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1. Highly recommended for Sleep Board Review
- do not pass up
American Academy of Sleep Medicine I recommend joining AASM (if you're not already a member) because of the great educational opportunities it offers. Some activities - like the national educational and board review courses - are open to all (higher fees for non-members), whereas others require membership (mainly access to the "members only" section of the AASM web site). AASM's board review offerings are listed below under national review courses, print publications, web sites and CDs. Only the specific items with internet links are HIGHLY RECOMMENDED. Study all the linked items in this category. Other, non-linked items that I mention will be listed again (with internet links) in a lower category of recommendation. a. National review courses - you can take AASM's course without being a member, at a slightly higher registration fee. See category 4, Review Courses, below. b. Print publications. The following two books, though published 3 years apart, are part of a package.
ICSD, 2nd edition, is the 'bible' of sleep medicine because it includes the official classification of sleep disorders, along with their diagnostic criteria, clinical course, pathology and pathophysiology. However, it is bereft of case examples and figures. That lack was remedied in 2008 with "Case Book of Sleep Medicine" that gives illustrative cases for almost every diagnosis. How to use these books? You should be familiar with the ICSD 2nd edition (either the regular version or the shorter ICSD 2nd edition "pocket version") and refer to it frequently, especially when studying a particular disorder, e.g. primary insomnia. I recommend reading the "Case Book" cover to cover. Some of the people who put this book together also write exam questions. The AASM Manual for the Scoring of Sleep and Associated Events, American Academy of Sleep Medicine, Westchester, IL, 2007. These scoring rules update the much older rules published in 1968 by Rechstaffen and Kales. The bottom line is you should know everything in this manual about how to score a PSG. c. Web site offerings: There is a wealth of material on AASM's web site, including lectures, journal articles, and quizzes (some requiring AASM membership). You should spend time on this site and review everything related to the board exam. As a minimum, be sure to closely study the American Academy of Sleep Medicine Practice Exams 1-6 and the new modules for sleep scoring 1-3. HIGHLY RECOMMENDED ($25 each for members). These practice exams have been updated for 2009. Some questions from the first edition of these practice tests were on the 2007 board exam!! d. Various CDs, including webinars. See more about ASSM's webinars in category 2. American College of Chest Physicians Like AASM, ACCP also publishes excellent materials for sleep board review. I don't recommend you join ACCP unless you are a chest-oriented physician, but do take advantage of their board-review offerings (higher fees for non-members). ACCP opportunities for sleep board review: a. National review courses - Many of the people who teach the AASM courses also lecture for ACCP. See category 4, Review Courses, below. b. Print publications. There are several, including the syllabus from their annual review course. However, the only HIGHLY RECOMMENDED print item is ACCP SEEK - Sleep, which was first published August 2008. SEEK provides 100 questions and answers, many with figures (PSG, actigraphy, sleep log). "ACCP SEEK - Sleep" is just the type of study guide needed for the board exam. An added plus: CME for this book is available thru December 31, 2010. (Note: Pevious versions of this web site also recommended two CDs from ACCP titled "Sleep 1 & Sleep 2: Study Lessons in Education and Evaluation of Polysomnography." These are no longer available. ACCP discontinued producing them after SEEK came out.) c. ACCP Web Site. There is some useful information on sleep for members; see category #2. American Thoracic
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2. Excellent because of Q & A format
or short reviews of sleep topics, but not as crucial to board review
as category 1
S.M.A.R.T. Sleep Exam is a web site recently revised by its author for the 2009 Board Exam. Board-certified sleep specialist Dr. Jeremiah S. Reedy (both ABSM and ABIM) is the author of all 240 multiple-choice questions. He wrote them orginally out of frustration over lack of suitable study questions when ABSM was the board exam, and has updated them for the 2009 ABIM exam. The 5 sample questions offered do seem relevant to the exam, and each comes with a short explanation and reference. Although the questions come in four modules, you have to pay for all 240 questions up front ($255, non-refundable), and the questions become unavailable immediately after the exam. I have only reviewed the 5 sample questions, but if the others are of the same type and caliber, this is probably a worthwhile study aide. Sleep Medicine Pearls, 2nd edition, by Richard B. Berry. Hanley & Belfus, 2003. Excellent case reviews by one of the physicians who wrote the board exam. If a new edition comes out before the exam, place it in the top category. Review of Sleep Medicine, by Teri Barkoukis & Alon Avidan. Butterworth-Heinemann Medical Publishers, 2007. The first section is straight text and somewhat turgid in its prose. The second section provides detailed Q&A with many polysomnograms, and should be useful for board review. AASM Webinars for Board Review. The webinars are hour-long lectures by experts in the field, originally broadcast live over the internet and now available on CD. They are no doubt worthwhile for board review, but cost is a main drawback. This set of 5 lectures is $460 for non-members ($300 for members). In 2009 AASM also came out with Webinars on Board Review Trouble Spots, including Pediatric Pulmonology and Sleep Apnea ($225/$150). Again, this is expensive for a single lecture, but if you can split the cost with a group it might be worth it. However, dollar for dollar, your money is better spent on items in Category 1, or on a single comprehensive course with many more lectures (live or on DVD). MP3 files on sleep topics from 2008 ACCP convention. In keyword search box type "sleep". You can listen to these in your car, a painless way to pick up useful information on sleep disorders. ACCP Sleep Medicine Network. As part of this network ACCP members have access to an educational slide kit to: "1) educate members of the College about sleep medicine, and (2) help members of the Sleep Medicine NetWork use their expertise to teach others about the important aspects of sleep medicine. These slides may also serve to help those who are preparing for certification examinations in sleep medicine." ATS conference recordings. Unfortunately the ATS web site is rather clunky and not user friendly for sleep board review. However, if you spend some time going over the lists of MP3 and DVD recordings of recent conferences provided in this link, you can find some interesting lectures/talks. While commuting to work I listened to many ATS lectures and picked up not only some useful information but also interesting perspectives you can't get from reading dry text. |
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3. Use as reference only - not as
primary study aide
Principles and Practice of Sleep Medicine (text + e-edition, which is a continually updated web site linked to the book). MH Kryger, T Roth and WC Dement, editors. W.B. Saunders Co. This is the standard textbook of sleep medicine. It is way over the top for any board review, and is recommended only with the e-edition for continual updates. In studying I referred to the text and companion web site frequently to review specific items, but I would not read this (or any comprehensive textbook) as sole preparation for board review. AASM Practice Parameters. These are state of the art reviews of evidence-based sleep medicine, by experts in each area. I would especially peruse the later ones (2006-2008), to get a good feel for accepted practice standards. These reprints from Sleep are available free on the AASM web site. |
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4. Review Courses
Sleep Review Courses are listed separately because they are relatively expensive and time consuming, and don't really fit any of the other categories. You can pass the exam without ever attending one, but they are very popular and, time permitting, definitely recommended (at least one). If nothing else, they focus your attention on what's important to review on your own. There are many more courses than you'll have time for, and only a few are listed here. Note also that many of these live courses are now available on DVD; while still expensive, DVDs eliminate travel and hotel costs, and can be reviewed at your leisure. If you have time for only one comprehensive course, choose either the ACCP or AASM board review course. ACCP Board Review The 2009 course will be in Phoenix, August 21-24. The 2008 ACCP course is available on DVD; see the 2009 ACCP catalogue. AASM Board Review Course. There are usually two courses offered each fall. If you register for the exam you will be receiving brochures. School of Clinical Polysomnograhpy in Medford, Oregon offers a 3 day review of polysomnography, given by Nic Butkov. I took the course and found it very helpful, mainly because Mr. Butkov is a real expert on the subject and also a very good teacher. School of Sleep Medicine, Stanford University This is probably the oldest of the comprehensive review courses. People who have attended state it is very good. The course is also available on DVD.
Atlanta School of Sleep Medicine
Offers a 3-day board review course.
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5. Recommended only if you wish to leave no stone unturned;
better to spend time on categories 1 & 2
Atlas of Clinical Sleep Medicine, by Meir Kryger, 2009. This new text, due out in October 2009, is by the senior editor of Principles and Practice of Sleep Medicine. Primer of Polysomnogram Interpretation, by Mark Pressman. Butterworth-Heinemann Medical Publishers, 2002. Sleep Medicine Secrets. Damien R. Stevens. Hanley & Belfus, 2004. Atlas of Sleep Medicine, by Sudhansu Chokroverty, Robert Thomas & Meeta Bhatt. Butterworth-Heinemann, 2005. Handbook of Sleep Medicine, by Alon Y. Avidan, Phyllis C. Zee. Lippincott Williams & Wilkins, 2006. Primary Care Sleep Medicine: A Practical Guide, by James F. Pagel and S.R. Pandi-Perumal, editors. Humana Press, 2007. From the review in JAMA (Vol. 198, 2007): "...provides primary care physicians with a suitable introduction to sleep medicine as well as with the basic knowledge reasonably necessary to recognize and treat the most common sleep disorders." Fundamentals of Sleep Technology. Nic Butkov and Teofilo Lee-Chiong, editors. Lippincott Williams & Wilkins, 2007. Sleep Medicine: Essentials and Review, by Teofilo Lee-Chiong. Oxford University Press, 2008. Sleep MultiMedia - SleepMultiMedia describes itself as: "a comprehensive computerized textbook of sleep medicine with text, sound, graphics, animation and video. This DVD-ROM based multimedia software product contains chapters on polysomnography, the physiology of sleep, chronophysiology, neurophysiology, respiratory physiology, insomnia, obstructive sleep apnea syndrome, pediatrics, narcolepsy, parasomnias, women and sleep, restless legs syndrome, epilepsy and sleep, aging and sleep, hypersomnias, and neurology and sleep; full glossary of sleep terminology; and extensive Medline references and abstracts." I put Sleep MultiMedia in this lower category because it is very expensive (several hundred dollars), is not web based, contains way more information than you need to study for the exam and, not least, the multiple choice questions after each section are rather simplistic and not relevant to what's on the ABIM board exam. Some of the tables and graphics are quite good (and I've used them in talks) and many references are provided that link directly to Medline, but I can't recommend it for primary board review. (Message to Sleep Multimedia: Make your product web-based, lower the price, and offer a specific set of questions that are geared to the ABIM sleep board exam.) Sleep Medicine Board Review is NOT geared to the ABIM exam. It is a series of quizzes downloaded from the internet, with questions made up largely from the 2005 edition of Principles and Practice of Sleep Medicine (not the e-edition, just the original hardcover text). SMBR was designed for the older American Board of Sleep Medicine exam; ABMS was heavily basic science-oriented and Ph.D.'s were also eligible for that test. The ABMS exam has been replaced by the new ABIM exam that is more clinically-oriented (only physicians are eligible to take it). I spent some time on part of these questions, and found most of them not helpful for the ABIM board review. If interested, you can purchase for download one of the sections and see for yourself. |
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6. Journals
Chest (ACCP), Sleep (ASSM) and AJRCCM (ATS) are all leading medical journals with emphasis on original research. They also publish reviews of sleep topics that can be useful for board review (including the AASM Practice Parameters mentioned in category 3). However, journals per se are a low-order priority for studying for the sleep boards. Most journal articles relevant for board review (such as the AASM Practice Parameters) are available on line. If you do want to peruse current or back issues of journals, the two I recommend are Journal of Clinical Sleep Medicine and Sleep Medicine Clinics. Journal of Clinical Sleep Medicine is included with membership in AASM. One article in JCSM you should find especially interesting is Development and Results of the First ABMS Subspecialty Certification Examination in Sleep Medicine (J Clin Sleep Med 2008;4(5):505-508). It explains how the exam was created, how it's scored, and gives the pass rates per type of examinee, (fellowship trained vs. practice experience vs. previous ABMS certification). |
I did not underestimate the test, nor should you. The pass rate of that first exam was 73%. It is a one-day, comprehensive, computer-based exam, covering clinical decision making and basic science (and a lot more pediatrics than was advertised). It is the SAME TEST for all, given under the auspices of several cooperating boards: internal medicine, family practice, pediatrics, neurology and ENT.
In preparation I took several out-of-town courses, including both the AASM and ACCP board review courses. Board review courses are worthwhile, mainly to get you out of the office, focus your attention and highlight what's important. But the most bang for your buck will be studying on your own, from materials that closely reflect what you need to know. I reviewed and studied numerous texts, CDs, DVDs and web site offerings, and found they ranged from very helpful (see HIGHLY RECOMMENDED) to a waste of time. In this web site are my recommendations of what to study (and what you can pass up) in preparation for the 2009 sleep exam. Please email me with any comments or other recommendations to larry.martin@roadrunner.com.
The 4 links below are to web sites I have authored for a general audience on sleep topics. They include patient-centered stories, plus detailed information about specific conditions such as sleep apnea, narcolepsy and insomnia. You may find the sites interesting and perhaps even informative, but they are not intended for sleep board review.
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