The Timeline: 11 to 15 Years After High School

Becoming an orthopedic surgeon takes 11 to 15 years after you finish high school. This includes four years of undergraduate study, four years of medical school, and five to six years of orthopedic residency training. Some surgeons add fellowship training in a subspecialty like sports medicine or spine surgery, which adds one to two more years.

The exact length depends on whether you pursue additional fellowship training and whether you complete your education without delays. Most orthopedic surgeons finish their core training by their early 30s, though some start their careers earlier if they move through each stage without interruption.

Key Takeaways

  • Medical school and residency together account for nine to ten years, making them the longest phases of orthopedic training.
  • Residency in orthopedic surgery lasts five to six years and includes both classroom learning and hands-on surgical experience under supervision.
  • Fellowship training in a subspecialty like sports medicine or hand surgery adds one to two years but is optional and not required to practice as an orthopedic surgeon.
  • Your undergraduate GPA, Medical College Admission Test (MCAT) score, and performance in medical school affect whether you can match into an orthopedic residency program.
  • Orthopedic residency is competitive; not all medical school graduates who want this specialty will find a position.

Undergraduate Education: 4 Years

Your first four years are spent completing a bachelor's degree at a college or university. You do not have to major in biology or chemistry, but you must complete specific science courses that medical schools require: biology, chemistry, organic chemistry, biochemistry, physics, and mathematics. Most students major in a science field because it naturally includes these courses, but some major in other subjects and take the required science classes alongside their major.

During these four years, you should also prepare for the MCAT, which you typically take in your junior or senior year. Medical schools use MCAT scores as a major part of their admissions decision. You will also want to gain experience in healthcare settings—volunteering at hospitals, shadowing doctors, or working as an emergency medical technician (EMT) or medical assistant. Medical schools look for evidence that you understand what the profession involves and are committed to it.

Medical School: 4 Years

Medical school is a four-year program that leads to either a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree. The first two years focus on classroom learning and laboratory work covering anatomy, physiology, pharmacology, and disease processes. The second two years shift toward clinical rotations, where you work alongside physicians in hospitals and clinics, seeing patients and learning how to diagnose and treat conditions.

During medical school, you take licensing exams—the United States Medical Licensing Examination (USMLE) for MD graduates or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) for DO graduates. Your performance in medical school courses, your board exam scores, and your clinical evaluations all factor into whether you can match into an orthopedic residency. Orthopedic surgery is one of the most competitive specialties, so strong grades and test scores matter significantly.

Orthopedic Residency: 5 to 6 Years

After medical school, you enter an orthopedic residency program, which lasts five to six years depending on the program. During this time, you are a licensed physician but still in training under the supervision of experienced orthopedic surgeons. You rotate through different areas of orthopedic surgery—the shoulder, knee, hip, spine, hand, foot, and trauma—learning to diagnose conditions, perform surgery, and manage patient care.

Residency is structured so that your responsibilities increase gradually. In your first year (called PGY-1, or postgraduate year 1), you handle more basic tasks and learn foundational skills. By your final years, you are leading surgical cases and making complex clinical decisions with less direct supervision. You also take the Orthopedic In-Training Examination (OITE) annually to track your knowledge, and you must pass the American Board of Orthopedic Surgery (ABOS) written and oral board exams to become board-certified.

Residency is demanding. You work long hours, including nights and weekends on call, and you are responsible for patient care. However, this is where you develop the surgical skills and clinical judgment that define an orthopedic surgeon's career.

Optional Fellowship Training: 1 to 2 Years

After residency, some orthopedic surgeons pursue fellowship training in a subspecialty. Common fellowships include sports medicine, hand surgery, spine surgery, trauma, joint reconstruction, pediatric orthopedics, and foot and ankle surgery. A fellowship typically lasts one to two years and provides deeper informed in a narrower field.

Fellowship is optional—you can practice as a general orthopedic surgeon without it. However, some surgeons pursue fellowship to specialize in an area that interests them or to improve their job prospects in a competitive market. Fellowship training also usually comes with a salary, though it is lower than what you would earn as a practicing surgeon.

Board Certification and Licensing

To practice as an orthopedic surgeon, you must be licensed in your state. This requires passing the USMLE or COMLEX exams during medical school and residency. Board certification through the American Board of Orthopedic Surgery (ABOS) is not legally required to practice, but most employers and hospitals expect it, and many patients view it as a mark of competence.

ABOS certification requires passing a written exam and an oral exam. The written exam is typically taken during your final year of residency, and the oral exam follows after you have completed residency. Once you pass both exams, you are board-certified and can use the title "board-certified orthopedic surgeon." Board certification is valid for ten years, after which you must complete continuing education and pass a maintenance exam to keep it current.

Factors That Affect Your Timeline

Several things can change how long your training takes. If you take time off during medical school or residency for personal reasons, family, or health, your timeline extends. Some people complete a gap year between undergraduate and medical school to work, volunteer, or improve their process, which adds a year to the overall timeline.

Your ability to match into an orthopedic residency also matters. If you do not match in your first attempt, you may need to reapply the following year, which delays your entry into residency by 12 months. Conversely, if you pursue fellowship training, you add one to two years. Some surgeons also pursue additional degrees—a Master of Business Administration (MBA) or Master of Public Health (MPH)—during or after training, which extends their timeline further.

Frequently Asked Questions

Can I become an orthopedic surgeon faster by skipping residency?

No. Residency is a legal requirement to practice as an orthopedic surgeon in the United States. You cannot skip it or shorten it. After medical school, you must complete a five- to six-year residency program before you can practice independently.

What if I don't match into an orthopedic residency on my first try?

If you do not match, you can reapply the following year. Many people who do not match the first time improve their process by gaining additional clinical experience, taking board exams again, or strengthening their letters of recommendation. This adds one year to your timeline, but it is a common path.

Do I have to do a fellowship after residency?

No. Fellowship is optional. You can practice as a general orthopedic surgeon after completing your five- to six-year residency and passing your board exams. However, some job markets or subspecialties favor candidates with fellowship training.

How much does it cost to become an orthopedic surgeon?

Medical school costs vary widely depending on whether you attend a public or private school and whether you receive scholarships. Many medical students graduate with student loan debt ranging from tens of thousands to over $200,000. Residency is paid, though resident salaries are modest compared to practicing surgeon salaries. Fellowship is also paid.

Can I work while in medical school or residency?

Medical school is full-time and does not allow outside employment. Residency is also full-time with long hours, making outside work impractical. Some residents take on small side projects or teaching roles, but these are rare and must fit within program requirements.