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Some programs like CMC and Houston Methodist are better than academic programs and routinely put people into those competitive fellowships. I know someone who went to a small community and matched to a large highly ranked plastics program. But you always want to give yourself the better chance if you think those other sub-specialties are appealing. Just think!!!Yeah this is the big hang up I have. It has nothing to do with training, but going to the community program will close some doors in that regard.
The community place has sporadically put people in Vasc, CRS, breast, etc, but it would be so much easier to land a fellowship from the university programs.