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How to Become an Orthopedic Surgeon: Training, Licensing, and Certification Requirements
Admissions Consulting • Internships Abroad • Medicine • Physician Assistant • Pre-Medicine • Pre-Nursing • Pre-PA • Residency • Study Abroad

How to Become an Orthopedic Surgeon: Training, Licensing, and Certification Requirements

by internationalmedicalaid

Last Updated March 16, 2025

How to Become an Orthopedic Surgeon?

Anyone who has sprained an ankle, broken an arm, or dislocated a kneecap will attest to the importance of a good orthopedist. This kind of medical doctor is both a physician and a surgeon. The orthopedic doctor works to prevent, diagnose and treat afflictions of the bones, ligaments, joints, muscles, and tendons. In short, orthopedic surgeons deal with the entire musculoskeletal system. Performing surgery to correct damage or injury, these specialists also put broken bones into position to heal optimally. They prescribe medication for pain and the reduction of degenerative diseases like arthritis and osteoporosis. They also prescribe physical therapy for post-surgical patients.

Those who are considering a future career in orthopedic surgery will complete many years of undergraduate education (with, perhaps, pre-med internships), medical school, internship and residency before they can practice. Nevertheless, there are many rewards, especially for students who enjoy the biological sciences and abundant human interaction. The satisfaction of healing bodies and enabling them to become more mobile, flexible and strong is immense. Furthermore, orthopedists receive highly competitive compensation compared to doctors and other professions. Treating musculo-skeletal traumas and diseases can be complicated and demanding so there is little doubt that orthopedic surgeons earn their pay.

Is an Orthopedic Surgeon the Same as a Chiropractor

While some orthopedic doctors may employ chiropractors — or partner with them on occasion — they are very different professions in approach and in training. Chiropractic aims to allow the body to heal itself through the precise alignment of the musculoskeletal system. This optimal positioning is achieved by manual manipulation of — primarily — the spine and its vertebrae. Other therapies vary by individual chiropractors. Many patients visit a chiropractor for back pain relief due to sports injuries, car accidents or strain from household tasks. Chiropractors are licensed after a minimum of three years in college and the completion of a four-year Doctor of Chiropractic (D.C.) degree at an accredited chiropractic college.

As noted, an orthopedic surgeon is a medical doctor (M.D.), the training of whom can be traced back to Hippocrates in ancient Greece. By contrast, chiropractic training originated with David Palmer in the late 1800s. As an MD, the surgeon approaches disorder and disease from multiple perspectives, alignment being just one. Orthopedic surgery embraces the germ theory of disease, considering bacterial and viral infections, biochemical imbalances and genetic conditions. This more comprehensive understanding of human infirmity is why orthopedic doctors must spend many more years in training.

How Many Years Does It Take to Become an Orthopedic Surgeon?

To get into medical school, prospective students must have earned a bachelor’s degree from an accredited college or university — usually four years of study, more or less. A course load heavy in science and pre-med internships increase the probability of acceptance. Medical school takes another four years, during which the aspiring doctor is drilled into basic sciences, including anatomy, biochemistry, physiology, and genetics. Clinical rotations follow this preliminary education in the standard medical specialties, e.g., surgery, medicine, obstetrics and gynecology, radiology, psychiatry, and neurology. Scholarly research is also mandated while students take electives in areas of interest.

With a medical degree in hand, a newly minted doctor can look forward to five years of on-the-job training as an intern and a resident with a hospital program — the first couple of years in general surgery before moving on to orthopedic procedures. During this time, they work alongside attending physicians in learning how to become an orthopedic surgeon.

Taking patient histories, evaluating conditions, assisting in surgery and conducting post-operative follow-ups are just a few of the tasks involved. This is a physically and emotionally taxing period in the aspiring orthopedist’s career, yet essential to gaining professional competence and patient rapport. Some doctors opt for fellowships or study abroad to gain expertise in a variety of sub-specialties like hand surgery, pediatric orthopedics or orthopedic oncology. 

That is 13 to 15 years of higher education.

Educational Journey

Becoming an orthopedic surgeon is a challenging and highly rewarding path that demands academic excellence, hands-on training, and personal resilience. In addition to the foundational knowledge acquired during undergraduate and medical school, aspiring surgeons must navigate a series of clinical experiences that shape their professional abilities and prepare them for the demanding nature of orthopedic practice.

Undergraduate Preparation and Early Exposure

The journey begins at the undergraduate level, where students build a strong foundation in the biological sciences. A deep engagement with subjects like biology, chemistry, and physics is essential to understanding the human body’s complexities.

During this phase, engaging in research projects provides dual benefits: strengthening scientific reasoning and offering exposure to clinical environments. Early experiences shadowing physicians or participating in healthcare internships enrich a student’s perspective on the challenges and rewards of a medical career. These formative years enhance medical school applications and instill an early appreciation for the intricate balance between theory and practice.

Beyond academic achievements, developing strong communication and interpersonal skills is vital. Students who engage in extracurricular activities, such as student organizations or volunteer work, learn to work effectively in teams and manage time efficiently. These experiences help create a well-rounded profile that will later serve as a foundation for the complex interactions inherent in patient care.

Medical School: Building a Solid Clinical Foundation

Once admitted into medical school, students transition from theoretical studies to a more hands-on approach in both classroom and clinical settings. The early years focus on mastering the core sciences—anatomy, physiology, biochemistry, and genetics—essential for understanding musculoskeletal health.

As students progress, clinical rotations become the cornerstone of their training. During these rotations, they gain practical experience in diagnosing and managing various conditions, with surgery and emergency medicine exposure.

In clinical rotations, students learn not only about musculoskeletal injuries but also about the dynamics of patient interaction. They begin to understand the nuances of physical examinations, imaging techniques, and pre-operative and post-operative care. This stage is pivotal for reinforcing theoretical knowledge through real-world application and developing the confidence needed to perform under pressure.

Residency and Fellowship: Mastering the Craft

Following medical school, the next phase is residency in orthopedic surgery—a period that transforms theoretical knowledge into surgical expertise. Residency is an immersive experience where newly minted doctors work under the guidance of experienced surgeons. The initial years are focused on general surgical principles, providing a comprehensive foundation that is later specialized in orthopedic procedures.

During residency, physicians refine their skills in the operating room by gradually assuming more responsibilities. They learn the art and science of patient management, from pre-operative assessments to post-operative care. This period is as much about understanding the technical aspects of surgery as it is about developing the ability to communicate effectively with patients and colleagues, an essential component for ensuring high-quality care.

Many orthopedic surgeons further refine their expertise by entering fellowship programs. These programs offer in-depth training in subspecialties such as pediatric orthopedics, sports medicine, or orthopedic oncology. In a fellowship, the focus shifts to mastering specialized techniques and handling complex cases, allowing surgeons to develop a refined approach tailored to specific patient needs. The fellowship experience deepens technical proficiency and fosters a more nuanced understanding of patient care, ensuring that practitioners are well-equipped to tackle even the most challenging cases.

Balancing the Challenges and Rewards

The career of an orthopedic surgeon is characterized by intense challenges and significant rewards. High-stress situations are a daily reality in the operating room, where split-second decisions and precise actions are essential for successful outcomes. This pressure necessitates a calm, focused mindset—a quality that is developed through training and continuous practice. Aspiring surgeons learn to deftly maneuver these pressures by drawing on their extensive clinical training and support from mentors, who guide them during particularly demanding moments.

Equally important is the challenge of maintaining a healthy work-life balance. The demanding nature of residency and early career practice can easily encroach on personal time, making it essential for surgeons to establish clear boundaries between their professional and personal lives. Effective time management and a commitment to self-care enable orthopedic surgeons to sustain their energy and focus, ensuring long-term success in a career that requires both physical and mental stamina.

The rewards of this profession are multifaceted. Beyond the financial benefits, among the highest in the medical field, the intrinsic satisfaction of alleviating pain and restoring mobility to patients is profound. The impact of a successful surgery extends far beyond the operating room, influencing the overall quality of life for those who have suffered from debilitating injuries or chronic conditions. This balance between the challenges and the deeply rewarding outcomes is what continues to attract new talent to the field of orthopedics.

Future Trends and Opportunities in Orthopedics

Orthopedic surgery constantly evolves, offering exciting opportunities for those entering the field. With ongoing advancements in diagnostic techniques and surgical methods, musculoskeletal care approaches are becoming increasingly refined. Emerging trends are pushing the boundaries of what is possible, allowing for more precise and individualized treatment plans that cater to each patient’s unique needs.

Global health initiatives also present new avenues for professional growth. Many orthopedic surgeons are increasingly involved in international outreach, providing care in regions with limited specialized medical services. These opportunities broaden a surgeon’s clinical experience and contribute to the global improvement of healthcare standards. Working in diverse environments challenges surgeons to adapt and innovate, further enhancing their skill sets.

Furthermore, integrating entrepreneurial ventures within orthopedics creates additional career pathways. Some surgeons are channeling their expertise into developing innovative medical devices or starting specialized practices focusing on niche care areas. This entrepreneurial spirit fosters an environment of continuous improvement and collaboration, driving advancements in both clinical practice and medical technology. As a result, today’s orthopedic surgeons are not only practitioners but also pioneers in the ongoing evolution of healthcare.

By embracing these trends and opportunities, orthopedic surgeons can continue to enhance their clinical practice while contributing to the broader field of medical science. This seamless integration of clinical expertise with innovative approaches ensures that orthopedics’ future remains dynamic and patient-focused.

What About Licensing and Certification?

Physicians must pass a three-part national licensing examination before residency commences. This exam tests medical knowledge and patient care aptitudes. After residency is finished—and any fellowships or study abroad programs are over—a doctor must practice for two years before sitting for a certification examination administered by the American Board of Orthopedic Surgeons. This extensive inquiry includes both computer-based and oral components.

The former consists of 320 multiple-choice questions; the latter is a Q&A analysis of the surgical procedures in which the candidate participated during residency. Failure to pass the oral exam mandates that the candidate must re-take the computer exam before another oral test is scheduled.

To be clear, a licensed surgeon must not be board-certified to practice orthopedics. Still, recognizing professional competence and integrity accorded by a jury of peers helps to establish the doctor as a reliable and worthy practitioner. It conveys comfort to prospective patients, making the surgeon more competitive in the marketplace.

In fact, certification carries such weight that it requires renewal through board evaluation, continuing education, and subsequent examination. These measures help to ensure that the orthopedic surgeon is up to date on all the advances in the art and science of surgical practice. Because new research and innovations continue to flourish, clinical practitioners must remain aware of them and deft in their employment.

Who Hires Orthopedic Surgeons and How Much Do They Earn?

A plurality of orthopedic surgeons (over 35 percent) work with a private practice group, while 11 percent opt for solo practice. These doctors are “on staff” at hospitals — i.e., having privileges to use facilities and staff — but are not directly employed by the institutions, as 17 percent of their colleagues are. Others work in academia, for HMOs or with government agencies and the military services. According to Forbes Magazine, their average annual salaries are among the highest for medical doctors: $519,000 per year.

Are Future Prospects Good for This Specialty?

Like most medical professions, orthopedic surgery is expected to grow seven percent in the coming decade. This is largely a recession-proof career. Prospective doctors who follow all of the steps to become orthopedic surgeons can be confident in the job security that awaits them.

Are you an aspiring orthopedic surgeon or orthopedic surgery PA? International Medical Aid has opportunities for pre-medical students to gain, invaluable first-hand clinical experience working with seasoned orthopedic surgeons in major teaching hospitals in East Africa and South America. Our study and intern abroad programs give our alumni a competitive advantage when applying to medical schools; helping to develop culturally competent, patient-centered future physicians. Learn more about our programs and apply today at medicalaid.org!

About IMA

International Medical Aid provides global internship opportunities for students and clinicians who are looking to broaden their horizons and experience healthcare on an international level. These program participants have the unique opportunity to shadow healthcare providers as they treat individuals who live in remote and underserved areas and who don’t have easy access to medical attention. International Medical Aid also provides medical school admissions consulting to individuals applying to medical school and PA school programs. We review primary and secondary applications, offer guidance for personal statements and essays, and conduct mock interviews to prepare you for the admissions committees that will interview you before accepting you into their programs. IMA is here to provide the tools you need to help further your career and expand your opportunities in healthcare.

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