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A Delphi-Based Consensus Statement on Podiatric Foot & Ankle Surgery Fellowships: Proceedings of the 2025 Montana
Thomas S Roukis1, Christopher F Hyer2, James M Cottom3
1Rothman Orthopaedic Institute, Orlando, Florida.
Abstract:
Despite the popularity of podiatric foot and ankle surgery fellowships, a clearly agreed-upon consensus statement is lacking. We elected to develop a consensus statement on podiatric foot and ankle surgery fellowships and report the results of the 2025 Montana Fellows Working Group proceedings. Forty-six podiatric foot and ankle surgery fellowship-trained surgeons participated in a process based on a modification of the Delphi method of achieving consensus. Initial statements generated that received >70% strongly agree/agree responses proceeded to a final vote of agree/disagree. The strength of consensus was characterized as follows: consensus 51% to 74%, strong consensus 75% to 99%, and unanimous 100% in favor of a proposed statement. All voting was conducted anonymously and with equal weight among participants. Of the final 15 consensus statements voted on, 6 achieved unanimous consensus, 7 strong consensus, and 2 consensus. We achieved consensus for statements pertinent to podiatric foot and ankle surgery fellowships that can be summarized as follows. First, fellowship training can only occur after graduating from a podiatric residency and should be 12 months long. Second, podiatric fellowships should ideally be devoid of industry sponsorship, can occur worldwide, should be sponsored through a combined private practice and academic center of excellence/university setting and should consist of direct "hands-on" clinical and operating room experiences. Finally, the primary purpose of podiatric fellowships is to obtain the highest level of subspecialized training, which is ideally coupled with student/resident education and involves scientific research, thereby becoming a "content expert" in their subspeciality.Levels of Evidence:V, Expert opinion-Decision Analysis.
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