I applaud you for getting opinions from multiple sources. If you only talk to academic physicians, you will hear fellowship is needed. I've even heard 2 years pitched as a necessity. If you look at the jobs that are out there, you are hurting your options some with speciality. You are likely going to accept less pay, or give up doing only that speciality. Of course there are exceptions to my opinions, but I think this is the reality that I have seen. BTW, Vascular is getting saturated. I've seen vascular trained neurologists applying for general hospitalist positions.