Foot and ankle fellowship training: a national survey of past, present, and prospective fellows.

BACKGROUND Surgical specialties have become increasingly subspecialized. An expanding demand for foot and ankle care administered by trained specialists has driven the need for foot and ankle-trained orthopaedic surgeons. This survey was designed to elucidate the reasons why residents choose a career in foot and ankle surgery. METHODS We conducted a national, anonymous, 11-question survey of past, present, and prospective foot and ankle fellows (156 mailed). The questions focused on trying to understand the decision-making process in pursuing a foot and ankle fellowship, and assessing the overall satisfaction of this career choice. Questionnaires were returned within one month of their mailing. RESULTS We achieved a 40% overall response rate. The fellow's relationship with their residency program's foot and ankle specialist was the primary catalyst for pursuing foot and ankle as a career. Nearly all respondents were satisfied with their decision to do a foot and ankle fellowship, though some were disappointed early in practice with remuneration, practice competition, and patient dissatisfaction. American Orthopaedic Foot and Ankle Society (AOFAS) membership was nearly unanimous. CONCLUSION The relationship established between a resident and his or her foot and ankle mentor while in training appears to have the greatest impact on pursuing foot and ankle surgery as a career. Once in practice, few trained fellows regret their decision, and few report disappointments not similarly voiced by other orthopaedic subspecialties. Based on this data, the importance of a foot and ankle rotation elective during orthopaedic residency and the impact subspecialty service attending have on resident interests and career choices seem clear.