1st yr resident very much interested in pursuing a fellowship centered around trauma/limb salvage. 

Just wanted to get some insight from my colleagues about them:  good progams,  bad ones, personal experiences, benefits of doing one, etc.  Thanks in advance!

Historically speaking there has been a paucity in post-graduate fellowship positions, and this is particularly true with our specialty.  Largely this is due to a difficulty in securing funding for fellowship positions.  Unlike resident positions, fellow positions are not funded through medicare, and therefore require funding from other sources (often industry grants, governmental grants, etc).

As to your question about "good" or "bad" fellowships, I think what matters most is to what you hope to accomplish through the fellowship.  There are a number of fellowship positions available with differing areas of focus (i.e sports medicine, Limb salvage, reconstructive surgery), and you need to select on that supports your interest and will help you accomplish your goals.  There are a number of CPME approved fellowships which can be found here.  Additionally there are a number of excellent non-approved fellowship positions, and often a Internet search is a good way to develop these leads.  As far as I am aware, there is no one source that lists every fellowship position, so you have to make your own inquiries initially.  Your upper level residents may be a good source of information, additionally, there are excellent resources, including PRESENT's Residency Insight, which often covers topics such as these.

Should you do a fellowship?  That is a little more complex, and only you can answer that.  While it is true that completion of a fellowship delays your entry into the "real world"  by another year or two, you may feel that this delay is a worthwhile sacrifice --a fellowship will provide you significant educational opportunities which are unique from your residency training encounters, and thus can prove to be an invaluable experience....

My recommendation would be to speak to current fellows and previous alumni who have completed the fellowships that you are interested in to get more specific information about the pros and cons of that specific fellowship.  Either way you'll learn something...and that is what is most important.

I highly recommend looking into the

LIMB PRESERVATION COMPLEX LOWER EXTREMITY SURGERY AND RESEARCH FELLOWSHIP

at Madigan Army Medical Center.

This is a two-year Fellowship accredited by the CPME.

http://www.mamc.amedd.army.mil/gme/documents/Residencies_Fellowships/G_LIMBPRESERVATION%20FELLOWSHIP.HTM

Also, please see this previous E-talk thread from last year.

Kevin is right, Dr. Roukis' program is a good one, as is the reconstructive surgery program at the University of Texas.  Dr. Jolly has a reconstructive Fellowship in Connecticut as well, and there are numerous others.  Ultimately, if you are considering fellowship, i would recommend speaking with someone who has/or will be completing a fellowship in your area of interest to get further information.

RHF

Also, if you are looking for a unique training opportunity while as a resident in the area of limb salvage, I recommend you check this out: Limb Salvage At the Southern Arizona Limb Salvage Alliance (SALSA).  Dr. Armstrong is an excellent mentor, and is on the cutting edge of advances in diabetic research and limb salvage.

I think there is also ones in these places that are open for all residents to apply (not exclusive to a certain residency program), though please double check:

Beth Israel Deaconess (Boston) - diabetes

Boston Medical Center (BU) - diabetes

Yale/New Haven - Diabetes

Louisville - trauma focus

West Penn (pittsburgh) - Diabetes

You really have to be an investigative reporter to figure this one out. Here are some hints on how to do your homework.
1. First of all, as a first year you don't know what you are going to need to fill out your education. What are you going to get throughout your residency program? What you don't get is what you will need to get in your Fellowship. (Also ask yourself, will you be able to perform and make a living doing trauma in your private practice? Look at the laws where you are going to practice, the type of practice you will enter, etc. to make sure you need that extra year.)

2. Visit as many of the programs as you can before you apply.

3. Talk to the fellows outside of the hearing of the attendings. Of course they will be proud of their program and they may puff it up a bit so try to ask the hard questions - numbers, do they get hands-on, if it is a two-year program who is doing the work, hours, lecture experiences, etc. Attitudes at the program. Does the attending build you up or tear you down?

4. Talk with the residents who work below the fellows. They will give you the real scoop. And don't forget the fellows who have just graduated. Track them down. They don't have anything to lose anymore! They will tell you. Have any fellows left the program before finishing and why? There has got to be a reason. It may be a perfectly good reason. Don't judge it harshly if they left for personal valid reasons. Just find out.

Good luck! By the way, Jolly's Connecticut program is great!