UWO Sleep Medicine Fellowship:
This is a one year clinical fellowship offered by the division of respirology at Western University and the
London Health Sciences Centre. The primary objective is to provide comprehensive training needed for a
career in Sleep medicine.
Graduates of this fellowship will be eligible to practice sleep medicine in the province of Ontario but
there is no formal certification exam currently offered.
This fellowship is open to trainees who have completed a Royal College training program in Respirology,
Psychiatry, or Neurology.
Faculty:
Respirology: Dr Charles George, Dr Alia Kashgari, Dr Marcus Povitz, Dr Mithu Sen
Psychiatry: Dr Jennifer Barr
Fellow duties and responsibilities:
Clinical Rotations:
1) Out-patient clinics: the fellow will manage his own patients under the supervision of the sleep
physicians. This will take place during all regularly scheduled clinics. Additionally the fellow may
be asked to see follow up patients that are of particular interest.
2) The fellow will ensure follow up on all diagnostic investigations initiated for their patients.
3) The fellow will participate in triage of new sleep medicine referrals.
4) The fellow will log his clinical encounters by diagnosis to ensure he has met the requirements
set-out by the CPSO
5) Fellows with respirology training will be required to demonstrate additional competence in the
initiation and follow up of chronic NIV for chronic respiratory failure.
Laboratory rotations:
1) Polysomnography scoring: the fellow will observe and then score raw polysomnography data for
at least 25 studies or until they reach a level of agreement with the sleep technologists that is
acceptable.
2) MSLT, MWT, actigraphy: the fellow will observe and score as many of these tests as are
performed during their fellowship.
3) Polysomnography set-up: the fellow will observe the sleep technologists setup and remove the
sensors required for polysomnography. They will then perform this task on at least 5 patients or
until they gain proficiency in the standard PSG hookup.
4) Polysomnography recordings: the fellow will attend day and night recordings to learn to trouble
shoot PSG signals.
5) Level 3 testing: currently this is not available in Ontario but the fellow is expected to develop
some familiarity with the uses and limitations of this modality.
6) CPAP initiation and titration: the fellow will attend CPAP titrations to learn the appropriate
sizing and fitting of CPAP masks and control of CPAP leak.
7) NIV titration: the fellow will attend NIV initiation and titration and should be familiar with
indications for use of NIV.
Polysomnography interpretations:
1) Once the fellow has achieved a satisfactory competence in the setup and scoring of
polysomnography they will perform polysomnography interpretations.
2) The fellow will be responsible for at least 200 polysomnography interpretations most of which
will arise during laboratory months.
3) The fellow will log all their PSG interpretations to ensure they have met the CPSO requirements.
On-Call duties:
1) No specific in house call is required.
2) The fellow will be required to spend some evenings in hospital to observe polysomnographies.
3) The fellow will be available by phone/pager for one week per rotation for questions or problems
arising during polysomnographies.
Electives:
1) No electives are mandatory during this fellowship but electives in chronic mechanical
ventilation, neuromuscular disease, pediatric sleep medicine, psychiatry, ENT surgery, clinical
psychology etc would be acceptable as long as the other requirements are met.
Presentations:
1) The fellow will be responsible for monthly journal article or case presentations at Sleep resident
rounds while on clinical service.
2) The fellow will complete 1-2 academic presentations during the academic year at Sleep
Academic Rounds.
3) The fellow will attend the presentations given by rotating residents at the completion of their
rotation when not on clinical service.
Attendance at rounds:
1) The sleep fellow will be present at sleep rounds Friday 7:30-8:30 monthly September to June.
2) The sleep fellow will attend respirology journal club when appropriate topics are presented
Mondays 8:00-9:00.
3) The sleep fellow will attend respirology city-wide rounds when appropriate topics are presented
Wednesday 4:30-6:00 September to June.