Traditionally, your feelings re. ped surg would have been correct. However, there is a dwindling applicant pool for the field & they're in real danger (like CTVS already is) of having more spots then applicants. I think last years #'s were up a very slight amt. but the trend is a little worrisome over the last decade. Many people in the past have felt pressure to do 1-2 years if lab time for many of the subspecialty fellowships, but frequently it's becoming less & less neccessary to match. For the most selective of the ped surg fellowships, I bet most successful applicants have as you said done lab time. As you get out into the second tiers of programs, the quality (on paper) of the candidates falls a bit