Top programs: Duke, HSS, Virginia Mason
I know some of these posts are a few years old, but times are changing for sure. Since acute pain/regional fellowships will be ACGME accredited in the next 2-3 years, regional fellowships are becoming much more competitive. Two programs at which I interviewed showed that their fellows are all above the 90th percentile on their ITE's, so the idea of regional fellowships attracting sub-par applicants is inaccurate. In my residency program, we do a TON of blocks, but we still have a good number who still want to do a regional fellowship to add to their CV in an anesthesia market that is moving toward hiring fellowship-trained personnel.
I would highly recommend doing an acute pain/regional fellowship if you enjoy procedures and a fast-paced working environment.