which a substantial portion of the sleep medicine training is embedded within the primary specialty training.

The guidelines for accreditation of fellowship training required that programs provide graduates with clinical, technical, and research experience that promotes sound clinical judgment and a high level of knowledge about the diagnosis, treatment, and prevention of sleep disorders. The guidelines emphasized education in specific content areas, including basic neurological sleep mechanisms; chronobiological mechanisms; cardiovascular, pulmonary, endocrine, and gastrointestinal sleep physiology; specific disorders of sleep; and the psychopharmacology of sleep, as well as the operation of polysomnographic equipment, polysomnographic interpretation, and troubleshooting.

Eligibility requirements for an accredited program include at least one year of training preceded by the completion of an accredited residency program, and sponsorship by an institution that meets fellowship training requirements set forth by the ACGME. The director of the program must be a physician who is a diplomate of the American Board of Sleep Medicine (ABSM), and the program has to be associated with a sleep disorders center accredited by the AASM.

Completion of training in an accredited program satisfies requirements for eligibility to sit for the sleep medicine certification examination administered by the ABSM.

ACGME Sleep Medicine Fellowship Training Programs

In 2002, the AASM submitted an application to ACGME for accreditation of fellowship training programs in sleep medicine. ACGME approved the program requirements for sleep medicine fellowship training programs in June 2004. Accreditation of fellowship training programs by the ACGME now provides a framework for the continued expansion of specialized clinical training in sleep medicine and draws greater attention to the necessity of training programs.

The ACGME fellowship requires 1 year of clinical sleep medicine. Trainees can enter the sleep medicine fellowship if they have been trained in one of the following: general internal medicine (3 years of postgraduate training); neurology (4 years of postgraduate training); psychiatry (4 years of postgraduate training); general pediatrics (3 years of postgraduate training); otolaryngology (5 years of postgraduate training).

In June 2004, ACGME convened a Sleep Medicine Working Group to develop requirements for fellowship training in sleep medicine and formalize the accreditation process. The working group created a comprehensive program guideline that included requirements to ensure competence in core areas, including facility and resources for training, faculty, assignment of

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