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Vocational Training
Respiratory
and Sleep Medicine (cont.)
SLEEP
MEDICINE
Definition of Specialty
Sleep
medicine encompasses sleep breathing disorders, disorders of daytime somnolence,
insomnias, parasomnias, disorders of chronobiology, and neurological and psychiatric
disorders affecting sleep. Sleep medicine is a cohesive blend of: clinical knowledge
of sleep disorders; knowledge of the basic sciences of normal and disordered sleep
processes; experience with specialised diagnostic techniques, tests and procedures
employed in clinical assessment; and expertise in the management of all clinical
sleep disorders.
Levels of
Training
There are 2 levels of training in sleep medicine that lead
to qualification to practise sleep medicine:
| Level 1: | 12
months core training in sleep medicine for advanced trainees, to enable them to
have a proportion of clinical practice in sleep medicine and to report sleep studies
(this may include 3 months training achieved during the course of a general respiratory
core year); | | Level
2: | 3 years training (2 core years plus an approved complementary
year) for advanced trainees to enable them to have clinical practice predominantly
or solely in sleep medicine, and to pursue a full time career in the speciality
of sleep medicine. |
Advanced Training Program
in Sleep Medicine - LEVEL 1
General Principles
of Training - Completion of level 1 advanced training in sleep
medicine qualifies advanced trainees to have a substantial clinical practice
in sleep medicine (e.g. manage sleep apnoea syndromes and more complex sleep-related
breathing problems), and is also required to apply for credentialling for
reporting sleep studies (as required by the Health Insurance Commission in
Australia).
- Twelve months of training
in clinical sleep medicine is necessary.
- For respiratory medicine
trainees this may be undertaken as an approved complementary year within the 3
years of advanced training in respiratory medicine, although 3 months of the 12
months may be undertaken during the 2 years of core training in clinical respiratory
medicine (as the mandatory 3 months of training in sleep medicine).
- Advanced
trainees from non respiratory medical disciplines may be eligible to undertake
level 1 training, provided there is a clear demonstration of at least one year
of relevant background advanced training in an appropriate complementary discipline
(e.g. neurology) and that the proposed program involves a substantial component
of respiratory sleep disorders. Where an advanced trainee has no complementary
training a period of 2 years of core training may be required.
- Training
may be undertaken as post FRACP supervised training in sleep medicine.
- It
may be undertaken in Australia, New Zealand or overseas.
- Successful completion
of level 1 training will enable trainees to reach a satisfactory level of competence
to report sleep studies.
- No more than 20% of core clinical training towards Level 1 Sleep Medicine
may be spent in research activities.
Core Training
Clinical Sleep Medicine
Quality training should
include a wide exposure to all common sleep disorders including sleep breathing
disorders; disorders of daytime somnolence; and other non respiratory sleep disorders.
Trainees will be expected to have a detailed practical knowledge of - sleep
physiology;
- the instrumentation, recording, scoring techniques and
interpretation of polysomnographic studies.
They will need to obtain
detailed experience and skill in the management of sleep breathing disorders
(including CPAP and non-invasive ventilation). They should also be familiar with
the diagnosis and
management of non respiratory sleep disorders.
It is desirable that training
should be undertaken in a multi-disciplinary sleep disorders service.
Procedural Skills
Essential Procedural Skills:
Full polysomnography, MSLT, MWT, overnight oximetry and transcutaneous CO2 monitoring,
CPAP and non-invasive ventilation.
Other
Specific Requirements - The trainee's supervisor(s) will confirm
in their written report(s) that a full 12 months of training has been spent in
the clinical areas of sleep medicine outlined in the program or 9 months, if 3
months are undertaken during the 2 core years of training in respiratory medicine.
- A sufficient number of procedures must be performed to allow the trainee
to develop competence in these procedures. Competence will be assessed on the
basis of the written assessment by supervisors, and by interview to assess the
trainee's experience and competence. A logbook of procedures will be required
to support the assessment of experience.
- Modules are proposed to
be developed between 2002 and 2005 and may be required as part of the overall
assessment of training and competence.
Training
Sites
See "Training Sites"
section under Advanced Training Program in Sleep Medicine - Level 2.
Sleep Medicine next
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