practice track

[cooper12]

Hi all! I'm a pgy 3 resident in internal medicine and am very interested in a career in Sleep Medicine. I wanted some more input on completing a practice track. Few questions- 1) If i complete this track at a acgme accredited sleep medicine fellowship site, would that fulfill my requirements? 2) If i complete this training in 12 months (july 2010- june 2011) will i be eligible to sit for the 2011 board exam ( the last exam to be eligle as the grandfathering process) ? 3) Will completing this pathway as opposed to an accredited fellowship limit the job opportunities that would be available? 4) traditionally, are participants given a salary during the training ? and if not, is moonlighting in your primary specialty allowed during the 12 months of training? Thanks!!!!

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[michaelrack]

The practice pathway and fellowship pathway are 2 separate ways of obtaining board elgibility.

The practice pathway is generally done in a private practice setting and NOT at an ACGME accredited sleep fellowship site.

 

[lung tiger]

I am currently a 3rd year pulm fellow who will be graduating in June of 2010. I will be joining a private practice group with a strong emphasis on sleep along with pulm/cc. They operate a 6 bed sleep center.
Is it possible for me to complete the clinical part of the sleep requirements before taking the boards in 2011 via the practice pathway?

 

[HomerSD]

It's possible that you can sit for the boards via the practice pathway, if you can satisfy their requirements for pt evals and PSGs (including MSLTs). The tricky part is that you need at least 12 months of time at the time of application, not when you actually sit for the boards. From the ABIM website:

For the first five years, the first three examinations, (2007, 2009, 2011), ABIM diplomates who have not completed 12 months of formal training in sleep medicine following training in internal medicine or a subspecialty will be eligible to apply for the sleep medicine examination if they can provide the following:
Practice Pathway A

• Attestation of 12 months of full-time post-training practice experience providing clinical care of patients with sleep disorders, accumulated over a maximum of five years prior to application for examination and involving minimum experience of evaluating 400 patients, as well as interpreting and reviewing raw data of 200 polysomnograms and 25 multiple sleep latency tests. ABIM reserves the right to audit this information. (Partial training in sleep medicine–that is, less than 12 months–will be counted on a month-by-month basis as practice experience, provided that it has not been credited toward requirements for admission to another ABIM examination.)

Practice Pathway A is open to candidates who have been in the practice of sleep medicine for a mimimum of 12 months at the time of application.

 

[lung tiger]

Per the ABIM website, the last date for registration for any subspecialty exam is June 1st. So let me make sure I understand this. I miss out on the practice pathway by ONE MONTH!!! That sucks. Please correct me if I'm wrong, and I do wish I am wrong. Can exceptions be made?
Thanks for your response by the way.

 

[michaelrack]

exceptions are usually not made. And even if you did have a full 12 months prior to the application, do you really think that you would be able to do full time sleep medicine for the full 12 months?

 

[lung tiger]

No. Who's talking about 12 months of full time sleep. That would be too boring and probably drive a person crazy. I'm talking about the board requirements which are the set amount of psg's and mslt's done over a defined amount of time (12 months). In a 6 bed private sleep center, I'm sure these requirements could have been met in a matter of several months. The mslt's may be a stretch I guess.

Anyways, I do like sleep as a complement to pulm/critical care, however, this does make things more unattractive for pulm fellows with the 6 years already put into training.

I guess the next question I have is:
How rigorous is a sleep fellowship? It can't be that hard given the workload and many call nights I've undergone.
Is it possible to work part-time for a pulm/cc group while doing this year's worth of fellowship.?

 

[michaelrack]

No. Who's talking about 12 months of full time sleep. That would be too boring and probably drive a person crazy. I'm talking about the board requirements which are the set amount of psg's and mslt's done over a defined amount of time (12 months). In a 6 bed private sleep center, I'm sure these requirements could have been met in a matter of several months. The mslt's may be a stretch I guess.

QUOTE]

The board requirement for the practice pathway is the equivalent of 12 months of full time sleep medicine. If you meet the practice pathway requirements over only 12 months, then you have to do full time sleep. If you meet the requirements over 24 months, then you could do half time sleep.

The # of psg's is usually no problem. As far as MSLT's, you could probably go back and read some old ones from your sleep center

 

[michaelrack]

How rigorous is a sleep fellowship? It can't be that hard given the workload and many call nights I've undergone.
Is it possible to work part-time for a pulm/cc group while doing this year's worth of fellowship.?

In most places, the fellowship is pretty cush- 40 hours per week

 

[lung tiger]

Thanks for your response.
40 hour workweek is not too bad. I'm used to working ~60 during my pulm/cc fellowship.

I guess the issue is if this group, which I really like (and whose clinic practice encompasses ~30% sleep) is willing to let me work for them part-time while I complete my sleep fellowship. Otherwise, I don't see how I could work for a group that is so sleep heavy w/o board certification. (All 4 members take turns reading the studies). Or am I wrong about this?

A more important issue is do I like sleep enough to spend a year more of training (with obvious delayed financial incentive)? I think I am especially if the financial rewards are there.

 

[michaelrack]

I guess the issue is if this group, which I really like (and whose clinic practice encompasses ~30% sleep) is willing to let me work for them part-time while I complete my sleep fellowship. Otherwise, I don't see how I could work for a group that is so sleep heavy w/o board certification. (All 4 members take turns reading the studies). Or am I wrong about this?

.

It depends on what compensation arrangement you have with the group. The profitable part of sleep is reading studies, the unprofitable part is seeing patients. If the group pays on an "eat what you kill" basis, they won't mind you seeing sleep patients in clinic while they read sleep studies.

Assuming the sleep lab is aasm accredited, As an unboarded doc you could only read studies if they were overread by a sleep-boarded doc. Your partners would probably not be happy doing this for you.

 

[neurologist]

Here some stats for you to chew on:

2007 pass rates for sleep board exam: (And before you ask, there is no 2008 data because there was no test given in '08.)

All takers: 73% (FYI, that was by far the lowest pass rate for any subspecialty exam -- source: http://www.abim.org/pdf/pass-rates/cert.pdf)

Fellowship trainees: 82%

"Practice pathway": 59%

The breakdown #s were offered up at a recent sleep med review course -- I suspect they are "real" and reliable.

 

[cooper12]

Per the ABIM website, the last date for registration for any subspecialty exam is June 1st. So let me make sure I understand this. I miss out on the practice pathway by ONE MONTH!!! That sucks. Please correct me if I'm wrong, and I do wish I am wrong. Can exceptions be made?
Thanks for your response by the way.

Would someone be kind enough to clarify this- If i start a practice pathway in July 2010, then i would complete my 12 month requirement on July 1 2011, If the registration deadline is June 1st, then I would NOT be able to take the exam in 2011????

 

[neurologist]

Would someone be kind enough to clarify this- If i start a practice pathway in July 2010, then i would complete my 12 month requirement on July 1 2011, If the registration deadline is June 1st, then I would NOT be able to take the exam in 2011????

I believe that is a correct interpretation. My understanding is that all training requirements must be complete prior to the registration deadline.

 

[danielmd06]

Hello gentlemen,

This question is repeatedly surfacing at my institution. Residents and Neurophys fellows at my program are asking about criteria for "grandfathering."

(1) Where can I find a website with the formal rules?

(2) Can training done during a fellowship count towards the numbers of PSG's and MSLT's required? What about residency? My previous understanding is that the answer to both is "no." Apparently, there are exceptions to this.

(3) If the final deadline for grandfathering is June 1, 2011, then can someone in general Neurology or Pulmonary practice register with less than 12 months of training if they have sufficient numbers? Especially if they have utilized a fellowship or residency to buffer the numbers?

Thank you.

Dan

 

[michaelrack]

Hello gentlemen,

This question is repeatedly surfacing at my institution. Residents and Neurophys fellows at my program are asking about criteria for "grandfathering."

(1) Where can I find a website with the formal rules?

(2) Can training done during a fellowship count towards the numbers of PSG's and MSLT's required? What about residency? My previous understanding is that the answer to both is "no." Apparently, there are exceptions to this.

(3) If the final deadline for grandfathering is June 1, 2011, then can someone in general Neurology or Pulmonary practice register with less than 12 months of training if they have sufficient numbers? Especially if they have utilized a fellowship or residency to buffer the numbers?

Thank you.

Dan

1. the info is hard to find. The ABIM and ABPN put up the requirements during the application period, and then take them down right after the application period is over.

2. My understanding is no, no

3. don't think so

 

[danielmd06]

Thank you Dr. Rack.

I found this:

http://www.abim.org/certification/policies/imss/sleep.aspx

and this:

http://www.abpn.com/sleep.htm

 

[michaelrack]

Thank you Dr. Rack.

I found this:

http://www.abim.org/certification/policies/imss/sleep.aspx

and this:

http://www.abpn.com/sleep.htm

thanks for posting the links- that abim link is great.

the abpn link gives less complete info. I would advise anyone thinking about applying for the sleep boards to check out the abim link.

 

[aylwang]

Note: Practice Pathway A is open to candidates who have been in the practice of sleep medicine for a mimimum of 12 months at the time of application. For the 2011 exam, those who completed training after June 1, 2010 cannot apply via Practice Pathway A.

 

[Phantom Spike]

What if one were to start an ACGME sleep fellowship, but not complete it? Would the completed months count towards the practice pathway? The above links seem to suggest so:

Partial training in sleep medicine - that is, less than 12 months - will be counted on a month-by-month basis as practice experience, provided that it has not been credited toward requirements for admission to another ABPN examination.

 

[aylwang]

but why would one want to start t hen stop

 

[NeuroRBD]

What can I do to be eligible for sleep boards 2011 by practice pathway??

I have about 80 PSG interpretations, 150 patients(I can get credit approved by my program director) from CNP fellowship last year. This year, I am doing Epilepsy fellowship which has some sleep but it does not count apparently. I am graduating June 30 2010. I am confused about the 'requirements', is it just the numbers of studies etc( 200 PSGs, 400 pts, 25 MSLTs) or both the numbers and 12 months fulltime duration prior to June 1st 2011?

I thought of working in a local sleep lab from July 2010 to June 1st 2011 and get the remaining volume( 120 PSGs, 250 patients and 25 MSLTs).

Am I interpreting it correctly? because, by this I can get the volume but not the '12 months' ?? Kindly share your thoughts.

PSG: polysomnograms
CNP: clinical neurophysiology

 

[michaelrack]

You won't be able to meet the requirement of 12 months. Sorry, you are out of luck unless you drop out of or complete your current fellowship early. You may want to check with the ABPN to be sure.

 

[cooper12]

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Note: Practice Pathway A is open to candidates who have been in the practice of sleep medicine for a mimimum of 12 months at the time of application. For the 2011 exam, those who completed training after June 1, 2010 cannot apply via Practice Pathway A.


This is from the ABIM website that say the deadline is June 1st, 2010, 2010 - therefore there is no option for starting practice pathway now, or even in a few months. Am i correct?

 

[cooper12]

again, thats 2010 not 2011

 

[michaelrack]

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Note: Practice Pathway A is open to candidates who have been in the practice of sleep medicine for a mimimum of 12 months at the time of application. For the 2011 exam, those who completed training after June 1, 2010 cannot apply via Practice Pathway A.


This is from the ABIM website that say the deadline is June 1st, 2010, 2010 - therefore there is no option for starting practice pathway now, or even in a few months. Am i correct?

June 1st 2010 is the deadline for STARTING the practice pathway (which you can't start until you are done with residency/fellowship training).