How To Become an Orthopedic Surgeon

July 8, 2019

We all know that it takes “a long time” to become a practicing orthopedic surgeon. Many people shy away from undertaking the profession due to the length of time it takes to achieve the goal.  Here is just what it takes to become an orthopedic surgeon. 

The educational journey for an aspiring orthopedic surgeon starts with undergraduate preparation followed by medical school, a specialized residency, as well as an optional fellowship. 

Undergraduate studies in biology, chemistry, physics, and mathematics are essential for entrance into medical school. Other courses required for admission into medical school may include humanities, social studies, and English.  It is not always mandatory to earn an undergraduate degree to apply to medical school, but the US Bureau of Labor Statistics reports that most medical school applicants have at least bachelor’s degrees.  Along with the mandatory undergraduate coursework, you have to score well on the Medical College Admission Test (MCAT).  Some programs also expect letters of recommendation from professors. 

An orthopedic surgeon must have either a doctor of medicine (M.D) or doctor of osteopathic medicine degree (D.O.).  Both degrees require four years of graduate-level study in an approved school. The first two years are classroom based and the final two tend to be hospital-based. The first two years of the program prepare you for advancement into clinical courses and include studies in anatomy, genetics, pathology, microbiology, pharmacology, and neurology. It also includes introduction to the process of developing clinical and diagnostic skills. Third year students focus on clinical rotations in a number of different practices including surgery, internal medicine, and pediatrics.  In the fourth year, you may complete rotations in specific electives which can include orthopedics. Some programs also include an internship or residency “boot camp” to prepare you for the next phase of medical training. 

The American Board of Orthopedics requires candidates for board certification to complete five years of post-graduate residency training. The orthopedic surgery residency program focuses on clinical, didactic, and research applications. You will be introduced to surgical rounds in which you will learn to diagnose and treat a number of orthopedic illnesses. You will also be required to attend conferences and lectures throughout the residency which allows you to interact with leaders in the field of orthopedics. Your residency may also include rotations in a number of sub-specialties like sports medicine, hand surgery, musculoskeletal oncology, and pediatric orthopedic surgery among others. 

Following a residency, you may qualify for licensure through your state medical board and begin to practice as an orthopedic surgeon. You might also choose to continue your training with a one or two year fellowship in a sub-specialty of orthopedic surgery. 

Upon completion of your residency or fellowship, you are eligible to take the American Board of Orthopaedic Surgery written exam for board certification.  This includes 310-320 questions that cover knowledge of orthopedic injuries and conditions and how to apply that knowledge to proper treatment. Thirty-three percent of the exam focuses on reconstruction procedures in adults. A physician who passes the written certification exam is considered “board eligible.” Board certification requires 22 months of practice while board-eligible. A valid state medical license is required for this and it is also required before taking the oral portion of the certification exam. All states require the United States Medical Licensing Examination (USMLE), and some states grant osteopathic medical licenses based on the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) exam.  Both licensing exams consist of three parts, and some states limit the number of times a candidate can take the exam. 

After 22 months of practice and satisfactory peer review, a candidate for board certification can take the ABOS oral exam.  This exam is based on 10 or 12 actual cases that the candidate must submit to the ABOS before he takes the exam. The exam consists of three 35-minute sessions in which examiners, all of whom are board-certified orthopedic surgeons, ask questions about the techniques followed in treating each case. Each candidate who passes this examination is awarded the title of “Diplomate of the American Board of Orthopedic Surgery.”  This must be renewed every 10 years by demonstrating continued competence as an orthopedic surgery shown by similar testing and examinations.  

So the next time you come in to see your orthopedic surgeon, remember all of the hours of study and the years of schooling and hands-on hospital training he or she has undergone to become an expert in orthopedic disease, injuries, treatment, and surgical procedures. It takes a great deal of commitment and desire to pursue and successfully achieve this occupation.  

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