The Jefferson Health Sleep Disorders Center is the primary clinical and academic site for the fellowship. This Center has been the focus of clinical, research, and education activity in sleep medicine since 1978 and received its first accreditation by the American Academy of Sleep Medicine (formerly known as the Association of Sleep Disorders Centers) in 1986. Fellows are assigned to this site continuously during the course of the year, where they spend approximately 90% of their time. Here, they diagnose and manage the gamut of sleep disorders, including the insomnias, narcolepsy and other disorders of excessive somnolence, sleep-related breathing disorders, parasomnias, various medical and psychiatric sleep disorders, and circadian rhythm sleep disorders. They also receive training and supervision in various modalities of treatment, including pharmacotherapy, cognitive behavioral therapy, positive airway management techniques, oral appliances, surgery, circadian realignment, and phototherapy, among others.

During their clinical hours in sleep medicine, new patients are assigned to fellows based on their availability and patient consent. Following the interview and physical and mental status examinations, the fellow presents the case to the attending physician, and a differential diagnostic assessment and strategies for evaluation and treatment are jointly formulated. The fellow’s written summary of the case, which includes the history and physical and mental status examination results, differential diagnosis, final diagnosis, and treatment plan, is reviewed by the attending physician with the fellow. The fellow is then identified as the primary physician contact for all subsequent care for that particular patient to preserve continuity of care.

On-call activity is always conducted via telephone from home, and the time dedicated to actual telephone contact with hospital staff is rarely more than one hour per week. An attending physician faculty member is assigned as backup call to the fellow for the purposes of administrative and clinical support and supervision during on-call hours.