With the explosion in interest in sleep surgery has come the need to improve training opportunities in this field. Sleep surgery encompasses the surgical evaluation and treatment of obstructive sleep apnea and snoring, and it is like anything in life: the more experience you have, the more likely it is that you will develop expertise. For several years, I have considered whether to start a sleep surgery fellowship. I have written previously about opportunities for surgeons interested in sleep surgery to acquire the necessary training. These opportunities have included scientific conferences and educational courses as well as fellowship programs that typically involve a year of additional training after someone has completed their residency. Dr. Terese Hammond at the Keck Medical Center of USC and Dr. Sally Ward of Children’s Hospital Los Angeles developed an outstanding sleep medicine fellowship program that offers multidisciplinary training in adult and pediatric sleep medicine. We have had the privilege of training Dr. Katherine Green of the University of Colorado and Dr. David Kent of Vanderbilt University in this program, and they are already becoming true leaders in sleep surgery.
Today marked the formal approval of a sleep surgery fellowship here at the Keck Medicine of USC. I presented the fellowship program proposal at our Graduate Medical Education Committee with the support of key people at our institution. There was unanimous approval. I am so excited. My goal is to make this the finest academic sleep surgery fellowship program in the world, combining three components:
- clinical sleep surgery, taking care of patients
- attendance at the lectures for the sleep medicine fellowship
- training in clinical research
What Do These Components Really Mean?
Clinical Sleep Surgery. Although Keck Medical Center of USC is an academic hospital with residents there, I take care of all of my own patients. I perform the surgeries, write the orders, and answer questions from patients (and nurses when patients are hospitalized after surgery). The purpose of my fellowship is not to isolate the patients from me. Instead, I want to train fellows to make decisions with their own patients, and during the fellowship they will gradually develop their own practice. The sleep surgery fellows will truly be able to provide patient care of the highest quality, as they will have completed their surgical residency and will be selected from an outstanding group of applicants. The advantage of being a fellow is that they will be able to discuss difficult cases with me easily and involve me as a surgical assistant without worrying about trying new procedures on their own.
Sleep Medicine Fellowship Lectures. Drs. Hammond and Ward have developed a comprehensive program of lectures to provide the foundation in sleep medicine. The sleep surgery fellows will attend the adult sleep medicine lectures (and pediatric, if interested). This will provide a knowledge base in sleep medicine, although not the same clinical experience in sleep medicine. I strongly feel that my own training as a Board-certified sleep medicine physician helps me take care of patients. The purpose of having the sleep surgery fellows attend the sleep medicine lectures is to enable them to have that same broad perspective on sleep disorders.
Training in Clinical Research. Sleep surgery has seen tremendous advances just within my own 15-year career that has largely been due to high-quality scientific research. I hope I have contributed to this, but my hope also is to train surgeons to perform their own research. These are not skills that we as surgeons receive naturally, so specific research training is required. When I was on the faculty at the University of California, San Francisco, one of my mentors had started a course in clinical and translational research study design that uniquely required students to develop their own research protocol using the concepts presented in the lectures. This was application of the concept of “learning by doing”. The course remains tremendously successful at UCSF, and when I moved to USC in 2013, I ended up starting a course based on the UCSF model. We have been fortunate to draw students from across many departments and schools at USC and CHLA. Our residents in otolaryngology-head & neck surgery and the sleep medicine fellows take the course, and now we will include the sleep surgery fellow.
If You Are Interested in the Sleep Surgery Fellowship
The fellowship is only open to citizens of the United States and Canada who will be graduates of residency programs in otolaryngology – head and neck surgery. If you are interested in learning more, please contact me. I would be happy to speak with anyone in more detail. I am currently accepting applications for the 2018-19 and 2019-20 fellowship years, as often residents will plan their fellowships before their final year of training.