There are several excellent community programs around the country that turn out great docs. There have been several threads on here that you should be able to find that talk about them. As far as fellowships, a lot of that is based on who knows who and can make phone calls/recommendations, so that that will vary b/t places (both academic and community). At our community program we have had several people go to "big name" fellowships recently (joints at harvard, spine at case, hand at mayo, spine in denver, shoulder at penn and columbia, trauma at carolinas, foot at Uwash and baltimore) I know when i interviewed at other community places they also had good luck with fellowshps, so i would say that you certainly can get quality fellowships coming out of a community place.