One year clinical Fellowship in orthopaedic trauma which combines acute fracture care, delayed reconstruction, post traumatic deformity, arthroplasty and business education. This is currently the only trauma fellowship in the United States that provides a formal business educational program in addition to high volume clinical training. Our fellows average over 1000 cases per year; 2.5 times greater than the OTA requirements while working with three fellowship-trained orthopaedic trauma surgeons in a community-based trauma system. Because there are no residents at our facility, there is no competition for cases. Business education involves a core curriculum with hospital and practice administrators to instill the successful business management principles of large group practices and the financial considerations of hospital trauma systems. This comprehensive educational experience provides the fellow with a unique opportunity to learn the clinical, surgical, and business skills necessary to navigate the political, bureaucratic, and financial obstacles present in both private and academic practices. Combined with a robust and active research program that produces multiple publications per year, we feel this is one of the most well-rounded fellowship opportunities offering a diverse educational experience not found anywhere else.