Every hospital varies in their placement of residents into fellowships, and is sometimes specialty dependent. For example, surgery- an academic hospital will likely have fellows in various subspecialties- as a resident in surgery, your likelihood of scrubbing in those cases decrease drastically, and time with cases may be shortened due to hospital academic requirements. However, some academic hospitals also prefer to accept home-grown residents, and to an extent other academically trained residents, so acceptance into their fellowship programs are good as long as you are an overall dependent resident. Academic hospitals will likely have good research structure to also become involved in to enhance your applications, as well as providing connections not available to isolated community hospitals. However, some community program with specialty services may not have fellowship training programs have residents functioning as fellows as early as PGY-3. University affiliated community programs tend to have a good mix of both. Every hospital differs, so its best to inquire each individual hospital's fellowship placement rates.
