The career path to becoming an orthopedic doctor, a physician specializing in the musculoskeletal system, is extensive and demanding. An orthopedic surgeon focuses on the diagnosis, correction, prevention, and treatment of skeletal deformities, disorders, and injuries, including those of the bones, joints, ligaments, tendons, and muscles. This training prepares a physician for complex surgical and non-surgical patient care. The estimated time commitment following high school is approximately 13 to 15 years before a doctor is practicing independently.
The Undergraduate Foundation
The first step requires the completion of a four-year bachelor’s degree from an accredited university. While there is no mandatory major, most aspiring doctors follow a pre-medical track to complete the prerequisite coursework for medical school admission. Admissions committees expect a high cumulative and science Grade Point Average (GPA), demanding a high level of performance during this period.
The required science curriculum typically includes a full year of biology, general chemistry, physics, organic chemistry, and often biochemistry. Beyond coursework, this period also involves extensive preparation for the Medical College Admission Test (MCAT). The MCAT is a standardized examination that assesses problem-solving, critical thinking, and knowledge of scientific concepts.
Medical School: Earning the M.D. or D.O.
Following the undergraduate degree, a student must complete four years of medical school to earn either a Doctor of Medicine (M.D.) or a Doctor of Osteopathic Medicine (D.O.) degree. The initial two years focus on preclinical, classroom-based learning, covering foundational sciences such as anatomy, physiology, pharmacology, and pathology. This knowledge is a prerequisite for clinical application.
The third and fourth years involve clinical rotations through various hospital departments like internal medicine, pediatrics, surgery, and obstetrics. Theoretical knowledge is applied in real patient care settings under supervision, allowing students to explore different specialties. Students must pass initial medical licensing examinations, such as the USMLE Steps 1 and 2 or the COMLEX equivalents, to progress in the training timeline.
The final phase involves applying for a residency position through the National Resident Matching Program (NRMP). Orthopedic surgery is a competitive specialty, requiring students to demonstrate exceptional academic performance, extensive research experience, and strong letters of recommendation. Securing a successful match into an orthopedic surgery program is necessary for all subsequent specialized training.
Orthopedic Surgery Residency Training
Orthopedic surgery residency is a five-year training program that immediately follows medical school graduation. This residency transitions the doctor from general medical knowledge to specialized surgical practice. The first year, called the PGY-1 or intern year, typically involves rotations in general surgery, surgical critical care, and trauma services to build a foundation in patient management and surgical technique.
The subsequent four years are dedicated to training across all sub-disciplines of orthopedics, as mandated by the American Board of Orthopaedic Surgery (ABOS). Residents rotate through specialized services such as adult joint reconstruction, hand and upper extremity surgery, pediatric orthopedics, and orthopedic trauma. These rotations involve increasing responsibility, from patient workups and post-operative care to performing complex surgical procedures under supervision.
Residents are expected to master surgical skills necessary for procedures like fracture fixation and arthroplasty, as well as the non-operative management of musculoskeletal conditions. This five-year period transforms the graduate into a competent, independent orthopedic surgeon eligible for board certification.
Advanced Sub-Specialization: Fellowship
Following the five-year residency, many orthopedic surgeons pursue sub-specialization through a fellowship program. This additional training typically lasts one to two years and provides experience in a narrow field of orthopedic practice. Completing a fellowship is common, as it is often required for securing positions in specialized group practices or academic centers.
Fellowship options allow a surgeon to become an expert in a specific anatomical area or patient population. Common sub-specialties include:
- Spine surgery
- Sports medicine, which often involves arthroscopic techniques and ligament reconstruction
- Adult reconstructive surgery, which focuses on complex joint replacements
- Foot and ankle surgery
- Hand surgery
- Musculoskeletal oncology
- Pediatric orthopedics
This final stage of formal training adds time to the overall timeline.
Licensing, Certification, and Practice
The path to independent practice involves several final administrative and examination hurdles. State medical licensure is required for any doctor to practice medicine and is typically obtained during or immediately following the first year of residency after passing the USMLE Step 3 or COMLEX Level 3 examination. This license allows the physician to practice under the supervision of the residency program while completing training.
The ultimate professional milestone is achieving Board Certification, administered by the American Board of Orthopaedic Surgery (ABOS). This process begins after residency and includes two major components: a written examination (Part I) and an oral examination (Part II). The Part II oral exam evaluates the surgeon’s clinical judgment and surgical competence based on a review of surgical cases performed during a defined practice period.
Once certified, an orthopedic surgeon is referred to as a Diplomate of the ABOS, but this status is not permanent. Surgeons must participate in the Maintenance of Certification (MOC) program, which requires ongoing professional development, continuing medical education (CME), and periodic assessments. This ensures their knowledge and skills remain current throughout their career.
Factors That Can Affect the Timeline
While the standard path is 13 to 15 years, several variables can alter the total time commitment. These deviations from the standard track can add between one and three years to the total time required before a surgeon begins independent practice.
Gap Years and Research
Many students take one or two “gap years” between undergraduate studies and medical school to gain research experience, volunteer, or strengthen their application. This extends the timeline by a year or more. Similarly, some medical students or residents may dedicate a full year to research outside of the standard curriculum, delaying graduation or residency completion.
Residency Match and Military Service
Military service commitments, undertaken at various points in the training, also modify the standard schedule. The competitive nature of the residency match process is another factor. A student who does not match into an orthopedic program on the first attempt may spend a year pursuing a different preliminary residency or dedicated research to reapply, adding time to the overall process.