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.