Fellowships in regional anesthesiology and acute pain medicine (RAAPM) have grown exponentially during the past decade, both in terms of total programs and fellows trained. This survey-based study reports fellowship graduates' assessment of the strengths and weaknesses of their training and how the fellowship has affected their careers.Graduates of North American RAAPM fellowships were asked to participate in a 16-question survey designed to describe their training and subsequent career. Academic anesthesiology department chairs were simultaneously surveyed to determine how the RAAPM components of their residency training programs are staffed and organized.Graduate and department chair response rates were 59% and 44%, respectively. During the past decade, significant improvements have occurred in peripheral nerve block, perineural catheter, and acute pain medicine training. Many fellowship graduates note less robust educational experiences in research and the nontechnical aspects of the subspecialty.The results of this study should prove useful to fellowship directors as they refine the educational offerings of their programs.