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The Division of Pulmonary, Critical Care and Sleep Medicine at Tufts Medical Center offers a one year ACGME accredited position for fellowship training in Sleep Medicine. Only one position is offered each year. The program is multidisciplinary, utilizing services in pulmonary, neurology, pediatric pulmonology and pediatric neurology, pediatric and adult ear nose and throat surgery, and dentistry. The majority of training occurs at Tufts Medical Center and the Tufts Dental School in Boston. To be eligible for the Sleep Medicine Fellowship, you must have completed an ACGME accredited residency program in anesthesiology, family medicine, internal medicine, neurology, otolaryngology, pediatrics, or psychiatry. Please plan to sit for a board exam in your specialty before or during your Sleep Fellowship training.
The goals of the Sleep Medicine Fellowship Program are to provide:
The Department of Medicine at Tufts Medical Center has a long-standing history of excellence in patient care, teaching and research. The house staff recruited for Internal Medicine training is excellent. The professional staff consists of approximately 150 full-time faculty, 72 house officers and 145 fellows in various subspecialties.
As a benefit of being on the main campus of Tufts Medical Center, there is ample opportunity for collaboration with other Divisions and Departments on campus. Our staff currently collaborates with the Departments of Oral-Maxillofacial surgery, Otolaryngology, Neurology, Psychiatry, Cardiology and Anesthesiology.
Collaboration also occurs at the Tufts University School of Medicine, Tufts Dental School, Graduate School of Biomedical Sciences, and the Clinical and Translational Science Institute (CTSI).
Tufts Medical Center has a 6-bed Sleep lab that provides the whole gamete of sleep studies for both adults and pediatrics. On average, the lab performs more than 1200 overnight studies annually in addition to portable home testing. The Sleep Laboratory Rotation for fellowship trainees aims to provide an extensive exposure to sleep medicine polysomnograpy and related techniques via didactic teaching, polysomnogram recording and interpretation and direct patient contact. These include standard polysomnography, multiple sleep latency testing, maintenance of wakefulness testing, portable polysomnography testing and actigraphy. Sleep study interpretations are completed by the fellow throughout the academic year and are fully reviewed using all available information including patient sleep medicine history questionnaires, technical notes during the study, pre and post study patient questionnaires and direct review of scored data recordings. After an introductory period, fellows will provide the initial interpretation independently of the attending, which will then be reviewed in detail with the attending.
The Sleep Medicine Inpatient Consult Service aims to provide excellent patient care, strong teaching, and a broad clinical exposure to consultative inpatient sleep medicine.This includes exposure via direct patient contact through a consult service staffed by the sleep medicine fellow and sleep medicine attending. The fellow will be expected to provide the initial assessment of the consult patient, including performing a complete general and targeted sleep medicine history and physical exam. The consult will then be reviewed with the attending and a full note generated with recommendations to the requesting service.
During the Dental Sleep Medicine Rotation Fellows will rotate through the dental sleep medicine service of the Dental School of Tufts University, under the direct supervision of Dr. Leopoldo Correa, who is board certified in dental sleep medicine, providing exposure to aspects of the dental clinical examination relevant to sleep medicine, the principles of oral appliance fitting and adjustment, and familiarity with the advantages and disadvantages of the different types of appliances.
The outpatient Behavioral Sleep Medicine Rotation will provide direct patient contact in the outpatient setting, and aims to provide strong teaching and broad clinical exposure in cognitive behavior therapy, under the direct supervision of a certified Behavioral Sleep Medicine psychologist. This rotation allows the fellow to witness first-hand the complex management of patients with insomnia, PTSD, anxiety and depression, as they relate to the development of abnormal sleep. The Sleep Psychologist will also be visiting our sleep lab for formal lecture/training on cognitive behavioral therapy.
The Neurology Sleep Medicine rotation for fellowship trainees in sleep medicine aims to provide an emphasis on neurology and the neurological aspects of sleep medicine. Fellows will be involved in the management of patients with Narcolepsy, Restless Leg Syndrome, and other movement disorders under the direct supervision of dual board certified Neurology and Sleep attending, Dr. Joel Oster. In addition, the sleep fellow will participate in a set of introductory sessions on basics of EEG, conducted by the neurology department at Tufts Medical Center.
The Otolaryngology Sleep Medicine rotation provides a broad clinical exposure to sleep medicine with an emphasis on the otolaryngology assessment and management of sleep medicine disorders as it pertains to the adult as well as pediatric population. This rotation will occur at Tufts Medical Center within the Division of Otolaryngology which is a leading center for the diagnosis and management of complete spectrum of otolaryngology disorders including sleep apnea. Dr. Elie Rebeiz (adults) and Dr. Mark Vecchiotti (pediatrics) will provide supervision in this clinic.
The Pediatric Sleep Medicine rotation aims to provide a broad clinical exposure to all aspects of pediatric sleep medicine which includes behavioral disorders as well as disorders of breathing like obstructive and central sleep apnea in addition to hypoventilation syndromes. The fellow will gain experience in pediatric polysomnograpy and related techniques via didactic teaching, polysomnogram recording and interpretation and direct patient contact in both the inpatient and outpatient settings.
Since this is only a one-year fellowship, the research component expectation is limited and will be individually tailored to you. You will be expected to do a scholarly project for the year. That will consist of any of the following:
Currently, the sleep division’s research interests include the study of sleep in the intensive care unit, sleep quality on noninvasive ventilation, screening for sleep apnea in the preoperative period, screening for sleep apnea in the pulmonary hypertension patient population, and the interaction between sleep disordered breathing and pulmonary hypertension in general, as far as pathophysiologic mechanisms and effects of therapies.
In addition to individual research mentoring and support from the sleep faculty, Tufts Clinical and Transitional Institute (CTSI), www.tuftsctsi.org, accelerates translation of laboratory research into clinical use, medical practice and health policy. The center works on connecting people to research resources, consultation, and education, and fostering collaboration with scholars of all disciplines and with community members and with the ultimate goal of improving the health of the public.
As part of our philosophy of ongoing education, the Division oversees and participates in several high quality conferences throughout the year. In addition to the conferences listed below, there are many other clinical and research conferences within TUSM and Tufts MC that are available for fellows to attend throughout the year. These include weekly medical Grand Rounds and the weekly Tupper Research Institute Seminar series, in which the staff of our Division actively participate. Also the fellow will have a chance to attend the Harvard Medical School Sleep Grand Rounds held monthly in the Longwood medical area.
Clinical Case Conference
The Fellow presents interesting and problematic cases from the outpatient clinic to attendings who discuss the cases in a problem-solving format. A clinically relevant topic summary is presented by the fellow under supervision of the attending. This conference also provides a forum for the fellow and attendings to discuss diagnostic and therapeutic dilemmas thus helping in the management of complicated cases. The fellow learns to critically review the literature pertaining to a topic.
Sleep Research Meeting
This conference is dedicated largely to review ongoing sleep related research in the division and provides an introduction early in the academic year to various research endeavors which will help the fellow make an informed decision about their choice of a research project. As the academic year progresses, it becomes a forum for the fellow to present data from his/her project.
The goals of this meeting are to critically evaluate important journal articles pertaining to Sleep Medicine, and to keep abreast of recent advances in the field. Fellows are encouraged to regularly review society journals like SLEEP, Journal of Clinical Sleep Medicine, CHEST, American Journal of Respiratory and Critical Care Medicine among others.
Didactic Lecture Series
Throughout the year, a faculty member presents a topic from a list of core lectures that covers the full span of sleep medicine. Areas like basic neuroanatomy, physiology of sleep, pharmacology of sleep, in addition to a long list of sleep disorders in accordance with the latest edition of International Classification of Sleep Diosrders (ICSD-3) are covered in detail. This serves as a great way to prepare the fellow to sit for the Sleep boards served by the American Academy of Internal Medicine at the end of their training.
Tufts Medical Center, the primary teaching hospital for Tufts University School of Medicine, is an academic medical center providing comprehensive inpatient and outpatient care in the heart of downtown Boston. The 359-bed medical center is one of only two full-service university hospitals in Boston. It has a nationally recognized staff that is committed to providing an integrated, interdisciplinary approach to the diagnosis and management of patients with complicated diseases. Tufts MC has a large and diverse research program with over $50 million of extramural funding. It is ranked among the top academic medical centers receiving National Institutes of Health (NIH) funding.
Boston is considered one of the most livable cities in the USA. Cultural and recreational opportunities abound thanks to the large number of colleges and museums in the area and the city’s proximity to the mountains and seashore.
Work in the Heart of Boston with Ocean and Mountains Nearby
Tufts MC is located in the Chinatown section of downtown Boston. We are minutes away from the historic Boston Common/Boston Public Gardens with the world-famous swan boats and within walking distance to Downtown Crossing. We are also close to Boston’s historic Faneuil Hall Marketplace and the Freedom Trail, as well as to the waterfront and Boston Harbor.
On the outskirts of Boston, you will find beaches and mountains an easy ride, and you will be just 90 minutes from beautiful Cape Cod, the mountains of New Hampshire and the seashores of Maine.
Aarti Grover, MD, Program Director; Assistant Professor of Medicine
Greg Schumaker, MD, Assistant Professor of Medicine
Joel Oster, MD, Neurologist
Peter Ostrow, MD, Pulmonologist
The Sleep Medicine Program at Tufts Medical Center participates in ERAS an electronic application process set-up by the AAMC. Therefore no formal paper application is needed. If you would like to forward your Curriculum Vitae to us you may do so by mail, fax or e-mail (see contact information below). Three letters of recommendation need to be submitted to ERAS to complete the application.
We do participate in the Subspecialty Match, so you also need to register at the following site: http://www.nrmp.org.
Aarti Grover, MD