To bridge the gap between the two disciplines, “We need to collaborate with our sleep medicine colleagues and integrate the sleep surgery and sleep medicine curriculums,” said Ryan J. Soose, MD, of the division of sleep surgery at the University of Pittsburgh Medical Center. “Sleep is a very multidisciplinary specialty by nature. Having one foot in sleep medicine and one foot in sleep surgery is not a problem, but rather a huge benefit. An ideal program is one with broad educational experience that includes pulmonary, neurology, psychiatry, pediatric, dental, and surgery perspectives. This diversity will provide well-rounded training and best prepare trainees for a successful career in sleep.”
According to Dr. Weaver, key ingredients for a hybrid program are an existing ACGME-accredited sleep medicine fellowship, an experienced sleep surgeon or team in the fellowship that practices the full range of sleep surgery (or at least the parts of sleep surgery of interest to trainees), and a collaborative sleep medicine team that works closely and well with the sleep surgery team.
Dr. Weaver believes funding might be a challenge for some new programs. “ACGME-accredited fellows are not allowed to bill directly for their services or have attending hospital privileges, which limits the funding and programmatic flexibility,” he said. However, ACGME accreditation ensures an excellent, well-rounded training experience and provides eligibility for sleep medicine board sub-certification that would otherwise not be available.