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 a residency program that lasts five to six years. Some surgeons add fellowship training afterward, which adds one to two more years. The exact length depends on whether you pursue additional specialization and whether you attend medical school when ready after your undergraduate degree.

The path is long because orthopedic surgery requires both broad medical knowledge and highly specialized surgical skills. You cannot skip steps or compress the timeline significantly—medical school accreditation and residency requirements are set by national bodies and do not vary by program.

Key Takeaways

  • Medical school takes four years, and you must complete it before you can enter a residency program.
  • Orthopedic surgery residency lasts five to six years and is where you learn to perform surgeries and manage patients independently.
  • Fellowship training after residency adds one to two years if you want to specialize further in areas like sports medicine or joint replacement.
  • Your undergraduate degree does not have to be in biology or chemistry, but you must complete specific science courses that medical schools require.
  • The total time from high school to practicing as an orthopedic surgeon ranges from 11 years (residency only) to 15 years (residency plus fellowship).

Undergraduate Degree: 4 Years

Your first four years are spent earning a bachelor's degree at a college or university. Medical schools do not require a specific major, but you must complete prerequisite courses in biology, chemistry, organic chemistry, physics, and biochemistry. Many students major in biology or chemistry because these majors naturally include the required courses, but you could major in engineering, psychology, or another field and take the prerequisites separately.

During these four years, you should also prepare for the Medical College Admission Test (MCAT), which you typically take in your junior or senior year. Medical schools use MCAT scores as a major part of your process. You will also want to gain experience shadowing doctors, volunteering at hospitals, or working as an emergency medical technician (EMT) or medical scribe—medical schools look for evidence that you understand what the job involves.

Medical School: 4 Years

Medical school is a four-year program that leads to either an M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathic Medicine) degree. Both degrees may have access to you to enter an orthopedic residency. The first two years focus on classroom learning and laboratory work covering anatomy, physiology, pharmacology, and disease. The second two years shift toward clinical rotations, where you work alongside doctors in hospitals and clinics.

During your clinical rotations in years three and four, you will rotate through different specialties, including orthopedic surgery. This is when you decide whether orthopedic surgery is the right fit and when orthopedic surgeons evaluate whether you would be a good resident. Your performance during these rotations, your board exam scores, and your letters of recommendation from attending physicians all factor into whether you match into an orthopedic residency program.

Orthopedic Surgery Residency: 5 to 6 Years

After medical school, you enter a residency program in orthopedic surgery. This is where you actually learn to perform surgeries and manage patients. Residency lasts five to six years depending on the program. During this time, you work long hours—often 60 to 80 hours per week—in operating rooms, clinics, and on hospital wards. You are supervised by senior surgeons, but you gradually take on more responsibility as you progress through the years.

In your first year (called PGY-1, or postgraduate year one), you focus on foundational skills and rotations through different orthopedic subspecialties like spine, sports medicine, trauma, and joint replacement. By your final years, you are leading surgeries and making clinical decisions with less direct supervision. You must also pass the written board exam (the OITE, or Orthopedic In-Training Exam) and eventually the oral board exam to become board-certified.

Fellowship Training: 1 to 2 Years (Optional)

After residency, many orthopedic surgeons pursue fellowship training to specialize further. Common fellowships include sports medicine, joint replacement (arthroplasty), spine surgery, hand surgery, trauma, pediatric orthopedics, and foot and ankle surgery. A fellowship typically lasts one to two years and allows you to develop informed in a narrower area. Not all surgeons do fellowships—some go directly into private practice or hospital employment after residency.

Fellowship is competitive, and the best programs are highly selective. If you want a fellowship, you should perform well during residency and express your interest early to senior surgeons who can mentor you and write strong recommendation letters.

Board Certification and Licensing

To practice as an orthopedic surgeon, you must be licensed in the state where you work. This requires passing the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA), depending on whether you earned an M.D. or D.O. You take these exams during medical school and residency.

Board certification by the American Board of Orthopedic Surgery (ABOS) is not legally required to practice, but most employers and hospitals expect it. To become board-certified, you must complete residency, pass the written board exam, and pass the oral board exam. The oral exam typically happens in your final year of residency or shortly after. Board certification demonstrates that you have met national standards for knowledge and surgical skill.

Why the Timeline Cannot Be Shortened

The length of training is set by the Accreditation Council for Graduate Medical Education (ACGME), which oversees all residency programs in the United States. Residency in orthopedic surgery is set at five to six years because that is the time needed to train a surgeon safely. You cannot compress this by working faster or taking extra courses—the timeline is built into the structure of the program.

Medical school is also four years by design. Some schools offer accelerated three-year programs, but these are rare and do not save time overall because you still must complete the same number of clinical rotations and coursework. The prerequisite courses for medical school also cannot be skipped, so if you did not take them in undergraduate, you must take them before explore to medical school, which adds time.

Frequently Asked Questions

Can I become an orthopedic surgeon in less than 11 years?

No. The minimum is four years of undergraduate study, four years of medical school, and five years of residency—that is 13 years. Some people take longer if they take time off between degrees, repeat a year, or pursue fellowship. You cannot legally practice as an orthopedic surgeon without completing all these steps.

Do I need a specific undergraduate major to get into medical school?

No. You can major in any subject as long as you complete the required science courses (biology, chemistry, organic chemistry, physics, and biochemistry). Many students major in biology or chemistry because it is convenient, but medical schools care about your grades in the prerequisite courses and your MCAT score, not your major.

What if I do not get into an orthopedic residency on my first try?

If you do not match into orthopedic surgery, you can enter a different medical specialty and try again the following year. Some people do a year in another residency and then transfer into orthopedic surgery, though this is uncommon. The more common path is to work as a physician in another field or take a research year and reapply to orthopedic programs the next cycle.

Is fellowship required to practice as an orthopedic surgeon?

No. You can practice as a general orthopedic surgeon after residency without fellowship training. However, many employers prefer surgeons with fellowship training in a specific area, and some subspecialties (like sports medicine at a professional sports team) may require it. Fellowship is optional but increasingly common.

How much does it cost to become an orthopedic surgeon?

Medical school tuition varies widely depending on whether you attend a public or private school and whether you receive scholarships. Public medical schools typically cost $30,000 to $50,000 per year, while private schools can cost $60,000 or more. Many students graduate with significant student loan debt. Residency is paid—you earn a salary as a resident, though it is lower than what practicing surgeons make.