Job situation is fairly good, and improving. But it's difficult to predict future developments. Demand seems to be steadily, albeit slowly, increasing, but main variable is supply. Generally better working hours and significantly lower malpractise risk (and thus lower insurance premiums) could increase interest in path.
Re. fellowship, trend is def. towards increased specialization, and several subspec's not uncommon. If you were hiring who would you take? Somebody with a AP/CP board or somebody with a board AND subspecialization? Would you pay extra for that? Yeah. Don't have numbers, but your base, and thus future, income would prob. be sufficiently higher to warrant another year with low income and mounting debt. Also, you could take the 3-yr straight AP+fellowship and be done in four yrs. So far, most employers have preferred AP/CP but, again due to incresed specialization, that's probably going to change.