rotation and duty, curriculum, program content, and clinical experience (ACGME, 2005b). The first round of program accreditation was effective July 1, 2005, and 25 programs have received accreditation from ACGME for fellowship training.

DEMONSTRATION OF KNOWLEDGE: BOARD CERTIFICATION

ABSM Certification

In response to increasing recognition and awareness of the importance of sleep and sleep disorders, professional certification in sleep medicine has been administered for physicians and practitioners to demonstrate skill and competence.

The American Sleep Disorders Association (now the AASM) in 1978 established an examination committee. That same year, the committee held the inaugural clinical polysomnography examination; 21 candidates passed the exam. Each year the examination committee received an increasing number of applications, which led to discussions regarding the future of certification. In 1989, the AASM voted to create an independent entity, and in 1991 the ABSM was incorporated and assumed all the activities and responsibilities of the former examination committee.

The ABSM is an independent nonprofit organization and has a board of directors that oversees all aspects of exam administration and governance. The ABSM was self-designated and was not recognized by the ABMS.

Until 2005, the ABSM certification examination consisted of two parts. The part I examination consisted of multiple choice questions covering the basic sciences of sleep, clinical sleep medicine, and interpretation of polysomnogram fragments and other material. Part II was computer-based and consisted of a series of clinical cases with partial polysomnograms, Multiple Sleep Latency Tests, and other relevant data, with candidates typing short answers to questions. The ABSM decided to fuse the two parts of the examination in 2005 and offer a single-day, one-part examination that incorporates the format of both former parts.

Eligibility for the examination is dependent on a candidate fulfilling five requirements as well as possessing acceptable experience in the evaluation of sleep disorders patients. These eligibility requirements ensure adequate and proper education and training—either through an accredited fellowship program or through a combination of training and experience—and competency evaluation through certification of a primary board. Professionals from other clinical disciplines, such as doctoral psychologists and nurses who met all criteria, were also eligible to sit for the examination.

Over the past 14 years, the ABSM certification examination has developed a strong reputation in the medical community and experienced tre-



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