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September 25, 2018; 91 (13) Contemporary Issues: Innovations in Education

Incorporating sleep medicine content into medical school through neuroscience core curricula

Rachel Marie E. Salas, Roy E. Strowd, Imran Ali, Madhu Soni, Logan Schneider, Joseph Safdieh, Bradley V. Vaughn, Alon Y. Avidan, Jane B. Jeffery, Charlene E. Gamaldo
First published September 5, 2018, DOI: https://doi.org/10.1212/WNL.0000000000006239
Rachel Marie E. Salas
From the Department of Neurology (R.M.E.S., C.E.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.E.S.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University, Chicago, IL; Department of Psychiatry Behavioral Sciences (L.S.), Stanford University School of Medicine, CA; Department of Neurology (J.S.), Weill Cornell Medical College, New York, NY; Department of Neurology (B.V.V.), University of North Carolina School of Medicine, Chapel Hill; Department of Neurology (A.Y.A.), David Geffen School of Medicine at the University of California, Los Angeles; and Department of Biochemistry and Molecular Biology (J.B.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Roy E. Strowd
From the Department of Neurology (R.M.E.S., C.E.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.E.S.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University, Chicago, IL; Department of Psychiatry Behavioral Sciences (L.S.), Stanford University School of Medicine, CA; Department of Neurology (J.S.), Weill Cornell Medical College, New York, NY; Department of Neurology (B.V.V.), University of North Carolina School of Medicine, Chapel Hill; Department of Neurology (A.Y.A.), David Geffen School of Medicine at the University of California, Los Angeles; and Department of Biochemistry and Molecular Biology (J.B.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Imran Ali
From the Department of Neurology (R.M.E.S., C.E.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.E.S.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University, Chicago, IL; Department of Psychiatry Behavioral Sciences (L.S.), Stanford University School of Medicine, CA; Department of Neurology (J.S.), Weill Cornell Medical College, New York, NY; Department of Neurology (B.V.V.), University of North Carolina School of Medicine, Chapel Hill; Department of Neurology (A.Y.A.), David Geffen School of Medicine at the University of California, Los Angeles; and Department of Biochemistry and Molecular Biology (J.B.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Madhu Soni
From the Department of Neurology (R.M.E.S., C.E.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.E.S.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University, Chicago, IL; Department of Psychiatry Behavioral Sciences (L.S.), Stanford University School of Medicine, CA; Department of Neurology (J.S.), Weill Cornell Medical College, New York, NY; Department of Neurology (B.V.V.), University of North Carolina School of Medicine, Chapel Hill; Department of Neurology (A.Y.A.), David Geffen School of Medicine at the University of California, Los Angeles; and Department of Biochemistry and Molecular Biology (J.B.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Logan Schneider
From the Department of Neurology (R.M.E.S., C.E.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.E.S.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University, Chicago, IL; Department of Psychiatry Behavioral Sciences (L.S.), Stanford University School of Medicine, CA; Department of Neurology (J.S.), Weill Cornell Medical College, New York, NY; Department of Neurology (B.V.V.), University of North Carolina School of Medicine, Chapel Hill; Department of Neurology (A.Y.A.), David Geffen School of Medicine at the University of California, Los Angeles; and Department of Biochemistry and Molecular Biology (J.B.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Joseph Safdieh
From the Department of Neurology (R.M.E.S., C.E.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.E.S.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University, Chicago, IL; Department of Psychiatry Behavioral Sciences (L.S.), Stanford University School of Medicine, CA; Department of Neurology (J.S.), Weill Cornell Medical College, New York, NY; Department of Neurology (B.V.V.), University of North Carolina School of Medicine, Chapel Hill; Department of Neurology (A.Y.A.), David Geffen School of Medicine at the University of California, Los Angeles; and Department of Biochemistry and Molecular Biology (J.B.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Bradley V. Vaughn
From the Department of Neurology (R.M.E.S., C.E.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.E.S.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University, Chicago, IL; Department of Psychiatry Behavioral Sciences (L.S.), Stanford University School of Medicine, CA; Department of Neurology (J.S.), Weill Cornell Medical College, New York, NY; Department of Neurology (B.V.V.), University of North Carolina School of Medicine, Chapel Hill; Department of Neurology (A.Y.A.), David Geffen School of Medicine at the University of California, Los Angeles; and Department of Biochemistry and Molecular Biology (J.B.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Alon Y. Avidan
From the Department of Neurology (R.M.E.S., C.E.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.E.S.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University, Chicago, IL; Department of Psychiatry Behavioral Sciences (L.S.), Stanford University School of Medicine, CA; Department of Neurology (J.S.), Weill Cornell Medical College, New York, NY; Department of Neurology (B.V.V.), University of North Carolina School of Medicine, Chapel Hill; Department of Neurology (A.Y.A.), David Geffen School of Medicine at the University of California, Los Angeles; and Department of Biochemistry and Molecular Biology (J.B.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Jane B. Jeffery
From the Department of Neurology (R.M.E.S., C.E.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.E.S.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University, Chicago, IL; Department of Psychiatry Behavioral Sciences (L.S.), Stanford University School of Medicine, CA; Department of Neurology (J.S.), Weill Cornell Medical College, New York, NY; Department of Neurology (B.V.V.), University of North Carolina School of Medicine, Chapel Hill; Department of Neurology (A.Y.A.), David Geffen School of Medicine at the University of California, Los Angeles; and Department of Biochemistry and Molecular Biology (J.B.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Charlene E. Gamaldo
From the Department of Neurology (R.M.E.S., C.E.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (R.E.S.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University, Chicago, IL; Department of Psychiatry Behavioral Sciences (L.S.), Stanford University School of Medicine, CA; Department of Neurology (J.S.), Weill Cornell Medical College, New York, NY; Department of Neurology (B.V.V.), University of North Carolina School of Medicine, Chapel Hill; Department of Neurology (A.Y.A.), David Geffen School of Medicine at the University of California, Los Angeles; and Department of Biochemistry and Molecular Biology (J.B.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Citation
Incorporating sleep medicine content into medical school through neuroscience core curricula
Rachel Marie E. Salas, Roy E. Strowd, Imran Ali, Madhu Soni, Logan Schneider, Joseph Safdieh, Bradley V. Vaughn, Alon Y. Avidan, Jane B. Jeffery, Charlene E. Gamaldo
Neurology Sep 2018, 91 (13) 597-610; DOI: 10.1212/WNL.0000000000006239

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Abstract

Objective To present (1) justification for earmarking sleep medicine education as an essential component of all medical school curricula and (2) various avenues to incorporate sleep medicine exposure into medical school curricula through (primarily) neuroscience and neurology courses.

Methods Per consensus of a team of leading neurology and sleep medicine educators, an evidence-based rationale for including sleep medicine across a 4-year medical school curriculum is presented along with suggested content, available/vetted resources, and formats for delivering sleep medicine education at various points and through various formats.

Results Growing evidence has linked sleep disorders (e.g., sleep-disordered breathing, chronic insufficient sleep) as risk factors for several neurologic disorders. Medical educators in neurology/neuroscience are now strongly advocating for sleep medicine education in the context of neurology/neuroscience pre and post graduate medical education. Sleep medicine education is also a critical component of a proactive strategy to address physician wellness and burnout. The suggested curriculum proposes a sleep educational exposure time of 2–4 hours per year in the form of lectures, flipped-classroom sessions, clinical opportunities, and online educational tools that would result in a 200%–400% increase in the amount of sleep medicine exposure that US medical schools currently provide. The guidelines are accompanied by the recommendation for use of technological education, to facilitate more seamless curricular incorporation.

Conclusion Even in this era with limited flexibility to add content to an already packed medical school curriculum, incorporating sleep medicine exposure into the current medical school curriculum is both justified and feasible.

Glossary

AAN=
American Academy of Neurology;
AASM=
American Academy of Sleep Medicine;
LCME=
Liaison Committee on Medical Education;
RITE=
Residency In-Service Training Examinations

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 587

  • Received January 16, 2018.
  • Accepted in final form June 11, 2018.
  • © 2018 American Academy of Neurology
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Disputes & Debates: Rapid online correspondence

  • Author response to Dr. Sethi
    • Roy E. Strowd, MD, Wake Forest School of Medicine
    • Logan Schneider, BS, MD, Stanford Hospitals and Clinics
    • Charlene E. Gamaldo, MD, Johns Hopkins School of Medicine
    • Rachel Marie E. Salas, MD, Johns Hopkins School of Medicine
    Submitted October 08, 2018
  • Reader response: Incorporating sleep medicine content into medical school through neuroscience core curricula
    • Nitin K. Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center (New York, NY)
    Submitted October 03, 2018
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