3) 1 Journal Club per month
4) 1 Research conference per month
5) Weekly University Pulmonary Sleep Clinic*,**
6) Weekly VA Sleep Clinic*,**
7) Pediatric sleep clinic **– every other week

* = full spectrum of sleep disorders evaluated
** Continuity experience for fellows

Schedule Common to ALL Rotations

Monthly Rotations:

Please note that these rotations will not necessarily be scheduled in the order listed.

1. Sleep Laboratory/Reading Rotation I

In this rotation the fellows will learn to score and read sleep studies under direct supervision. They will also watch patient hookups, calibration, and biocalibration for two nights every other week. Fellows will perform consultations on inpatients at Shands UF or the Malcom Randall VAMC with sleep issues, presenting those to the sleep medicine faculty for discussion

2. Sleep Laboratory/Reading Rotation II (MSLT, MWT emphasis)

In this rotation the fellows will learn to perform and score MSLT and MWT studies in the sleep laboratory. Depending on the number of patients undergoing these studies they will be supplemented with practice tests on some normal volunteers. Fellows will read all MSLT and MWT studies performed in the laboratory all months. Fellows will perform consultations on inpatients with sleep issues, presenting those to the sleep medicine faculty for discussion.

3. Neurology Rotation I (Parkinson’s, Dementia)

In this rotation fellows will attend a neurology clinic on Monday and Thursday mornings with Dr. Eisenschenk. In this clinic fellows will see patients sleep disorders, narcolepsy, and epilepsy. They will gain experience in movement disorders with in Friday clinics with Dr. Fernandez. Experience in evaluating patients with memory disorders and dementia will be gained by attending Wednesday afternoon clinic with Dr. Burks.
They will read clinical EEGs with Dr. Eisenschenk. On Tuesday and Wednesday mornings fellows will perform consultations on inpatients with sleep issues presenting and discussing them with the sleep medicine core faculty.

4. Neurology Rotation II (Narcolepsy, Epilepsy)

In this rotation the fellows will attend Monday and Thursday neurology clinics. They will see adult neurology patients with Dr. Eisenschenck and on Thursday morning they will evaluate pediatric patients with Dr. Paul Carney, Chief of Pediatric Neurology. Pediatric patients with a wide variety of disorders including narcolepsy, hypersomnia, obstructive sleep apnea, attention deficit disorder and epilepsy are followed in this clinic. Dr. Carney has an interest in the effect of epilepsy on sleep. Fellows will learn more about the evaluation of normal and abnormal EEG patterns during their Wednesday afternoon rotation in the Epilepsy Monitoring Unit. This will afford them the opportunity to observe nocturnal seizures. For three afternoons each week the fellow will read clinical EEG with a neurologist.

5. Dental/ENT

In this rotation the fellow will attend an ENT clinic every Monday (morning and afternoon) and Friday afternoon. In this clinic patients with snoring and sleep apnea are evaluated for possible surgical procedures. The fellows will also be instructed in examination of the upper airway and observe fiberoptic endoscopy. Fellows will see patients with Dr.’s Collins, Harwick or Sedwick who staff the ENT clinic with two attendings staffing each clinic session. These clinics follow patients of all ages with a wide variety of upper airway issues. Fellows will also participate in consultations on inpatients who are often evaluated in the ENT clinic if well enough to be seen in the outpatient clinic area within the Shands Hospital. On Wednesday morning and afternoon the fellows will attend a Dental clinic where sleep patients are seen for oral appliance treatment evaluation.

6. Orofacial Surgery/ENT

In this rotation fellows will attend an ENT clinic every Monday (morning and afternoon). Again fellows will evaluate patients with Dr.’s Collins, Harwick and Sedwick. Two attending staff each clinic session and follow patients of all ages with a wide variety of upper airway issues. Fellows will also participate in consultations on inpatients who are often evaluated in the ENT clinic if well enough to be seen in the outpatient clinic area within the Shands Hospital. A craniofacial clinic will be attended on Thursday afternoon. In this clinic patients with craniofacial anomalies are evaluated for surgical repair. On Friday mornings (alternate weeks) and all Friday afternoons fellows will attend the Maxillofacial Clinic.

7. Insomnia/Sleep Lab Administration

In this rotation the fellows will attend two morning insomnia clinics and participate in patient evaluation. They will obtain experience in the various methods to evaluate and treat insomnia. The behavioral insomnia clinic will give the fellows directed experience in the behavioral methods used to treat patients as well as appropriate follow-up. The fellows will also receive didactic lectures and practice with psychometric testing and actigraphy. On Tuesday mornings they will learn about the issues involved in running in sleep center. This will include patient safety, quality assurance, scheduling, and billing.

8. Psychology/Psychiatry

In this rotation the fellow will attend psychiatric clinic and see inpatient psychiatric consults with Dr. Cheong. They will also attend psychology clinic with Dr. Sears. These experiences will allow the fellows to understand the interaction of sleep and sleep disorders with psychiatric conditions. They will have the opportunity to evaluate patients in the inpatient and outpatient setting allowing them to appreciate a wide spectrum of disease. Dr. Cheong sees a wide variety of patients at Shands at UF and the Malcom Randall VAMC in a very busy psychiatric consult service.

9. Pediatrics Rotation I

In this rotation fellows will rotate through pediatric sleep clinic and concentrate on reading pediatric sleep studies. They will participate in pediatric inpatient consults related to sleep disorders or ALTEs (Shands at UF). The will be familiarized with documented monitoring and home ventilators for patients with congenital hypoventilation.

10. Pediatrics Rotation II

In this rotation fellows will rotate through pediatric sleep clinic and concentrate on reading pediatric sleep studies. They will participate in pediatric inpatient consults related to sleep disorders or ALTEs (Shands at UF). The will be familiarized with documented monitoring and home ventilators for patients with congenital hypoventilation.

11. Adult Pulmonary/Cardiology Rotation

In this rotation fellows will have instruction and read pulmonary function tests two mornings per week and attend a University and VA general pulmonary clinic each one afternoon per week. They will attend pulmonary grand rounds each week on Wednesday at noon. They will also read EKGs with cardiology supervision two mornings a week and attend a cardiology heart failure clinic on Thursday morning. The fellows will have the opportunity to perform inpatient consultations on adult patients with sleep related issues presenting and discussing them with the sleep medicine core faculty.

12. Elective

The fellows will have one elective rotation during which they may repeat any of the previous rotations. This will allow them to gain addition training in an area of interest or to increase their exposure to an area with a shortened rotation period due to vacation. They will continue to attend the routine weekly conferences and continuity clinics during this rotation.

Vacation

Over the course of the year fellows will be allowed to take a total of three weeks of vacation time interspersed over the course of the year’s rotations. The clinic schedule outlined above is constant from week to week, thus the total schedule will not need to be altered during fellow vacation times.

Moonlighting

Fellows participating in the Sleep Medicine Fellowship at the University of Florida will not be permitted to moonlight.

For More Information Contact:
Fellowship Program Assistant
Division of Pulmonary, Critical Care and Sleep Medicine
1600 SW Archer Road, Room M452
Gainesville, FL 32610-0225
Phone: 352-273-8734
Fax: 352-392-0821