Is it an Ortho Foot and Ankle Problem, or a Problem of Fellowships in General?

From 2012 to 2023, overall U.S. applicants to American Orthopaedic Foot & Anke Society fellowship slots declined, with the steepest drop among male MD applicants; female applicants remained stable.

In the 2026 SF Match, 88 applicants competed for 79 positions – 46 matched, with one additional position filled post-match, for fellowship match rate of 59%.

The hard reality: Most orthopaedic fellowships don't pay off financially

A 2025 career-long financial model finds that for most orthopaedic surgeons, fellowship training costs more than it returns. Spine surgery is the lone exception – the only subspecialty with a positive lifetime return, breaking even six years post-fellowship. If your decision is purely economic, other paths to avoid include military funded education, academic practice, and trauma surgery. 

Follow the interest, not the spreadsheet

The real ROI for orthopedic surgeons: Choose a fellowship for clinical interest and lifestyle, not financial return.