The timeline is 14 to 15 years after high school

Becoming an orthopedic surgeon takes 14 to 15 years from high school graduation. That breaks down into four years of undergraduate study, four years of medical school, and five to six years of orthopedic surgery residency and fellowship training. Some surgeons add an extra year or two for subspecialty fellowships in areas like sports medicine or joint replacement, which extends the total further.

The length is fixed by medical licensing requirements and the structure of surgical training in the United States. You cannot compress these years or skip steps. Each phase has its own gatekeeping exams and credentials that must be completed before the next one begins.

Key Takeaways

  • Medical school is four years, but you must first complete a four-year undergraduate degree, making eight years before residency even starts.
  • Orthopedic surgery residency is five years minimum, and most surgeons add a one-year fellowship in a subspecialty afterward.
  • You must pass the United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examination (COMLEX) during medical school and residency to practice.
  • The entire pathway requires passing multiple board certification exams, the final one taken during or shortly after your fellowship year.

Undergraduate degree: four 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 prerequisite courses that medical schools require: organic chemistry, inorganic chemistry, physics, biology, and biochemistry. Most students major in a science to satisfy these requirements efficiently, but some major in other fields and take the prerequisites alongside their major coursework.

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 their admissions decision. Your GPA in both overall coursework and science courses matters significantly.

Medical school: four years

Medical school is divided into two phases. The first two years focus on classroom and laboratory learning: anatomy, physiology, pharmacology, pathology, and other foundational sciences. You also begin clinical rotations in the second year, working alongside doctors in hospitals and clinics.

The second two years are almost entirely clinical rotations. You work in different medical and surgical specialties, including a rotation in orthopedic surgery. This is where you decide whether orthopedics is the right fit and begin building relationships with surgeons who may later write letters of recommendation for your residency process.

During medical school, you take the USMLE Step 1 exam (usually after second year), Step 2 CK and Step 2 CS exams (usually in your fourth year), or the COMLEX equivalents if you attend an osteopathic medical school. These are licensing exams required to practice medicine.

Orthopedic surgery residency: five years

After medical school, you enter a residency program in orthopedic surgery. This is a five-year training program where you work as a resident surgeon under the supervision of attending surgeons. You perform surgeries, manage patient care, and gradually take on more responsibility as you progress through the years.

Residency is competitive. You must match into a program through the National Resident Matching Program (NRMP), which pairs medical school graduates with residency positions based on rankings from both the program and the candidate. Orthopedic surgery is one of the most competitive specialties, so strong board exam scores, clinical performance, and letters of recommendation are essential.

During residency, you take the USMLE Step 3 exam (usually in your first year) and begin preparing for the American Board of Orthopedic Surgery (ABOS) Part 1 exam, which you typically take in your final residency year.

Fellowship training: one to two years

After residency, most orthopedic surgeons pursue a one-year fellowship in a subspecialty. Common fellowships include sports medicine, joint replacement (arthroplasty), spine surgery, hand surgery, pediatric orthopedics, and trauma. A fellowship is optional but increasingly expected by employers and hospitals.

Some surgeons pursue two-year fellowships or multiple fellowships, which adds time to the overall timeline. Fellowship positions are also competitive and require strong performance during residency.

During or shortly after your fellowship, you take the ABOS Part 2 exam, which is the final board certification exam. Passing this makes you a board-certified orthopedic surgeon.

Board certification and licensing

Board certification is separate from the ability to practice. You can practice as a surgeon after residency without board certification, but most hospitals require it or expect it within a certain timeframe. The American Board of Orthopedic Surgery (ABOS) administers the certification exams.

You must also maintain a medical license in the state where you practice. This requires continuing medical education throughout your career and periodic license renewal.

Why the timeline cannot be shortened

Each phase of training has legal and professional requirements that cannot be skipped. Medical school accreditation requires four years. Residency length is set by the Accreditation Council for Graduate Medical Education (ACGME) and cannot be shortened. You cannot practice orthopedic surgery without completing residency, regardless of how much medical school you have finished.

Some physicians pursue additional training in related fields (like a PhD in orthopedic research) while in medical school or residency, but this adds time rather than replacing it. Dual-degree programs like MD/PhD take six to eight years instead of four, not less.

Frequently Asked Questions

Can you become an orthopedic surgeon faster by going to medical school part-time?

No. Medical school is four years full-time, and part-time options are extremely rare and do not shorten the total time. Residency is also full-time and cannot be compressed. The timeline is set by accreditation standards, not by how intensively you study.

Do osteopathic doctors (DOs) take longer to become orthopedic surgeons than MDs?

No, the timeline is the same. Both MDs and DOs complete four years of medical school, then five years of orthopedic residency, then typically one year of fellowship. The main difference is the licensing exams: DOs take COMLEX instead of USMLE, though many take both.

What if you already have a medical degree from another country?

International medical graduates (IMGs) must complete additional steps before entering residency. You typically need to pass USMLE or COMLEX exams, complete a clinical skills assessment, and often complete an additional year of training called an IMG residency or clinical observership. This adds one to two years to the timeline.

Do you have to do a fellowship, or can you practice as an orthopedic surgeon after residency?

You can practice after residency without a fellowship, but most surgeons do one. Hospitals increasingly prefer or require fellowship training, and it makes you more competitive for jobs and higher pay. If you skip fellowship, you are board-certified as a general orthopedic surgeon after passing the ABOS Part 2 exam.

How much of the 14 to 15 years is spent actually in the operating room?

Most of your residency and fellowship is spent in clinical training, including surgery, but the exact amount varies by program. You perform fewer surgeries in your first residency year and more in later years. By your final residency year and fellowship, you are in the operating room regularly, but you are still learning under supervision.