This article provides an overview of the current situation regarding domestic fellowships for young cardiovascular surgeons in Japan, based on the author's personal experience and the results of a nationwide survey. The author undertook a one-year domestic fellowship beginning in April 2023 at the Department of Cardiovascular Surgery, Fukuoka Children's Hospital. In addition to gaining extensive experience in pediatric cardiac surgery, the author had opportunities to engage in clinical research and present at academic conferences. Conducting research alongside hands-on clinical training offered valuable insights and deepened the author's understanding of various cardiac conditions. At the same time, practical considerations such as relocating with family and establishing childcare support systems required careful planning. Furthermore, a survey targeting U40 committee members was conducted to investigate the motivations, outcomes, and challenges associated with domestic fellowships. The results revealed that many young surgeons viewed domestic fellowships positively, citing benefits such as diverse clinical experience, acquisition of new knowledge, and the development of professional networks. However, several barriers were also identified, including limited access to information, personnel constraints due to institutional staffing systems, and disruptions to personal and family life. The findings suggest that enhanced cross-institutional support and improved information sharing are essential to facilitate the development of young surgical talent in Japan.