Lam Austin S, Wise Sarah K, Dedhia Raj C
1 Emory University School of Medicine, Atlanta, Georgia, USA.
2 Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA.
Otolaryngol Head Neck Surg. 2017 Jun;156(6):1025-1031. doi: 10.1177/0194599816671699. Epub 2016 Sep 27.
Objective To assess the practice characteristics of adult sleep otolaryngologists within US otolaryngology residency training programs. Study Design Cross-sectional online survey. Setting Otolaryngology residency training programs. Subjects and Methods Program directors from 106 otolaryngology training programs in the United States were contacted. Program directors were instructed to forward a survey to otolaryngologists within the institution who provided Accreditation Council for Graduate Medical Education (ACGME) Otolaryngology Milestone Project feedback in "sleep-disordered breathing." The survey assessed demographics, nonsurgical practices, and surgical/procedural practices of adult sleep otolaryngologists. Data were collected and analyzed. Results Forty-six surveys met inclusion criteria, representing 40 of 106 (38%) programs. Ninety-three percent of respondents reported that residents gained a significant portion of their sleep medicine training from themselves (ie, the respondents), yet only 36% of respondents spent ≥50% of their time on sleep medicine/surgery. Forty-one percent reported being board certified in sleep, with 18% having completed an ACGME fellowship in sleep medicine. Respondents with board certification were more likely to spend greater portions of their practice on sleep medicine/surgery, χ(3, n = 44) = 23.161 ( P < .001), treat non-obstructive sleep apnea sleep disorders (13 of 18 vs 1 of 26, P < .001), interpret polysomnograms (13 of 17 vs 1 of 15, P < .001), and perform drug-induced sleep endoscopy, χ(1, n = 43) = 5.43, ( P = .02). A similar pattern was seen with stratification by ACGME sleep medicine fellowship. Conclusion This study highlights the variance in practice patterns among sleep otolaryngologists who instruct residents. Board certification and fellowship training in sleep medicine significantly influence breadth of trainee exposure to this field. The highly disparate trainee experiences to sleep otolaryngology across US programs require attention.
目的 评估美国耳鼻咽喉科住院医师培训项目中成人睡眠医学耳鼻咽喉科医生的实践特点。研究设计 横断面在线调查。研究地点 耳鼻咽喉科住院医师培训项目。研究对象与方法 联系了美国106个耳鼻咽喉科培训项目的项目主任。项目主任被要求将一份调查问卷转发给所在机构内为研究生医学教育认证委员会（ACGME）耳鼻咽喉科里程碑项目提供“睡眠呼吸障碍”反馈的耳鼻咽喉科医生。该调查问卷评估了成人睡眠医学耳鼻咽喉科医生的人口统计学信息、非手术实践以及手术/操作实践。收集并分析数据。结果 46份调查问卷符合纳入标准，代表了106个项目中的40个（38%）。93%的受访者表示住院医师的睡眠医学培训很大一部分是从他们自己（即受访者）那里获得的，但只有36%的受访者将≥50%的时间用于睡眠医学/手术。41%的受访者报告拥有睡眠医学专业认证委员会认证，18%的人完成了ACGME睡眠医学进修项目。拥有专业认证委员会认证的受访者更有可能将其大部分实践时间用于睡眠医学/手术，χ(3, n = 44) = 23.161（P < .001），治疗非阻塞性睡眠呼吸暂停睡眠障碍（18人中有13人，26人中有1人，P < .001），解读多导睡眠图（17人中有13人，15人中有1人，P < .001），以及进行药物诱导睡眠内镜检查，χ(1, n = 43) = 5.43，（P = .02）。按ACGME睡眠医学进修项目分层时也观察到类似模式。结论 本研究突出了指导住院医师的睡眠医学耳鼻咽喉科医生实践模式的差异影响。睡眠医学专业认证委员会认证和进修培训显著影响住院医师在该领域的接触广度。美国各项目中住院医师在睡眠医学耳鼻咽喉科方面的经历差异极大，需要引起关注。
