Normalized Competitive Index: An Updated Analysis of Trends in Surgical Fellowship Training Over the Past Decade...

Area of Science:

• Surgical Education
• Medical Subspecialties
• Surgical Residency Training

Background:

• Subspecialty training is increasingly common for General Surgery residents.
• The normalized competitive index (NCI) quantifies fellowship competitiveness.
• Understanding fellowship competitiveness aids prospective applicants.

Purpose of the Study:

• To provide an updated analysis of surgical fellowship competitiveness using the NCI.
• To compare the competitiveness of various surgical subspecialties against each other and over time.

Main Methods:

• Retrospective cohort study analyzing National Resident Matching Program (NRMP) data from 2015-2024.
• Calculated the competitive index (CI) as percentage of programs filled divided by match rate.
• Normalized CI (NCI) to a baseline of 1 for standardized comparison.

Main Results:

• Over the past decade, Pediatric Surgery (NCI 1.43) and Minimally Invasive Surgery (NCI 1.24) were significantly more competitive.
• Surgical Critical Care (NCI 0.64) was significantly less competitive.
• Thoracic Surgery's competitiveness increased, while Pediatric Surgery and Complex General Surgical Oncology decreased from 2015-2019 to 2020-2024.

Conclusions:

• The NCI is a valuable metric for assessing surgical fellowship competitiveness.
• Annual NCI data could assist applicants and programs in the matching process.