ME556M.J

Sleep Disorders Medicine

Credits: 4.00 CREDITS (Clinical Elective)
Sites: BIDMC, BWH, CHMC
Directors: Thomas, Robert Joseph
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Offered: Full time for one month. Not offered in June and July.
Open to Exclerks: Yes (may be restricted for international students)
Description:
The sleep medicine elective is a flexibly structured experience that takes into account the background training of the student and their individual goals. The structure has an inner core, an outer core, and opportunities for electives.

The inner core is the adult and pediatric sleep medicine clinics at the Beth Israel Deaconess Medical Center in Boston (primarily), supplemented by the Brigham and Women's hospital-affiliated Sleep health Centers sleep clinic (Brighton) and the Children's Hospital (Boston).

The outer core consists of an exposure to sleep laboratory technology at the American Academy of Sleep Medicine accredited clinical sleep laboratories affiliated with the Beth Israel Deaconess Medical Center. This includes direct teaching by the course director during physician-attended laboratory nights that also form part of the curriculum for the ACGME-accredited sleep medicine fellowship. The student will be exposed to standard and innovative approaches to recording physiological data and management of sleep-breathing disorders.

Electives (one or two half days a week) are structured based on the interest of the candidate - dental sleep medicine, maxillofacial surgery, circadian lab, basic sleep research, functional brain imaging, advanced non-linear signal analysis, upper airway pathophysiology, hemodynamic approaches to sleep research, and the business aspects of sleep medicine.

At least one full day is dedicated reading time (no clinical activities). There are two 2-hour lectures per week that are student-specific. Learning activities thus span across attending sleep clinic, sleep laboratory, conferences (2/week), and targeted reading. Students interact closely with faculty and Fellows in the training program, and may if they choose shadow a Fellow of Faculty to appreciate "a day in the life of".
Learning Goals:
Learn basic sleep physiology and the poathophysiological basis of disease.
Understand the clinical approach and evaluation of sleep disorders, and fundalental approaches to sleep research.
learn the basics of polysomnogram interpretation.
Obtain an understanding of sleep laboratory technology.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Basic science information is incorporated in the course through formal lectures bases on the Sleep Research Society "Basics of Sleep" slide set, supplemented by slides prepared by the course director (and normally used for the ACGME-accredited sleep medicine fellowship). The students have sit down sessions twice a week (2 hours each) with the course director and work through the entire slide set. If the course director is unavailable, a board certified sleep medicine specialist or senior research scientist affiliated with the Harvard Division of Sleep Medicine will provide this teaching.

Evidence based sleep medicine is taught by reviewing (students and a board certified sleep medicine specialist affiliated with the Harvard Division of Sleep Medicine) the American Academy of Sleep Medicine's formal practice guidelines, a continuously updated series that uses standard evidence-based principles for data collection, tabulation, and interpretation.
Evaluation:
The multi-component evaluation includes:

The Final exam is 50-item multiple choice question test that spans the clinical and basic aspects of sleep medicine. A passing grade is 70%.

A written paper on any sleep-related subject, minimum 2 pages long (maximum), that requires data synthesis from multiple sources. It cannot be a smaller version of an existing and published review article.

Ability to recognize sleep stages, and major pathology on the sleep study (20 items).

Engagement of the student in the process and course of this elective will be observed by the course director (or designee if the director if out of Boston for the majority of the duration).

These elective specific evaluations will supplement the HMS evaluation forms available via MyCourses.
Grade Criteria:
High Honors:
Exam: 46 or higher

Written paper: 8 or higher on a scale of 0-10 (poorly referenced, prepared and organized/thoroughly referenced, prepared, well organized

Polysomnogram feature identification: 18 or higher

Engagement in the elective learning process: 8 or higher on a scale of 8-10 (rarely present, does not do required reading or ask relevant questions, poorly engaged with faculty / asks appropriate questions, does required and more reading, demonstrates intellectual curiosity and drive.
Honors:
Exam: 40-45
Written paper: 6-7 on a scale of 0-10 (poorly referenced, prepared and organized/thoroughly referenced, prepared, well organized

Polysomnogram feature identification: 14-16

Engagement in the elective learning process: 6-7 on a scale of 8-10 (rarely present, does not do required reading or ask relevant questions, poorly engaged with faculty / asks appropriate questions, does required and more reading, demonstrates intellectual curiosity and drive.
Satisfactory:
Exam: 30-39

Written paper: 4-5 on a scale of 0-10 (poorly referenced, prepared and organized/thoroughly referenced, prepared, well organized

Polysomnogram feature identification: 10-13

Engagement in the elective learning process: 4-5 on a scale of 8-10 (rarely present, does not do required reading or ask relevant questions, poorly engaged with faculty / asks appropriate questions, does required and more reading, demonstrates intellectual curiosity and drive.
Unsatisfactory:
Exam: less than 30

Written paper: less than 4 on a scale of 0-10 (poorly referenced, prepared and organized/thoroughly referenced, prepared, well organized

Polysomnogram feature identification: less than 10

Engagement in the elective learning process: less than 4 on a scale of 8-10 (rarely present, does not do required reading or ask relevant questions, poorly engaged with faculty / asks appropriate questions, does required and more reading, demonstrates intellectual curiosity and drive.
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