Orthopedic Surgeon Career Guide,
Salary, Licence & Jobs 2026

Typically fourteen years after high school: four years of college, four of medical school, a five-year orthopedic surgery residency, and — for roughly nine in ten graduates — a one-year subspecialty fellowship. ABOS board certification then completes in two stages, with the oral exam taken after collecting a case list from your first years of independent practice. Most orthopedic surgeons are in their mid-thirties before their first full attending year.

BLS OEWS May 2025 reports a $358,550 median ($172.38/hr) for orthopedic surgeons excluding pediatric specialists (SOC 29-1242). The distribution is steep: $84,170 at the 10th percentile — largely trainees and part-time academic roles in the wage data — $530,700 at the 75th, and $659,290 at the 90th, where high-volume spine and joint subspecialists with surgery-center ownership operate. Trauma call stipends and wRVU productivity bonuses add further upside.

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Consistently among the most competitive in the NRMP. Successful applicants typically pair top-tier board scores with substantial research output, strong clerkship grades and away rotations that convert into interviews. DO applicants match in growing numbers but face steeper odds at academic programs. The scarcity is structural — residency positions grow slowly — and it flows directly into the profession's economics: BLS counts only about 400 openings a year for a specialty every hospital needs.

The standard fellowship menu: sports medicine, spine, adult reconstruction (hip and knee replacement), hand and upper extremity, trauma, foot and ankle, shoulder and elbow, pediatric orthopedics and musculoskeletal oncology. Hand and sports medicine offer formal ABOS subspecialty certificates. Financially, spine and adult reconstruction tend to lead; lifestyle-wise, hand and sports carry lighter call. Pediatric orthopedics is tracked as its own SOC occupation in federal wage data.

Yes — it is one of medicine's most physical specialties. Reducing dislocations, impacting joint components and holding retraction through long cases demand real strength and stamina, and surgeons accumulate documented rates of neck, back and hand strain over careers. Lead aprons during fluoroscopy-heavy trauma cases add load. Many surgeons manage longevity deliberately: ergonomic technique, robotic assistance, physician assistants for closures, and case-mix shifts toward clinic and outpatient procedures in later career.

No — a large share of orthopedic practice is non-operative. Clinic days fill with fracture care in casts and braces, joint injections, osteoarthritis management and surgical-candidacy decisions; many patients are treated definitively without an incision. A typical week splits between OR days and clinic days, plus trauma call. The judgment about when not to operate — exhausting conservative care before a replacement, letting a stable fracture heal in a boot — is as central to the craft as the technical work.