Surgical oncology fellowships need to evolve to meet the actual career paths of graduates.

• Current selection favors research, but most trainees intend to focus on clinical practice.
• Only a small percentage of fellows achieve long-term research productivity despite extensive dedicated research time.

Adapting fellowships to include clinically intensive tracks could better prepare surgeons for today’s workforce demands.

• Proposed changes include reevaluating selection criteria to prioritize clinical skills and holistic evaluations.