Surgical subspecialties are now well established, and many surgery residents pursue fellowship training for various reasons. Fellowships can bridge the gaps found in many residency programs by providing graduating residents with opportunities to master surgical skills, gain confidence and progressive autonomy, and receive further mentorship. The experience also eases the transition to independent practice by allowing surgeons to tailor their training to coincide with personal interests and future practice goals. It is unlikely that the number of surgery residents pursuing fellowship training will decrease, so it is important to provide the infrastructure, oversight, and opportunities to meet their needs.