Fellowship Directory

Centralizing Sleep Surgery Fellowship Information

It is my fourth year of clinical otolaryngology training, and this is the time to decide on what type of fellowship to pursue, if any. My decision was straightforward, as I am lucky to have completed a two-year National Institutes of Health (NIH) T32 research fellowship with Dr. Edward Weaver, a well-established sleep surgeon. I was drawn to sleep surgery because of the vast research opportunities and, more importantly, it is a field ripe for my research interest in shared decision-making. Guided by my research interests and other notable highlights of sleep surgery from Dr. Raj Dedhia, I begin the much anticipated process of applying for sleep surgery fellowship.

The ISSS aims to create a comprehensive sleep surgery fellowship directory to centralize information and to support applicants in making the right choice in fellowship. Similar to shared decision-making in the clinical setting, where patients are given information to decide what option best aligns with their preferences and goals, we have designed the directory to be easy to access, to provide comparisons side-by-side, and to filter by different program features.

Additionally, there is a growing number of sleep surgery fellowships in the United States. Often learning about these new opportunities is by word of mouth, so we hope this directory will alleviate this barrier and widen the applicant pool. Furthermore, the ISSS recognizes that it is not uncommon for trainees to train abroad for fellowship, and there are strong reasons to consider this opportunity. Thus, this directory is aimed at the interests of this broader fellowship applicant pool.

As a trainee, I have had the pleasure of meeting other trainees going through the application process and observing them train at their respective programs. I have also kept in touch during their early career stage and learned from their reflective perspectives. Synthesizing their experiences and advice, here are a few key aspects of fellowship to consider when applying:

• Trainees, who have completed otolaryngology training in the United States, are familiar with the ACGME-accreditation. Similar to residency, there are some ACGME-accredited fellowships (often the hybrid sleep medicine/sleep surgery programs), and there are non-ACMGE accredited fellowships (typically sleep surgery only). Sleep surgery only fellowships provide exposure to advanced sleep surgery techniques – however, fellowship trainees are not eligible to sit for the sleep medicine board exam. Conversely, the hybrid sleep medicine/sleep surgery programs have designated sleep medicine colleagues and provide training in reading sleep studies. Among U.S. trainees, there is a trend towards the ACGME-accredited programs.
• Surgical case load. In the hybrid sleep medicine/sleep surgery programs, at least 30% of the trainee’s time will be spent with sleep surgery. There are different ways this time can be spent, including time in the operating room. Every sleep surgeon’s practice is different, and exposure to different surgical techniques is variable. Types of surgical cases are often divided into nasal, pharyngeal (soft tissue), skeletal (MMA, palatal), and device implantation. There are nuances even within these buckets if trainees are interested in expertise in certain techniques, such as with exposure to multiple different device implants. Other influencing factors are the number of sleep surgeons, number of co-fellows, and surgical volume of the site.
• Recent graduates. If you want the “boots on the ground” perspective of a program, there is no better perspective than that of current and past fellows. Programs with a track record of sleep surgery fellows are often used as a marker for a good program, in terms of having a framework. However, programs that have not had fellows recently, or are new, have their own appeal in that an incoming fellow would pioneer their training and with strong mentor support, would likely have customized training. Our hope is this directory will foster these relationships.
• Sleep medicine exposure. If pursuing a hybrid sleep medicine/sleep surgery fellowship, you will be spending time with sleep medicine. Before pursuing, it is important to determine if sleep medicine exposure interests you, to what extent you are interested in this robust training, and the importance of integration/comradery of the two divisions.
• Last but not least, life outside of work seemed to be a common consideration among applicants. What does life look like when you are not working? Personal ties and family considerations? Can you imagine spending a year, or two, living in said location?

Over the six years in training and with one more to go, I have come to realize that every individual resident has a different residency training experience. It is impossible to control for every change in the schedule, adjust for more intense experiences, or account for unique cases during certain rotations. Thus, selecting the right fellowship program is very individualized to one’s own experiences and aims for fellowship. From my perspective, there is no perfect or best fellowship program – but there is the right fellowship, at the right time, for you.

Enjoy the journey!