Sleep Medicine Fellowship Through Psychiatry: Program Fit Guide

Sleep Medicine Fellowship Through Psychiatry: Program Fit Guide

Sleep medicine is one of the few fellowships where a psychiatry background is genuinely competitive rather than merely tolerated. The field sits at the intersection of neuroscience, behavioral medicine, and physiology—and psychiatry training builds real competency in at least two of those three domains. This page works through program fit systematically: how to identify programs where your background strengthens your application, what to look for and avoid, and how to construct a rank list that reflects honest self-assessment rather than prestige anxiety.

Why Sleep Medicine Attracts Psychiatry Residents

The draw is usually not convenience. Psychiatry residents rotating through sleep clinics routinely encounter something that shifts their clinical thinking: the recognition that sleep architecture, circadian biology, and wake-state regulation are not peripheral to psychiatric illness but mechanistically entangled with it. Mood disorders, psychotic disorders, anxiety, PTSD, and substance use all carry sleep disturbance as a core feature—not a symptom cluster to hand off. Residents who notice this and want to work the problem at both levels are the applicants sleep programs describe as well-motivated.

Psychiatry training also builds competency in cognitive-behavioral therapy for insomnia (CBT-I), motivational interviewing for PAP adherence, and the longitudinal management of patients with complex comorbidity. These are genuine clinical skills, not rhetorical talking points, and programs with a behavioral sleep medicine orientation will recognize them as such.

Where the motivation is less durable: residents who view sleep medicine primarily as a lower-acuity exit from psychiatric call, or who are drawn by lifestyle perceptions without having sat through a polysomnogram interpretation session or managed a patient's CPAP titration failure. Sleep medicine has its own procedural and cognitive demands. The honest question—addressed in the self-assessment section below—is whether you are moving toward sleep or away from psychiatry.

How Psychiatry-Sponsored vs. Multi-Specialty Sleep Programs Differ

Sleep medicine fellowship programs are accredited by ACGME and share a common set of core competency requirements, but their departmental homes shape culture, caseload emphasis, and the implicit hierarchy of what counts as sophisticated work.

Psychiatry-Anchored Programs

Programs housed within or co-led by psychiatry departments tend to weight behavioral sleep medicine heavily. Insomnia, hypersomnia with psychiatric comorbidity, circadian rhythm disorders, nightmare disorder, and PTSD-related sleep disturbance will occupy a larger fraction of the clinical caseload. CBT-I may be delivered by fellows directly rather than delegated entirely to psychology. Research infrastructure frequently includes mood-sleep interaction studies, trauma and sleep, and psychopharmacology effects on sleep architecture. If your residency produced strong behavioral and psychopharmacologic reasoning, these programs allow you to build on existing scaffolding rather than starting from zero.

Pulmonology- and Critical Care–Anchored Programs

These programs developed historically from the respiratory medicine side of sleep. Their clinical volume is often dominated by sleep-disordered breathing—obstructive and central sleep apnea, obesity hypoventilation, PAP titration, and DISE (drug-induced sleep endoscopy) coordination with ENT and surgical colleagues. Fellows from internal medicine and pulmonology backgrounds are culturally normative here. A psychiatry applicant is not disqualified, but the learning curve on respiratory physiology and procedural interpretation is steeper, and the faculty may have less direct experience mentoring someone from your background. These programs can be excellent training environments if you want comprehensive respiratory sleep exposure, but fit assessment requires more active due diligence.

Neurology-Anchored Programs

Neurology-based programs frequently emphasize hypersomnolence disorders—narcolepsy, idiopathic hypersomnia—and movement disorders in sleep (RLS, PLMD, REM sleep behavior disorder). The neurophysiology of polysomnogram interpretation tends to receive more explicit teaching attention here. Psychiatry applicants with strong neuroscience backgrounds or interest in neurodegenerative sleep phenotypes may find genuine intellectual alignment. The overlap with movement disorder neurology and REM sleep behavior disorder as a prodrome to synucleinopathies can be a specific research hook worth exploring.

True Multi-Specialty Programs

Some programs are formally multi-departmental, with co-sponsorship across pulmonology, neurology, and psychiatry. These programs often offer the broadest caseload and intentionally recruit fellows from diverse specialty backgrounds. The tradeoff is that mentorship may be diffuse and institutional culture around behavioral sleep medicine can vary by attending. Interview questions about how prior psychiatry fellows have been mentored—and what they went on to do—are especially high-yield at these programs.

What Sleep Fellowship Programs Look For in Psychiatry Applicants

Programs evaluating psychiatry applicants are answering a specific question: can this person handle the full scope of sleep medicine practice, including the components their residency did not cover? Your application needs to address that question directly rather than hoping it won't be asked.

Clinical Exposure That Transfers

• Documented sleep clinic time. Any exposure to a sleep medicine clinic—even elective rotations, consultation experience, or moonlighting in a sleep lab—is meaningful. List it precisely on your application. Elective months in sleep medicine during residency are the single highest-yield preparation step available to you.
• PSG interpretation exposure. If you have read polysomnograms under supervision, say so explicitly. If you have attended sleep lab overnight studies or observed titration protocols, document it. Programs need evidence that the learning curve on technical interpretation is not starting from zero on day one of fellowship.
• Behavioral sleep medicine practice. Residents who have delivered CBT-I, managed insomnia systematically rather than pharmacologically by reflex, or worked with PTSD patients on nightmare-focused protocols have a concrete clinical story to tell.
• Comorbidity management. Psychiatry residency typically produces strong longitudinal comorbidity reasoning. The ability to hold a patient's OSA, treatment-resistant depression, and psychotropic-related weight gain as a single integrated clinical problem is a real competency. Frame it as such.

Research Readiness

Programs vary in how heavily they weight research experience, but any scholarly activity in sleep-adjacent domains strengthens your application. Relevant prior work includes mood-sleep interaction studies, CBT-I outcome research, circadian biology in psychiatric populations, or psychopharmacology effects on sleep architecture. Even a poster presentation from a sleep research rotation counts. The key is that it signals genuine engagement with sleep science rather than a career pivot made at the last moment.

Board Eligibility and Examination Pathway

Sleep medicine board certification requires completion of an ACGME-accredited sleep medicine fellowship. Psychiatry is among the eligible base specialties for the sleep medicine subspecialty examination. Programs know this and will not treat your base specialty as a technical obstacle. What they are evaluating is whether you have used your residency to build toward sleep medicine or whether you are arriving without prior investment in the field.

Core Clinical Fit Signals: Do You Belong in Sleep?

The following questions are designed to produce honest self-assessment, not interview preparation. Answer them privately before you construct your application strategy.

• Have you found yourself spending extra time in sleep clinic during electives, or did you rotate through to check a box?
• When you encounter a patient with treatment-resistant depression, is your first instinct to ask about sleep architecture and circadian phase, or does sleep feel like a downstream variable?
• Are you genuinely curious about the neurophysiology of state transitions—wake, NREM, REM—or does PSG reading feel like a technical chore you are willing to tolerate?
• Do you want to manage CPAP adherence, device titration, and the practical engineering of sleep-disordered breathing treatment over a career, or does that feel like a detour from what you actually want to do?
• If behavioral sleep medicine (CBT-I, circadian interventions, nightmare protocols) were removed from your practice, would the remaining scope still feel like a career you want?

If several of these questions produce discomfort rather than clarity, it is worth examining whether sleep medicine is the right destination or whether a consultative or collaborative role—seeing sleep patients within a psychiatry practice—might be a more honest fit. Fellowship training is a significant commitment, and programs can usually detect ambivalence across an interview day.

Research Fit: Aligning Your Scholarly Focus with Program Priorities

Sleep medicine fellowship research mentorship is most productive when there is genuine overlap between what you want to study and what the program's faculty are actively funded to pursue. The following map is not exhaustive, but it covers the intersections most relevant to psychiatry-trained applicants.

Mood-Sleep Bidirectionality

The relationship between sleep disturbance and mood disorder recurrence, treatment response, and suicidality is an active research domain. Programs with faculty publishing in this area—often housed in psychiatry or psychology departments—are natural fits for applicants with clinical or research exposure to affective disorders. Look for faculty with NIMH or AHRQ funding in this space; their grant abstracts are publicly searchable.

Insomnia and CBT-I Outcomes

CBT-I efficacy, implementation in non-specialty settings, digital delivery, and stepped-care models are active areas with substantial NIH funding. Programs affiliated with behavioral sleep medicine psychologists or with health services research infrastructure may offer mentorship here. Psychiatry applicants with prior CBT training have a natural entry point.

Circadian Rhythms in Psychiatric Populations

Circadian biology in schizophrenia, bipolar disorder, and major depression—including light therapy, chronotherapy, and social zeitgeber theory—sits squarely at the psychiatry-sleep interface. Programs with circadian core facilities or affiliated chronobiology labs are worth identifying specifically if this is your research direction. Academic sleep centers affiliated with research universities are more likely to have this infrastructure than community-based programs.

PTSD and Sleep

Nightmare disorder, sleep-disordered breathing in trauma-exposed populations, and the interaction between PTSD hyperarousal and insomnia are areas of active VA and DoD funding. Programs with VA affiliations and faculty working in trauma-related sleep disorders are worth targeting if your residency produced PTSD-focused clinical or research experience.

REM Sleep Behavior Disorder and Neurodegeneration

If your interest extends toward the neurology-sleep interface, REM sleep behavior disorder as a synucleinopathy prodrome is an area with significant longitudinal research infrastructure at several academic centers. Psychiatry applicants with neuroscience backgrounds can find genuine fit here, though the research mentorship will typically be neurologist-led.

Before applying to any program, identify two or three faculty members whose published work you could credibly discuss and whose ongoing work you could contribute to. Generic research interest statements are detectable and unconvincing in a small fellowship match.

Reading a Sleep Program's Website and Fellowship Directory Listing

Program websites and ACGME fellowship directory listings are imperfect but readable sources of fit information. The following decoding framework applies specifically to sleep medicine programs evaluated by a psychiatry applicant.

Departmental Home and Leadership

Identify which department administratively houses the program director. A pulmonologist program director does not disqualify the program for psychiatry applicants, but it sets a prior: the training culture and implicit norms will reflect that specialty's values. Cross-list the faculty and look for explicit sleep psychiatry or behavioral sleep medicine appointments.

Lab Volume and Caseload Descriptions

Programs that describe caseload in terms of PSG volume, MSLT/MWT numbers, and titration nights are signaling a procedural and technical emphasis. Programs that describe caseload in terms of diagnostic complexity, behavioral management, or psychiatric comorbidity are signaling a different emphasis. Neither is wrong; the question is where your interests and deficits fall.

Faculty Backgrounds

Look up individual faculty on PubMed and the program's departmental page. What are they publishing? What are their board certifications? Is there a behavioral sleep medicine psychologist on the faculty or in a close affiliate relationship? Programs with embedded or closely affiliated behavioral sleep medicine psychologists tend to offer stronger CBT-I training and are more likely to have deliberately considered how to train psychiatry fellows.

Prior Fellow Outcomes

Where did recent graduates go? Academic medicine, community practice, VA, or research positions? Programs that list prior fellow placements—and whose graduates have gone into academic behavioral sleep medicine or psychiatry-affiliated sleep practices—have a demonstrated track record with the kind of career trajectory you may be considering.

ACGME Program Information Forms

The ACGME Accreditation Data System (ADS) is publicly accessible and contains basic program information including size, accreditation status, and program director contact. It does not contain detailed caseload or culture information, but it confirms accreditation status and program continuity—relevant for smaller programs that have had accreditation variability.

Geographic and Lifestyle Fit Considerations

Sleep medicine fellowship is a one-year commitment. Geographic considerations interact with career trajectory in specific ways worth thinking through before rank-list construction.

Call and Night Coverage Structure

Sleep labs operate overnight, and fellow involvement in overnight studies varies substantially by program. Some programs require fellows to be present for or available during overnight PSG and titration studies as part of technical training; others have separate overnight technical staff and expect fellows to interpret studies during daytime hours. Understanding the overnight call structure before you rank a program is not a lifestyle question—it is a training content question. Ask explicitly during interviews.

Procedural Exposure: DISE and Surgical Coordination

Drug-induced sleep endoscopy (DISE) is a procedural assessment for surgical candidates with OSA, conducted in coordination with ENT or oral-maxillofacial surgery. Not all programs offer substantial DISE exposure, and psychiatry applicants will not arrive with procedural airway experience from residency. If you intend to practice in a setting that manages surgical referrals, programs with active surgical sleep medicine partnerships offer training that community programs may not.

Academic vs. Community Program Tradeoffs

Academic programs affiliated with research universities offer richer research mentorship, more complex caseloads, and greater exposure to rare diagnoses (narcolepsy type 1, idiopathic hypersomnia, fatal familial insomnia in the extreme), but they may have more administrative complexity and less clinical autonomy during fellowship. Community-affiliated programs often offer higher procedural volume, more direct patient management responsibility, and practice patterns that align with non-academic career trajectories. For psychiatry applicants who already know they want to practice behavioral sleep medicine in an outpatient setting, a community program with strong CBT-I infrastructure may be a better fit than a large academic program where the fellow is a junior member of a research hierarchy.

Geographic Considerations and Career Networks

Sleep medicine is a small specialty. The networks formed during fellowship—with faculty, co-fellows, and affiliated specialty colleagues—disproportionately shape early career opportunities. Matching in a geographic region where you intend to practice long-term provides relationship capital that is difficult to replicate from a distance. This consideration is worth weighing explicitly in rank-list construction, especially for applicants with family or practice location constraints.

Crafting a Fit Narrative in Your Personal Statement

The personal statement for a psychiatry-to-sleep application must accomplish two things simultaneously: establish genuine intellectual and clinical motivation for sleep medicine, and preemptively address the technical competency gap that programs will be thinking about. Attempting the first without the second produces a statement that reads as incomplete. Attempting the second without the first produces a defensive document that undermines itself.

The Origin Story Framework

A credible origin story for a psychiatry-trained sleep medicine applicant is not "I realized sleep was important to mental health"—that is true of every psychiatry resident and is not differentiating. A credible origin story is specific: a patient whose treatment-resistant depression resolved only after polysomnography identified severe sleep apnea, a research question that emerged from noticing that your bipolar patients' circadian disruption was neither addressed nor measured in their standard care, a mentor who works at the sleep-psychiatry interface and whose practice model you want to build toward. Specificity is the signal. Generality is the noise.

Addressing Technical Readiness Without Overexplaining

Acknowledge your training background directly—do not bury it—and then immediately describe the steps you have taken to build toward sleep medicine specifically. A sentence or two on elective rotations, PSG interpretation experience, or CBT-I training is sufficient. The goal is to preempt the competency question by answering it before it becomes a worry, not to spend half the statement apologizing for being a psychiatrist.

Connecting to the Specific Program

If you are submitting to programs with meaningfully different emphases, your statement should reflect awareness of that difference. A statement submitted to a psychiatry-anchored behavioral sleep program should not read identically to one submitted to a pulmonology-anchored program with high OSA surgical volume. Tailoring is not superficial; it demonstrates that your interest in a specific program reflects genuine fit assessment rather than broadcast application strategy.

Letters of Recommendation: Who Should Write for a Psych-to-Sleep Applicant

Letter strategy for a psychiatry-to-sleep applicant requires deliberate balancing. The two competing needs are: letters that can speak to your clinical and academic quality with specificity (typically from psychiatry attendings who know your work well) and letters that can speak to your readiness for sleep medicine specifically (typically from sleep faculty who have observed you in the relevant context).

The Ideal Portfolio

A strong letter set for this application typically includes at least one letter from a sleep medicine faculty member who has directly supervised you—on an elective rotation, in a research collaboration, or in a consultation service. This letter addresses the competency question directly and carries high signal weight precisely because the writer can speak to specialty-specific performance rather than general impressiveness. If you do not yet have this relationship, building it before your application cycle is the single highest-leverage preparation step available to you.

The remaining letters should come from psychiatry attendings who know your work deeply and can speak with specificity about clinical reasoning, scholarly productivity, and professional character. A letter from a prominent faculty member who supervised you briefly is worth less than a letter from a mid-career attending who can describe your performance on ten specific clinical encounters.

Who Not to Ask

Letters from writers who will describe you in generic terms—hardworking, compassionate, strong team player—consume a slot without contributing information. Programs in a small match can read the difference between a letter written by someone who knows you and a courtesy letter from someone who agreed to write because you asked. Ask people who will write something that could only be about you.

Navigating the Specialty Mismatch

Some psychiatry departments have no formal relationships with sleep medicine faculty, and arranging a meaningful elective or research experience requires initiative. Reaching out directly to sleep medicine programs at your institution or at nearby academic centers, proposing a defined elective or research contribution, is a normal and respected step. Sleep medicine faculty are generally aware that psychiatry residents rotate through their services less frequently than pulmonology or neurology residents, and an unsolicited but well-prepared elective request is not unusual.

Program Cultures That May Be a Poor Fit for Psychiatry Backgrounds

The following patterns—identifiable through websites, fellowship directory listings, and interview-day observation—suggest a program where a psychiatry-trained fellow may face more friction than average. None are disqualifying in isolation, but multiple signals in combination warrant honest evaluation.

• Exclusively respiratory-procedural caseload emphasis. Programs that describe their training almost entirely in terms of OSA volume, titration nights, and DISE procedures, with minimal mention of insomnia, hypersomnolence, or behavioral management, are signaling a training culture built around pulmonology and surgery. A psychiatry fellow can complete the ACGME requirements here, but may spend the year in a perpetual catch-up posture on technical skills while finding little institutional support for the aspects of sleep medicine where their training is an asset.
• No prior psychiatry-trained fellows in recent history. Ask directly during interviews whether the program has trained psychiatry residents previously. A program that has never done so is not impossible, but you will be building the template for how they handle your background, and the mentorship infrastructure for your specific training needs may be underdeveloped.
• No behavioral sleep medicine faculty or affiliated psychologist. A program without anyone on faculty or in close affiliate relationship who practices behavioral sleep medicine is unlikely to offer the CBT-I training depth that represents one of psychiatry's genuine entry advantages. You would arrive with a CBT-I orientation and find no one to develop it further.
• Faculty publication record concentrated entirely outside psychiatry or behavioral science. Faculty research interests shape what fellows learn to think about. A program where every faculty member publishes exclusively in respiratory physiology, surgical airway management, or PAP device engineering will produce fellows who think about sleep medicine primarily through that lens. Whether that aligns with your career trajectory requires honest self-assessment.

Note: the above describes program-side culture patterns that represent a structural mismatch for a specific applicant profile. This is fit analysis, not a judgment about program quality.

Questions to Ask During Interviews to Assess Real Fit

These questions are designed to elicit concrete information about program culture and mentorship. They are not small talk. Use the answers to update your rank-list decisions, not to perform interest.

"Have you trained psychiatry residents in this fellowship previously, and where are they practicing now?"

Why this works: It is specific, it is answerable, and the answer tells you whether the program has thought through your training needs or whether you would be the first case they have managed. A confident, detailed answer is a positive signal. Hesitation or a redirected answer is information.

"What fraction of your clinical caseload involves patients with primary psychiatric comorbidity, and who manages that component—the sleep fellow, a consulting psychiatrist, or a co-management model?"

Why this works: This asks directly about the clinical scope you care about and reveals whether the program treats psychiatric comorbidity as central to sleep medicine or as something to refer out. A program that refers all psychiatric complexity to a separate service limits your ability to practice the integrated model you are training toward.

"How is CBT-I delivered in your program—by fellows directly, by embedded psychologists, or primarily by referral?"

Why this works: It establishes whether you will develop CBT-I competency during fellowship or simply know it exists as a referral option. For a psychiatry-trained applicant, this distinguishes programs that will build on your skills from those that will work around them.

"What does your PSG interpretation curriculum look like in the first month—is there a structured ramp-up, or are fellows expected to arrive reading-ready?"

Why this works: It is honest about your starting point without being apologetic, and it asks about pedagogical intentionality. Programs that have structured their technical onboarding are more likely to succeed with fellows who arrive with strong behavioral but limited technical preparation.

"Who would serve as my primary research mentor, and what are their active funded projects?"

Why this works: Research mentorship in a one-year fellowship is easily underprovided. A program that can name a specific mentor with specific funded projects has thought about this. A vague answer about "opportunities" is a signal that research mentorship is aspirational rather than structured.

"What is the overnight call structure—are fellows expected to be present for overnight studies, and how is that organized?"

Why this works: Legitimate training content question. The answer shapes the technical exposure you will receive and the scheduling demands of the year.

"How do program faculty think about the role of sleep medicine in the management of patients with serious mental illness—is it integrated into the program's training philosophy, or is it a niche?"

Why this works: This is an open-ended question that lets faculty reveal their framing. Enthusiastic engagement suggests genuine alignment; polite deflection to "we see all comers" suggests it is not a priority the program has thought through.

"What have fellows gone on to do after graduation, and are there faculty here who practice in an academic behavioral sleep medicine setting I could shadow or work with?"

Why this works: Career outcomes data is the most honest signal about what a program actually produces. If no graduates have gone into behavioral sleep medicine or psychiatry-affiliated sleep practices, that is not disqualifying, but it is meaningful information about the program's career pipeline.

Ranking Strategy for the Sleep NRMP Match

Sleep medicine fellowship matches through the NRMP as a subspecialty match. The pool is small relative to most fellowship matches, and psychiatry applicants are a minority within it. This creates specific strategic considerations.

Rank Honestly for Fit, Not Prestige

In a small match, a poor fit at a prestigious program produces a miserable fellowship year and an underdeveloped skill set in the domains that matter for your career. A well-fit program at a less prominent institution produces a fellow who emerges competent, well-mentored, and professionally positioned. Prestige in a one-year fellowship is not nothing, but it is much less important than it is in residency, where brand effects on career outcomes are more established. Rank the program where you will be best trained for the career you actually want, not the program with the best department name.

Do Not Over-Concentrate on a Single Program Type

If your rank list is exclusively psychiatry-anchored programs, you may be concentrating fit signal appropriately, or you may be narrowing your match probability unnecessarily. The correct approach is to evaluate each program on its actual characteristics—faculty, caseload, mentorship, culture—rather than using departmental home as a proxy for fit. Some pulmonology-anchored programs have strong behavioral sleep medicine infrastructure; some psychiatry-anchored programs have thin procedural training. Individual program characteristics dominate departmental affiliation as fit signals.

The Fit Assessment Before You Rank

Before finalizing your rank list, you should be able to answer the following for each program you are ranking: Who would mentor my research? Who would supervise my CBT-I practice? What is the overnight structure? Have they trained psychiatry residents before? If you cannot answer these questions, you have not done enough due diligence to rank that program confidently. Interview season is the time to collect this information.

Lower-Ranked Programs Are Not Consolation Prizes

In a small fellowship match, a program ranked lower on your list because it is geographically inconvenient or less prominent is still a program you evaluated as a genuine fit and a place where you could be trained well. Do not rank programs you would not be proud to attend. A rank list that includes programs you would decline is a list that can hurt you without strategy benefit.

After the Match: Setting Yourself Up as a Psychiatry-Trained Sleep Fellow

Matching is the beginning of the fit question, not the end. How you enter fellowship shapes whether your psychiatry background becomes an asset or a source of imposter friction.

PSG Interpretation: Build Before Day One

If you have access to sleep study interpretation software or teaching cases before fellowship begins—through your current institution's sleep medicine service, through your program's pre-fellowship orientation, or through published teaching resources—use it. Arriving with basic AASM scoring criteria internalized reduces the cognitive load of the first weeks and signals preparedness to your supervising faculty. This is not about performance; it is about having enough technical headspace free to learn the clinical reasoning layer on top of the technical layer simultaneously.

PAP Titration and Device Management

PAP device management—initiation, troubleshooting, residual event interpretation, adherence support—is a clinical domain that psychiatry residency does not teach. It is also one that requires accumulated experience with specific device types and software. Identify early in fellowship which attending or respiratory therapist is the program's resource for PAP management and build that working relationship intentionally. This is not weakness acknowledgment; it is efficient adult learning.

Leveraging What You Bring

Psychiatry training produces clinical skills that sleep medicine fellows from other backgrounds frequently lack: systematic motivational interviewing for PAP adherence, longitudinal comorbidity management, comfort with the ambiguity of chronic illness, and facility with behavioral interventions. These skills are most visible and most valued when you deploy them intentionally rather than assuming other fellows share them. Early in fellowship, demonstrating these competencies in clinical settings—rather than waiting for them to be solicited—establishes your value to the program and to patients.

Relationship-Building Across Specialty Lines

Sleep medicine is inherently multi-specialty in its referral patterns. Build relationships with the pulmonology, neurology, ENT, and oral surgery faculty and fellows you will encounter during the year. These relationships are professionally valuable in practice and are also the fastest route to learning the clinical reasoning of specialties whose perspective your training has not yet provided. The best sleep physicians think fluidly across the respiratory, neurological, and behavioral dimensions of sleep pathology. Fellowship is the time to build that fluency.

A Note on Board Preparation

The sleep medicine subspecialty board examination tests content across the full scope of sleep medicine practice, including respiratory physiology, neurological sleep disorders, and technical PSG interpretation, in addition to behavioral and psychiatric sleep medicine. Fellowship-wide study groups that include fellows from pulmonology and neurology backgrounds offer access to explanatory knowledge you may not acquire through clinical experience alone. Invest in those relationships early.