The path for physicians to become credentialed sleep medicine specialists has changed in many ways in the last few decades. Currently, sleep medicine is recognized as an independent subspecialty with appropriately rigorous and comprehensive training required to become a board-certified sleep medicine physician. However, added time for requisite fellowship training, coupled with an aging sleep medicine physician workforce, have had the unintended consequence of decreasing the number of sleep medicine physicians at a time when the demands for sleep medicine care continue to rise. Thus, new training pathways that provide flexibility to trainees, while ensuring high-quality, comprehensive, and multidisciplinary sleep medicine training are needed to maintain a workforce that can meet the sleep health needs of the present and future. Here, we describe two pilot programs that apply principles of competency-based medical education to sleep medicine fellowship training. These novel models are likely to attract additional well-qualified physicians to the field who might otherwise not pursue a career in sleep medicine.