Department of Medicine

Pulmonary, Critical Care, and Sleep Medicine

Sleep Disorders Fellowship Program

Overview

The University of Florida Sleep Disorders Fellowship is sponsored by the Department of Medicine but will be completely multi-disciplinary.  The sponsoring academic institution is the College of Medicine of the University of Florida. The program will include 3 geographic centers all in close proximity. The centers are Shands at UF Hospital and Clinics (the major university teaching hospital), the Malcom Randall VAMC (located across the street), and Shands at AGH (affiliated hospital and location of the University Sleep Disorders Center). The University Sleep Disorders Center is an eight bed facility that has been accredited by the American Academy of Sleep Medicine.  The facility has two beds dedicated for monitoring pediatric patients. The sleep center medical director is Dr. Richard B. Berry, a Diplomate of the American Board of Sleep Medicine. Dr. Berry will also be co-director of the sleep fellowship. The other co-director is Dr. Mary Wagner, also a Diplomate of the ABSM. Dr. Wagner is the associate medical director of the UF sleep Disorders Center.

Facilities:
Shands at UF is a 600 bed teaching hospital and the major tertiary referral center for northern Florida. The hospital is on the University of Florida campus. Shands at UF clinics are located in buildings in close proximity to the hospital. The weekly Pulmonary Sleep Clinic, Neurology clinics, and biweekly Pediatric Sleep Clinic are located in the Shands at UF Clinic facilities. Didactic lectures, clinical case conferences, and journal club/research conference will be held at facilities at Shands at UF or in conference rooms at the Malcom Randall VAMC. The Malcom Randall VAMC is a 250 bed full service VA hospital and is a major teaching affiliate. A four bed sleep laboratory with state of the art equipment and a busy Thursday afternoon VA sleep clinic are located in this hospital. Durable medical equipment for treatment of sleep disorders (CPAP, Bi-level PAP) is provided by the Prosthetics Service and dispensing of the equipment, patient education, and changes in prescription pressure are performed by respiratory therapists in the VA Pulmonary, Respiratory, Sleep Section. Shands at AGH is a 300 bed affiliated hospital located about 5 minutes from Shands at UF. The UF Sleep Disorders Center occupies an entire wing on the fifth floor and consists of sleep rooms with hotel décor and state of the art monitoring equipment.  Sleep studies are read at the center or at physician offices. Facilities to read sleep studies are available at all sites.

Faculty:
The faculty for the fellowship includes members of the Division of Pulmonary, Critical Care, and Sleep Medicine in the Department of Medicine (Richard Berry and Rahul Kakkar), the Division of Pediatric pulmonary medicine in the Department of Pediatrics, the Department of Neurology, the Division of Pediatric Neurology in the Department of Pediatrics, the Division of Otolaryngology in the Department of Surgery, and the Dental School including faculty from the Division of Maxillofacial surgery.  As noted above, the co-directors of the Sleep Fellowship include Dr. Berry a pulmonologist and Dr. Mary Wagner a pediatric pulmonologist. Both are Diplomates of the American Board of Sleep Medicine. Other core faculty include: Dr. Kakkar a pulmonologist and Diplomate of the American Board of Sleep Medicine, and Dr. Stephan Eisenschenk a neurologist and expert on Epilepsy.  All of these faculty will read sleep studies with the fellows and supervise them in sleep clinics. The sleep fellow will rotate through a number of specialty clinics under the direction of non-core faculty. These Neurology clinics will include movement disorders (Dr. Hubert Fernandez), Epilepsy (Dr. Eisenschenk), pediatric neurology (Dr. Paul Carney), and dementia (Dr. David Burks). The surgery clinics include Otolaryngology (Dr. Savita Collins) and Maxillofacial surgery (Dr. Franklin Dolwick).  Rotations with Dr. Charles Smith in the College of Dentistry will familiarize the fellow with all aspects of oral appliance treatment of sleep apnea. The Department of Health Psychology will provide faculty with major interests in insomnia (Dr. Christina McCrae) and depression (Dr. Samuel Sears).  The fellow will rotate through insomnia clinics with Dr. McCrae and learn the basic aspects of neuropsychological evaluation.

Outstanding features:
This program has a number of outstanding features including a large and diverse multidisciplinary faculty, a large volume of clinical material, and ongoing funded research offering opportunities for fellow participation. The core faculty includes three Diplomates of the American Board of Sleep Medicine (Berry, Wagner, Kakkar). Dr. Berry has published several textbooks on Sleep Medicine and is an experienced educator spending 75% of his time devoted to clinical sleep medicine or research. He is frequently asked to give talks at National Meetings and Sleep Courses. Dr. Wagner is an experienced pediatric pulmonologist who devotes 75% of her time to sleep medicine. She is an expert on ventilatory support of chronic respiratory disorders. Dr. Kakkar recently finished an accredited sleep fellowship at the University of Michigan and is an enthusiastic teacher. The other core faculty member Dr. Eisenschenk is a neurologist devoting 40% of this time to sleep medicine and 60% to patients with Epilepsy. He provides valuable expertise in video PSG with extended EEG. He is director of the Epilepsy monitoring Unit at Shands at UF.    The second outstanding characteristic is a large volume and diversity of clinical material including over 2000 sleep studies performed yearly at the associated sleep centers including 400 pediatric sleep studies. The VA setting will provide an exceptional experience in learning practical aspects of positive pressure treatment of sleep apnea. All durable medical support (CPAP machines, masks, adjustments) is performed by VA respiratory therapists. This includes onsite involvement in the sleep clinic.  The VA sleep clinic also evaluates patients with narcolepsy, the restless legs syndrome, and the REM sleep behavior disorder. In the University Pulmonary Sleep Clinic the entire spectrum of sleep disorders are evaluated and treated including insomnia and circadian disorders.  This clinic sees referrals of difficult patients from all over northern Florida for second opinions. Direct experience in the use of oral appliance treatment and upper airway surgery will be provided by rotations with experienced and enthusiastic faculty. Dr. Smith (College of Dentistry) devotes his entire practice to Dental Sleep Medicine. The third outstanding feature is the opportunity of the fellows to become involved in either basic or clinical research involving sleep disorders. Dr. Berry has a VA grant to study the effects of serotonergic and noradrenergic compounds on upper airway in both humans and chronically instrumented rats.  Other clinical projects include portable monitoring, auto-titration positive pressure, and CPAP adherence studies. Dr. Christina McCrae is funded to study behavioral interventions for patients with insomnia.

For More Information Contact:
Fellowship Program Assistant
Division of Pulmonary, Critical Care and Sleep Medicine
1600 SW Archer Road, Room M452
Gainesville, FL 32608-0225
Phone: 352-846-2537
Fax: 352-392-0821