In 1960, the American Orthopaedic Association (AOA) established the North American Traveling Fellowship (NATF). Inspired by John Fahey, MD, the AOA NATF has served as a mechanism to stimulate an intellectual exchange of ideas and leadership in the field of orthopaedics. The NATF has since evolved into a venue whereby young orthopaedic surgeons who are commencing a potential career in academics may learn by sharing ideas regarding the current leadership and research challenges in orthopaedics. Although it has been held more frequently, the current NATF model is one in which five fellows (four American and one Canadian) are selected every odd year to travel to the East Coast, Midwest, or West Coast of the United States and Canada. Our 2005 tour was organized by Kristy L. Weber, MD (Chief, Division of Orthopaedic Oncology, Johns Hopkins University), who coordinated all of our visits on the West Coast.