Become an Orthopedic Surgeon

Orthopedics is the diagnosis and treatment of the musculoskeletal system, and orthopedic surgeons are specially trained to operate on patients having problems with arms, legs, bone, and tissue. Orthopedists spend a significant amount of time performing surgery, but they prescribe other types of rehabilitative treatment for people with musculoskeletal system problems. Orthopedic surgeons have hospital privileges, but typically practice as solo practitioners, with an orthopedic group, or as specialists within a multi-specialty group.

Steps

Going Through School

1. Make an education plan. Even in high school, you can start planning for a career in orthopedic surgery. In fact, the earlier you starting planning, the better. You need to have a high aptitude for school work, which entails testing well, having good study strategies, and learning things quickly.
   • Plan to maintain a good high school resume—including high grades, high test scores, community service, and clubs and organizations—in order to get into a top college.
   • Your college application should also include an impeccable entrance essay, evidence of personal attributes that will do well in college (i.e. leadership qualities), and letters of recommendation from teachers.
   • Classes that are most directly related to orthopedic surgery in high school might include biology, anatomy and physiology, chemistry, and the Advanced Placement (AP) versions of these courses.
2. Develop strong study habits. In high school and college, you should do your utmost to develop good study habits. These habits will be your key to success in medical school, during your residency, and if you have your own practice. Orthopedic surgeons should have strong skills in study management, self-discipline, memorization, organization, and concentration.
3. Learn finger dexterity. All surgeons need to show signs of a mechanical ability, specifically being good with their hands and fingers. Surgery is a delicate skill, especially when operating on the spine. Orthopedic surgeons must have excellent finger coordination. Do things like playing cards, sewing, playing guitar, or making jewelry.
   • Orthopedic surgeons also need to have extremely good 3-D visualization skills in order to execute successful surgeries. You can develop these spatial skills by practicing drawing or drafting.
   • Orthopedic surgeons are also usually very active individuals, enjoying sports and showing leadership in athletics.
4. Complete four years of undergraduate college. The first step after high school for an orthopedic surgeon is to get into a good undergraduate college. Orthopedic surgeons should major in biology, pre-medicine, or a field related to this. After obtaining a Bachelor’s of Science in one of these fields, aspiring surgeons can look toward medical school.
   • Just as having a strong high school resume was required to get into a good undergraduate program, a strong and well-rounded college resume is required to get into medical school.
   • In order to apply for medical school, undergrads must take the MCAT, a standardized entrance exam that proves you are ready for the rigors of medical school.
   • The MCAT can cost anywhere from $100 to $2,000.
5. Finish four years of medical school. After obtaining a BS in biology or pre-med or something similar, and getting a high MCAT score, your next step is to attend medical school. During these four years in medical graduate school, you will earn a Doctor of Osteopathic Medicine (D.O.) or Doctor of Medicine (M.D.) degree. Maintain high grades and skill performance here in order to get a residency.
   • There are only about 650 residency programs available each year, making this a highly competitive field.
6. Do a 5-year residency. The most important part of an orthopedic surgeon’s training is their residency, which should last five years, and specializes in orthopedic practices. Most residencies today include four years of orthopedic surgery training followed by one year of training in general medicine.
   • The final year of general medicine can be in general surgery, internal medicine, or pediatrics.
   • Some residencies require even more general training, and include only three years of orthopedic training with two years of general medicine.
7. Practice orthopedic surgery for two years. Before being able to obtain a license as an orthopedic specialist, you must have two years of practicing orthopedic surgery under your belt. That means that before you can actually obtain a license, which you need for opening your own practice, you must pass through at least 13 years of training after high school.
   • This means that if you graduate high school at 18, you will be at least 31 before you are officially called an orthopedic surgeon.

Getting Certified

1. Study for the licensing exam. After 13 years of training, you must pass two examinations in order to obtain your orthopedic surgery licensure. These exams are usually taken while students are still in their residencies and have both written and oral components.
2. Pass the Medical Licensure Boards. The U.S. Medical Licensing Examination (USMLE) and/or the Comprehensive Osteopathic Medical Licensure Examination (COMLEX) are required in order for orthopedic surgeons to legally practice medicine. The exam contains three steps and evaluates a doctor’s aptitude for being a doctor, including knowledge, concepts, and principles.
   • Each step of the exam has a different fee, costing $70, $600, and $1,275 for different components.
   • This is the general licensure exam that all doctors must take.
3. Pass the board certification exam. In order to become licensed as an orthopedic specialist, surgical residents must also pass the American Board of Orthopedic Surgery (ABOS) and/or the American Osteopathic Board of Orthopedic Surgery (AOBOS) exams. These exams ensure the safe practices of orthopedic surgeons in the U.S. The exam is called Maintenance of Certification (MOC) and has four sections.
   • Fees for the exam are over $1,000, with a late fee of $350.
   • This test is required again every 7 to 10 years.

Becoming Familiar with the Field

1. Learn how often you will perform surgery. Duties of orthopedic surgeons are usually divided between actual surgery and non-surgical maintenance of injuries or diseases. The split is usually 50% each, so even if you are passionate about surgery and want to always be in the operating room, you should be prepared to spend half your time in the doctor’s office.
   • Surgeries typically performed by orthopedic surgeons are usually done to repair damage done by injury to bones, joints, tendons, skin, nerves, ligaments, or muscles.
2. Know how to care for patients without surgery. Since half an orthopedic surgeon’s patients do not require surgery, an orthopedic surgeon should be well versed in body care that does not place patients under the knife. They should be able to use rehabilitative methods to treat musculoskeletal injuries just as well as they use surgery.
   • They should also use medical knowledge and physical methods to treat musculoskeletal problems.
3. Work with other doctors. Orthopedic surgeons often work with other doctors to treat many different types of medical conditions. In fact, they treat so many different conditions that their knowledge of the body is extremely vast, which is why residency programs require at least one year of work in general medicine in addition to working in an orthopedic specialty.
   • Orthopedic surgeons often serve as consultants for primary care doctors and others who receive patients with musculoskeletal complaints.
   • Orthopedic surgeons must be able to treat many different conditions, including but not limited to bone breaks, sprains, torn ligaments, club feet, abnormalities in the fingers and toes, and bone tumors.
   • Orthopedic surgeons also have the ability to replace joints with prosthetic devices, called total joint replacement.
4. Stay current with career requirements. Orthopedic surgeons, even after receiving licensure and having their own practice, must maintain understanding of the medical field. They must know current medical technologies, stay abreast of medical ethics, and keep up to date with pharmacology and physiology.
   • This may mean attending conferences and training sessions on top of their responsibilities with their patients.
   • They must obtain a re-certification from the ABOS or AOBOS every 7 to 10 years.
5. Know the projected job growth and salary. Both the prospects for growth in this field and the salary of orthopedic surgeons are hopeful for prospective doctors. Between 2014 and 2024, the entire field of surgery is expected to grow by 14%, which is much faster than average. The median U.S. salary for all surgeons in 2015 was $187,200 per year.

Finding Employment

1. Work for a hospital. Currently only about eight percent of orthopedic surgeons are employed solely by hospitals, although that number is predicted to increase over the next few years. Hospital employment is good for surgeons who want predictable hours and freedom from the stress of managing their own practices.
   • However, working for a hospital means your schedule and activities are dictated.
2. Start your own practice. About 20 percent of orthopedic surgeons today run their own practices, which is a lot more than the eight percent who work in hospitals. Private solo practices are good for surgeons who want to make a name for themselves, want freedom to dictate their own schedules, and who don't mind paperwork.
   • Having a solo practice means you need to also have head for business, since a solo practice essentially means running a small business.
3. Be part of an orthopedic group. The vast majority--42 percent--of orthopedic surgeons work in private practice, which means they either work as part of an orthopedic group or part of a multi-specialty group. As part of an orthopedic group, you share the business management with other surgeons and can find others to cover shifts.
   • The downside of joining a group of surgeons in the same specialty is that it reduces potential for making a strong name for yourself.
4. Function as part of a multi-specialty group. Some orthopedic surgeons join practices that offer other specialties in orthopedics, such as spine, sports medicine, and hip surgeons. Multi-specialty offices tend to pay surgeons at a higher rate than other locations.
   • For example, orthopedic spine surgeons in multi-specialty groups got paid over $622,000 in 2009, while those in single-specialty practices made around $605,000.

Tips

• Many orthopedists are involved in education, either by teaching in medical school or supervising residents.
• The above steps address how to become an orthopedic surgeon in the U.S., although the basic process is the same in most countries.
  • For example, in the UK, doctors who have completed their training may opt for an orthopedic specialty by taking a two-year foundation program followed by selection into higher training programs.
  • In Australia, doctoral students can choose to advance into a surgical specialty by finding residency programs to train them in surgery and orthopedic surgery.
• The need for orthopedic surgeons is influenced by an aging population and medical-technological advancements.

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