{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:53:54Z","timestamp":1782129234298,"version":"3.54.5"},"reference-count":26,"publisher":"Elsevier BV","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Education"],"published-print":{"date-parts":[[2026,5]]},"DOI":"10.1016\/j.jsurg.2026.103893","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T09:23:04Z","timestamp":1772097784000},"page":"103893","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Normalized Competitive Index: An Updated Analysis of Trends in Surgical Fellowship Training Over the Past Decade (2015-2024)"],"prefix":"10.1016","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8072-6711","authenticated-orcid":false,"given":"Cole E.","family":"Ogrydziak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik T.","family":"Criman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher G.","family":"Yheulon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jsurg.2026.103893_bib0001","doi-asserted-by":"crossref","DOI":"10.1016\/j.jsurg.2024.103409","article-title":"Fellowship by the NUMBERS: surgical fellowship applications in the United States","volume":"82","author":"Turlington","year":"2025","journal-title":"J Surg Educ"},{"key":"10.1016\/j.jsurg.2026.103893_bib0002","first-page":"187","article-title":"Early specialization in surgery: the new frontier","volume":"81","author":"Longo","year":"2008","journal-title":"Yale J Biol Med"},{"key":"10.1016\/j.jsurg.2026.103893_bib0003","doi-asserted-by":"crossref","DOI":"10.1177\/00031348251337168","article-title":"Great debates: the wave of the future vs tried and true: integrated training in surgery vs general surgery training followed by fellowship","author":"Aguayo","year":"2025","journal-title":"Am Surg"},{"key":"10.1016\/j.jsurg.2026.103893_bib0004","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jsurg.2019.07.023","article-title":"Normalized competitive index: analyzing trends in surgical fellowship training over the past decade (2009-2018)","volume":"77","author":"Yheulon","year":"2020","journal-title":"J Surg Educ"},{"key":"10.1016\/j.jsurg.2026.103893_bib0005","article-title":"Evaluating the feasibility of a normalized competitive index (NCI) to assess the competitiveness of general surgery residency","volume":"15","author":"Treffalls","year":"2023","journal-title":"Surg Pract Sci"},{"key":"10.1016\/j.jsurg.2026.103893_bib0006","article-title":"The competitiveness of orthopaedic surgery residency programs: a twenty-year analysis utilizing a normalized competitive index","volume":"12","author":"Martinez","year":"2023","journal-title":"Surg Pract Sci"},{"key":"10.1016\/j.jsurg.2026.103893_bib0007","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.avsg.2022.03.009","article-title":"How competitive are integrated vascular surgery residency programs? A ten-year comparison using a normalized competitive index","volume":"87","author":"Treffalls","year":"2022","journal-title":"Ann Vasc Surg"},{"key":"10.1016\/j.jsurg.2026.103893_bib0008","article-title":"Analyzing trends in obstetrics and gynecology fellowship training over the last decade using the normalized competitive index","volume":"2","author":"Pyskir","year":"2022","journal-title":"AJOG Glob Rep"},{"key":"10.1016\/j.jsurg.2026.103893_bib0009","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/ajt.16075","article-title":"Extinguishing burnout: national analysis of predictors and effects of burnout in abdominal transplant surgery fellows","volume":"21","author":"Kassam","year":"2021","journal-title":"Am J Transplant"},{"key":"10.1016\/j.jsurg.2026.103893_bib0010","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.jamcollsurg.2021.04.032","article-title":"Transplant Surgery pipeline: a report from the American Society of Transplant Surgeons pipeline taskforce","volume":"233","author":"Quillin","year":"2021","journal-title":"J Am Coll Surg"},{"key":"10.1016\/j.jsurg.2026.103893_bib0011","doi-asserted-by":"crossref","DOI":"10.1111\/ctr.13659","article-title":"The abdominal transplant surgery workforce: current state and future trends","volume":"33","author":"Kaldas","year":"2019","journal-title":"Clin Transplant"},{"key":"10.1016\/j.jsurg.2026.103893_bib0012","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.1016\/j.jsurg.2017.06.027","article-title":"Is it all about the money? Not all surgical subspecialization leads to higher lifetime revenue when compared to general surgery","volume":"74","author":"Baimas-George","year":"2017","journal-title":"J Surg Educ"},{"key":"10.1016\/j.jsurg.2026.103893_bib0013","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/SLA.0b013e3181ac4dfd","article-title":"Burnout and career satisfaction among American surgeons","volume":"250","author":"Shanafelt","year":"2009","journal-title":"Ann Surg"},{"key":"10.1016\/j.jsurg.2026.103893_bib0014","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1002\/jso.27101","article-title":"Breast surgical oncology fellowship applicant selection and ranking: a survey of society of surgical oncology programs","volume":"127","author":"Hedges","year":"2023","journal-title":"J Surg Oncol"},{"key":"10.1016\/j.jsurg.2026.103893_bib0015","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1177\/00031348231220574","article-title":"Colon and rectal surgery fellowship applicant and matching trends in the United States: an analysis of national resident matching Program data","volume":"90","author":"Sohail","year":"2024","journal-title":"Am Surg"},{"key":"10.1016\/j.jsurg.2026.103893_bib0016","doi-asserted-by":"crossref","first-page":"2259","DOI":"10.1007\/s00268-023-07034-0","article-title":"The virtual face of colon and rectal surgery training in the USA: an In-depth evaluation and analysis of fellowship programs website content","volume":"47","author":"Farhan","year":"2023","journal-title":"World J Surg"},{"key":"10.1016\/j.jsurg.2026.103893_bib0017","doi-asserted-by":"crossref","unstructured":"Becker ER, Xu CT, Pratt CG, et al. The lasting impact of virtual interviews on surgical fellowship applicants. Glob Surg Educ: J Assoc Surg Educ. 2024;3:90. doi:10.1007\/s44186-024-00290-1","DOI":"10.1007\/s44186-024-00290-1"},{"key":"10.1016\/j.jsurg.2026.103893_bib0018","doi-asserted-by":"crossref","DOI":"10.4293\/JSLS.2020.00080","article-title":"Ten year trends in minimally invasive surgery fellowship","volume":"25","author":"Shockcor","year":"2021","journal-title":"JSLS"},{"key":"10.1016\/j.jsurg.2026.103893_bib0019","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.jpedsurg.2021.10.055","article-title":"Success in pediatric surgery: an updated survey of program directors 2020","volume":"57","author":"Gupta","year":"2022","journal-title":"J Pediatr Surg"},{"key":"10.1016\/j.jsurg.2026.103893_bib0020","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/j.jsurg.2023.05.011","article-title":"Assessing trends in supply and demand for pediatric surgery training","volume":"80","author":"Silvestre","year":"2023","journal-title":"J Surg Educ"},{"key":"10.1016\/j.jsurg.2026.103893_bib0021","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.jss.2020.09.029","article-title":"Virtual interviews may fall short for pediatric surgery fellowships: lessons learned from COVID-19\/SARS-CoV-2","volume":"259","author":"Lewit","year":"2021","journal-title":"J Surg Res"},{"key":"10.1016\/j.jsurg.2026.103893_bib0022","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.jsurg.2022.11.004","article-title":"Comparing match outcomes in a surgical subspecialty: independent versus integrated training pathways","volume":"80","author":"Silvestre","year":"2023","journal-title":"J Surg Educ"},{"key":"10.1016\/j.jsurg.2026.103893_bib0023","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.surg.2021.03.035","article-title":"An analysis of applicant competitiveness to general surgery, surgical subspecialties, and integrated programs","volume":"170","author":"Vaysburg","year":"2021","journal-title":"Surgery"},{"key":"10.1016\/j.jsurg.2026.103893_bib0024","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.jsurg.2023.11.011","article-title":"Trends in surgical critical care fellowship match: an analysis of national resident matching Program data","volume":"81","author":"Sohail","year":"2024","journal-title":"J Surg Educ"},{"key":"10.1016\/j.jsurg.2026.103893_bib0025","unstructured":"Physician compensation report 2024. Published online 2025. https:\/\/www.doximity.com\/reports\/physician-compensation-report\/2024. Accessed Aug 1, 2025"},{"key":"10.1016\/j.jsurg.2026.103893_bib0026","doi-asserted-by":"crossref","DOI":"10.1016\/j.jsurg.2025.103466","article-title":"Changes in matches into surgical residencies and fellowships following the ACGME merger","volume":"82","author":"Soliman","year":"2025","journal-title":"J Surg Educ"}],"container-title":["Journal of Surgical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1931720426000267?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1931720426000267?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:37:50Z","timestamp":1782128270000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1931720426000267"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["S1931720426000267"],"URL":"https:\/\/doi.org\/10.1016\/j.jsurg.2026.103893","relation":{},"ISSN":["1931-7204"],"issn-type":[{"value":"1931-7204","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Normalized Competitive Index: An Updated Analysis of Trends in Surgical Fellowship Training Over the Past Decade (2015-2024)","name":"articletitle","label":"Article Title"},{"value":"Journal of Surgical Education","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jsurg.2026.103893","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"103893"}}