Orthopaedic trauma education: how many to train and how to pay for it?

Fellowship training has become an expected extension of residency. The OTA has led the way in orthopaedics with a carefully orchestrated process, which has evolved to meet the needs of the growing interest in postgraduate orthopaedic trauma fellowships. The OTA developed the Center for Orthopaedic Trauma Advancement in a time when industry support of fellowships was declining. With the growth in fellowship programs to meet the growth of fellowship applicants, quality control has become an issue. Given that every fellowship experience is unique and the lack of regulatory control for non-Accreditation Council for Graduate Medical Education programs, the OTA has initiated its own accreditation process. The purpose of this article is to discuss current trends in orthopaedic trauma fellowship education regarding how many fellows should be trained, how to adequately pay for this training, and how the current dilemmas in fellowship training could be avoided. These issues are vital to understand in the context of health policy issues surrounding orthopaedic trauma.