Curriculum

Our 1-year sleep medicine ACGME accredited fellowship program has a multidisciplinary curriculum anchored at the Trinity Health Grand Rapids Sleep Center. While fellows will have a primary focus on outpatient adult sleep medicine, the curriculum will include excellent exposure to pediatric sleep medicine at Trinity Health and at Helen Devos Children’s Hospital. Other clinical opportunities will occur at local specialty offices in Grand Rapids.

Program Focus

Sleep Medicine is a 1-year multidisciplinary specialty. All blocks are 4 weeks in length, totaling 13 blocks through the fellowship. We offer a “boot camp” during the first 2 weeks of the fellowship on the basics of sleep disorders, polysomnography and expectations to get the fellows started off on the right foot.

Learning is offered during normal clinic hours, and there is no in-house night call or weekend call. There is limited weekday home call for rare emergencies in the sleep lab.

Fellows will participate in continuity clinics one half-day per week. Through our outpatient continuity clinic experience, our fellows build the skills necessary to independently practice outpatient sleep medicine. Fellows will have ample exposure to a wide variety of sleep disorders including Sleep Apnea, Insomnia, Restless Legs Syndrome, Hypersomnias, Parasomnias and Circadian Rhythm Disorders. Due to our connection to a tertiary neuroscience center, we have a wide variety of referrals, often overlapping with neurological disorders and sleep. We also have close connections to our Pulmonology and Cardiology practices at Trinity Health.

Fellows will have dedicated polysomnography (PSG) reading time each week to hone skills in reading a variety of sleep diagnostics, including home sleep apnea testing (HSAT), in-laboratory PSG, titration studies with a variety of PAP modalities (CPAP/BiPAP/ASV/VAPS), hypoglossal nerve stimulation titrations, dental device titrations, and actigraphy.

Our program’s pediatric sleep experience is centered at Helen Devos Children’s Hospital (HDVCH) with Dr. John Schuen and can be tailored for additional experience there based on the background of the fellow. We also have pediatric sleep exposure at our primary Trinity Health sites with Dr. Albert Ho. HDVCH has a large volume of pediatric sleep patients from infancy through teenage years with both inpatient and outpatient experiences as well as behavioral sleep medicine support. Fellows will have diverse, comprehensive exposure to a wide range of pediatric sleep pathology and PSG interpretation.

Rotations

Weekly longitudinal rotations

• Sleep Clinic – 6 months
• Pediatric Sleep Medicine at Helen Devos Children’s Hospital – 2 months
• Dental Sleep Medicine – 2 weeks
• ENT with focus on upper airway surgery – 2 weeks
• Pulmonary consult with focus on inpatient sleep – 2 weeks
• Cognitive behavioral therapy for Insomnia – 2 weeks

Unique elective rotation opportunities include:

• Outpatient Neurology
  • Focus on Epilepsy/EEG, neuromuscular
  • Other subspecialty clinic options: Movement disorders, neuro-immunology/MS, neuro-palliative care, neuropsychology, pain/spine clinic, neuro-oncology, vascular neurology, neuro-ophthalmology
• Pulmonology/Critical Care
• Psychiatry – Psychiatric Medical Unit and outpatient care
• Research

Sample Block Diagram

Conferences and Didactics

Based on our strong commitment to educational excellence, the following opportunities will be offered during your training. There will be 4 hours of dedicated, protected teaching time each week to facilitate learning and education of the broad aspects of sleep medicine.

Didactics will include a mix of both live faculty-led didactics and virtual/prerecorded didactics with faculty support, helping to cater to a variety of learning styles for fellows and allowing for off-site education at times.

Didactic modules include:

• Sleep Related Breathing Disorders
  • Sleep Apnea diagnosis and treatments including Advanced PAP, ventilation and alternatives such as Oral Appliance and neuromodulation therapies
  • Hypoventilation
• Polysomnogram interpretation
• Circadian Rhythm Disorders, Chronobiology and Actigraphy
• Interesting case conference
• Hypersomnia Disorders (Narcolepsy, Idiopathic Hypersomnia)
• Insomnia Diagnosis and Treatment, Cognitive Behavioral Therapy for Insomnia (CBT-I)
• Movements Disorders (e.g. Restless Legs Syndrome)
• Neurobiology of Sleep, Normal Sleep and Variants
  • Sleep Deprivation
• Parasomnias
• Pediatric Sleep Focused sessions on all the above disorders
  • Sleep in neurodevelopmental disability populations
• Practice management – with both community and academic based providers
• Sleep in Special populations – Women, Pregnancy, Menopausal, Epilepsy, Neurodegenerative
• Artificial Intelligence in Sleep Medicine
• Advocacy in Sleep Medicine
• Medicolegal consideration
• Research education

Research

Fellows will have the opportunity to participate in research during their 1-year fellowship and will be strongly encouraged to submit an abstract to the APSS Annual sleep conference in June. There are multiple local and state-wide forums to present fellow research projects as well. Our residents receive support to present research projects at local, regional, and national meetings. Our department offers resources including a research coordinator, biostatistics consultant, on-site Institutional Review Board, audio/visual and poster preparation expertise, and a clinical trials unit (CTU).