AIRE Pilot Programs: Innovative Sleep Medicine Training

Issue Date: October 17, 2022
Full Application Due Date: January 9, 2023
Award Selection Notification: February, 2023
Period of Performance: 2023-2024 Academic Year
Amount of Award: $10,000 to $100,000 (dependent on model)
Application Format: Electronic submission with all materials and inquiries sent by e-mail to the address below.
Contact: Sally Podolski
Fax: 630-737-9790

Sleep Medicine AIRE Pilot: Question and Answer

Learn more about the Advancing Innovation in Residency Education (AIRE) Pilot Program and the advantages it offers. Members of the Innovative Fellowship Models Advisory Panel (IFMAP) answer questions about the program and the application process.

Is Blended Sleep AIRE (Advancing Innovation in Residency Education) Right for My Program?

This session will discuss the background and current status of the AIRE Blended Model Sleep Program, which is available to Adult Pulmonary/Critical Care fellows and Pediatric Pulmonary fellows. The nuts and bolts of applying and maintaining a program will also be explained. After the webinar, interested programs can request to be paired with a mentor who implemented an AIRE program at their site.

Fresh AIRE: Advancing Innovation in Sleep Medicine Training

Listen to this episode of the Talking Sleep podcast for a discussion of the AIRE innovative fellowship training pilot programs in sleep medicine. Program directors and fellows discuss the benefits of the blended and part-time models.

The American Academy of Sleep Medicine (AASM) is seeking sleep medicine fellowship training programs that are interested in participating in innovative pilot programs as part of the Advancing Innovation in Residency Education (AIRE) initiative. Approved by the Accreditation Council for Graduate Medical Education (ACGME), these sleep medicine pilot programs are testing innovative models of graduate medical education that emphasize competency-based training methods. Selected institutions will test training and assessment tools developed by the AASM through two novel fellowship training pathways:  a part-time model and a model blending sleep training with additional specialty training. The AASM will provide funding for required additional training slots to participate in the pilot.

Currently, sleep training occurs predominantly in a time-based model with a focus on process and structure as fellows are required to score a fixed number of polysomnograms, interpret a set number of sleep studies and manage a pre-determined number of patients. This is counter to the trend in medical education for competency-based training. In addition, despite success in establishing > 80 fellowship training programs since recognition of sleep medicine in 2005, current workforce projections show the number of new board-certified sleep medicine physicians is unlikely to keep up with projected losses from retirement much less increase the number of sleep specialists.  A major barrier to training additional sleep physicians is the added time required for training on top of other specialty and subspecialty training. Novel training pathways are needed to lower barriers to obtaining sleep medicine training.

ACGME established the Advancing Innovation in Residency Education (AIRE) program in an attempt to catalyze innovation in graduate medical education (GME).  The AASM submitted a proposal to develop alternate training pathways utilizing a competency-based curriculum and uniform evaluation tools.  Education committees within the AASM have developed a standardized competency-based curriculum for training sleep medicine fellows to allow comparison of achievement of curricular-based milestones of clinical competency across training programs. Competency-based assessment tools will be provided to participating programs to accomplish the comparisons. A component of the proposal is exploration of the feasibility of alternate training pathways, including a Part-Time Model and a Blended Model allowing concurrent training in sleep medicine and another related subspecialty.

The overall goal is to improve the quality and safety of delivered health care through innovation in fellowship training. Specifically, participants in this pilot will implement alternate training pathways utilizing a competency-based curriculum that allows it to be blended with other fellowship training programs with overlapping knowledge and skills (i.e. pulmonary diseases, pulmonary critical care medicine, pediatric pulmonology) or accomplished on a part-time basis and compare these pathways with a traditional time-based sleep medicine fellowship model. A second goal will be to validate standardized competency assessment tools, based on the ACGME Milestones Report framework, that have been developed and disseminated by AASM.

Participating programs must meet the following eligibility criteria:

  • An ACGME accredited sleep medicine fellowship program in good standing
  • Division/Department willingness to utilize AASM-provided standardized competency assessment tools for fellows in both innovative pathways and standard pathway.
  • Ability and capacity to add an additional fellow slot
  • For participation in the Part-Time Model, agreement to allow variable completion dates, not to exceed 2 years from the starting date.
    • Fellows participating in the Part-Time Model must have board certification or board eligibility through the American Board of Internal Medicine, American Board of Pediatrics, American Board of Psychiatry and Neurology, or the American Board of Otolaryngology – Head and Neck Surgery.
  • For participation in the Blended Model
    • Related ACGME accredited fellowship program (adult pulmonary medicine, adult critical care medicine, pediatric pulmonology) in good standing.
    • Agreement from related subspecialty to participate and adjust fellow’s schedule to allow completion of both fellowships.

Interested programs should provide the following:

  • Completed application form
  • Support letter from sleep medicine Program Director and Division/Department Chief
  • For programs applying for the Blended Model, a support letter from the Program Director and Division/Department Chief of the related fellowship program (adult pulmonary medicine, adult critical care medicine, pediatric pulmonology) will be required before completion of the selection process.
  • Support letter from Institution’s Graduate Medical Education leadership/Designated Institutional Officer (DIO)
  • CV of sleep medicine Program Directors
  • For programs applying for the Blended Model, CV of the Program Director of the related fellowship program (adult pulmonary medicine, adult critical care medicine, pediatric pulmonology)
  • Program Status Form

Applications will be submitted to the AASM’s Innovative Fellowship Model Advisory Panel, which will oversee this program.  This group is composed of program directors, former program directors or persons with needed educational leadership experience from nonparticipating sleep medicine fellowship programs. The AASM’s Board of Directors will give final approval to the Committee’s recommended selections.

The AASM will provide up to a total of $4 million dollars over 5 years to cover fellow salary and benefits, and the costs of development and implementation of the competency-based assessment tools. Institutional indirect costs are not allowed under this award.

For a fellow participating in the Part-Time Model of training, the AASM will provide the equivalent salary and fringe to a fellow participating in the traditional pathway of training at that institution, up to $100,000.

For a fellow participating in the Blended Model of training, the AASM will provide $10,000 per year to programs during the first 3 years of blended training. If a fellow is not able to achieve competency in sleep medicine and their pulmonary (adult/pediatric) fields, the AASM will provide the equivalent salary and fringe for up to an additional year of fellowship training to provide additional time to achieve competency, up to $100,000.

Initial programs selected for the pilot went live as of AY2019/20.