Author describes his observations from two-year neurosurgical fellowship in University of Arizona, USA. During the fellowship he underwent rotations to Pediatric Neurosurgery Department at Phoenix Children's Hospital for one year, Neurosurgery Department at University Medical Center for six months, Neurosurgery Department at Veterans Affairs Hospital for three months and private neurosurgery group based on three separate hospitals for three months. Work in the particular departments is described as well as process of fellowship position obtainment and statistical data regarding fellowships and residences in neurosurgery in USA.