Evaluating Expectations of Foot and Ankle Fellowships: A Comparison Among Foot and Ankle Societies

BackgroundFoot and ankle training has evolved with the development of the fellowship curriculum. Increased specialization has enhanced management of foot and ankle pathology. Despite this, physician marketing schemes have clouded this definition.PurposeThe purpose of this study was to review and compare current foot and ankle fellowship programs (podiatric and orthopaedic) to better define what a surgical foot and ankle fellowship is, thereby more appropriately delineating between that of a preceptorship.Study Design/ MethodsA digital search was performed through online published American Orthopedic Foot and Ankle Society (AOFAS) and American College of Foot and Ankle Surgeons (ACFAS) fellowship programs. Number of programs, case volume, faculty demographics, and duration (years) were all recorded.ResultsWe identified 51 total orthopaedic programs compared with 62 podiatric programs. Both societies defined a fellowship as a year-long experience. Each had a large attending faculty-to-fellow ratio [median of 3-1 orthopaedics and 6-1 podiatric, respectively]. Average case volume digitally published per year was on average 680 (±128) cases for orthopaedics and 481 (±123) for podiatric programs. However, publishable data are scarce and hard to prove.ConclusionThe foot and ankle community should continue to vet and differentiate what constitutes "fellowship training." Improved publicly available data would allow better transparency of different types of extended training. Further studies are warranted to provide a clearer definition of "fellowship" training, thereby maintaining quality control and preventing false advertising.Level of Evidence:Level IV.