Becoming an orthopaedic surgeon


If you are a student considering a career in orthopaedics, we have a range of resources to assist you in planning for your future.
 

The term ‘orthopaedics’ is derived from the Greek ortho (‘correct’, ‘straight’) and pais (child). It was first used in 1741, when it most frequently applied to the care of crippled children, often with spine and limb deformities. Orthopaedics today involves the care of the musculoskeletal system of the human body.

An orthopaedic surgeon is a medical doctor with extensive training in the diagnosis and surgical, as well as non-surgical, treatment of the musculoskeletal system. Some of the common problems orthopaedic surgeons treat include:

  • Musculoskeletal trauma
  • Sports injuries
  • Degenerative diseases
  • Infections
  • Tumours
  • Congenital disorders

While some orthopaedists practice general orthopaedics, many specialise in treating the foot and ankle, hand, shoulder and elbow, spine, hip or knee. Others focus on a particular age group or area of orthopaedics, such as paediatrics, trauma, sports medicine or oncology, or the treatment of specific conditions such as osteoporosis, arthritis or work-related injuries.

There are approximately 1,300 orthopaedic surgeons currently employed in Australia, with the majority working in private practice.
 

Frequently asked questions:

What are some of the best things about being an orthopaedic surgeon?

A response from John Cunningham, Victorian orthopaedic surgeon

There are so many aspects of being an orthopaedic surgeon that it’s difficult to name only a few. When you meet patients, they are often in pain, and no longer enjoying their lives, and you get to know very well the sort of person they are and what they miss most. Working with them and their family, it’s so rewarding to develop a plan and then to carry it out with the team around them – their family, the nursing and hospital staff, and their local doctors. We regularly make very significant improvements to patients’ lives and nothing beats the smile on their faces when they see you afterwards.

From a technical point of view orthopaedic surgery has allowed me to learn incredible skills. I can safely operate on almost all parts of the body, and often use precision instruments to implant highly engineered and carefully designed devices to achieve the patient’s goals. Whilst most operations are fortunately common and we become familiar with them, regularly as a surgeon we come across more challenging cases, and this can be intellectually demanding before, during and after the operation, as well as being a test of our skills. Fortunately, orthopaedic surgeons have a long history of cooperation with each other, and lending a hand – or asking for a hand – is commonplace.

Lastly, being advocates for patient safety and public health is also a key role in our profession. You will find orthopaedic surgeons giving advice to sporting teams and organisations, and also liaising with governments to improve the health of all.

What are some of the difficult things about being an orthopaedic surgeon?

A response from Li-on Lam, Western Australian orthopaedic surgeon

There are many good things about becoming an orthopaedic surgeon, but like everything in life worth doing, there are difficult aspects to it. After the years it takes to become a doctor, surgical training involves further study, exams and research. This can take between six and ten years post-graduation. These years can be busy and require one to balance on-call duties and exams on top of a day job, along with all the other bits that accompany this season of life. On becoming a consultant, there is the further challenge of setting up practice and often competing for public hospital appointments. The community and our surgical colleagues rightly hold us to a high standard of practice and this necessarily involves scrutiny of our work, ethics and behaviour. We have to learn to deal with complications, criticism and also learn how to engage teams that work effectively. All of these are, of course, tremendous opportunities for personal and professional growth. I have found that surgery is truly a teacher of life and have no hesitation recommending it.


Do you need manual strength to be an orthopaedic surgeon?

A response from Nicole Williams, South Australian orthopaedic surgeon

A reasonable degree of physical fitness is helpful to get through long orthopaedic operating lists, which are often conducted while wearing protective lead gear and involve performing a range of manual tasks. It is by no means necessary to be a muscle-bound gym junkie. If you look around the room at an AOA Annual Scientific Meeting, you will see that orthopaedic surgeons come in a range of sizes and shapes. Technique generally trumps brute force when trying to get things done in orthopaedics.


In what regions of Australia are orthopaedic surgeons most needed?

As with all medical specialties, there is a need for more orthopaedic surgeons to work in rural and regional areas. According to the Royal Australasian College of Surgeons (RACS), approximately 31 per cent of Australians live in rural, regional and remote areas, but only 15 per cent of practicing surgeons work in these areas. As the surgical workforce ages and the rural population continues to grow, more surgeons will be needed to serve the rural and remote communities of Australia.

AOA’s training program includes a number of rural rotations in each region, and we encourage our trainees to consider a career in rural Australia.


Is it possible to balance work and family as an orthopaedic surgeon?

A response from Kate Stannage, Western Australian orthopaedic surgeon

Work-life-family balance is a difficult concept! I had two children during training, and they are now 15 and 12 years of age. I remain happily married. I have run a marathon and play in an orchestra. I have achieved goals in orthopaedics that once seemed unattainable. But life seems more about juggling than balance. Happily, it seems possible to juggle multiple balls whilst walking across a balance beam. Occasionally a ball is fumbled, or I wobble on the beam, but life and work both continue. I think maybe balance isn’t as important as satisfaction… and I am definitely satisfied with my work and life.


Is orthopaedic surgery an appropriate career choice for women?

Yes! Currently, only about three per cent of all orthopaedic surgeons in Australia are female. However, recent trainee intakes have seen a significant increase in the number of female trainees joining the training program, and we are hopeful that the specialty will see a more equal representation of women in future years. AOA is fully committed to increasing the diversity of the profession. Through the implementation of its five-year Diversity Strategy, AOA is taking concrete steps to support our female trainees and consultants, including:

  • the promotion of flexible training opportunities
  • establishment of the Orthopaedic Women’s Link and the Champions of Change initiative
  • On-site childcare and private rooms for personal use at conferences and events, and
  • flexibility in the selection process to allow for periods of parental leave.

If you are a female student thinking about a career in orthopaedics and you would like to speak with a female surgeon about their experiences, please get in touch with us and we will do our best to facilitate this for you.

For Australian students, the first step in the journey to becoming an orthopaedic surgeon is completion of a medical degree at university. Upon graduation, new doctors must complete a minimum of three years of postgraduate pre-vocational work in a clinical setting, which must include some experience in orthopaedic surgery.

Following the third year of postgraduate work, or ‘PGY3’, many doctors meet the eligibility criteria for the AOA 21 Training Program and can apply for an orthopaedic training position. See below for more information regarding the structure and duration of the AOA 21 Training Program.

Upon successful completion of all of the requirements of the AOA 21 Training Program, our graduates can apply for Fellowship of the Royal Australasian College of Surgeons (FRACS) and Fellowship of the Australian Orthopaedic Association (FAOrthA) and become practising specialist orthopaedic surgeons. Some surgeons go straight into clinical practice in Australia; others choose to complete a specialty fellowship overseas or move into a research-focused position.

The best way to get experience in orthopaedics during your degree is to complete one or more of your elective terms in orthopaedic surgery. In addition, in conjunction with universities, AOA offers several undergraduate scholarships and prizes that are designed to encourage students to gain experience in orthopaedic surgery:

AOA Undergraduate workshop
AOA Joint Scholarship Program – University of Melbourne
AOA Joint Scholarship Program – James Cook University
AOA Joint Scholarship Program – University of Wollongong
AOA Joint Scholarship Program – University of Sydney

If you are interested in a career in orthopaedics, we strongly encourage you to consider applying for these opportunities during your time at university.

You can find the current Selection Regulations and more information about the selection process for the orthopaedic surgery training program on our Becoming an AOA Trainee page.

How competitive is orthopaedic surgery training?

Orthopaedic surgery is one of the more competitive surgical specialties, with an average of four to five applicants per available training post each year.


What can I do to increase my chances of getting onto the training program?

There are several things that you can do to give yourself the best chance at selection:

  • Review the Selection Regulations to make sure that you meet the requirements for selection. The Regulations are updated annually, so be sure to check the regulations for your intake when you are ready to apply.
  • Review the RACS requirements for registration and selection.
  • Find a mentor who can support and guide you through your PGY 1-3 years and the application process. This might be a consultant surgeon or even a current orthopaedic trainee.
  • Put your best foot forward in your unaccredited registrar positions during the years prior to your application to the training program. Referee reports are a key component of the selection process.
  • Consider attending your local AOA branch scientific meetings and the national AOA Annual Scientific Meeting to network and learn from the top surgeons in the field. These events also provide you the opportunity to meet AOA staff and committee members, who can answer your queries and give you advice.
  • If you have the opportunity and time, consider participating in research projects.

For more information regarding the requirements for international medical graduates (IMGs), please visit our International medical graduates page.

How long is the training program?

On average, it takes five years to complete the AOA 21 Training Program. The diagram below shows the structure of the training program.

Stages-of-Training-Graph


Can I train part time?

Yes. AOA supports trainees wishing to train part time and have identified potential part-time training positions in each region. Each request for part-time training is considered on a case-by-case basis, depending on the reason for the request and the part-time load that you wish to work.


Can I take breaks in training?

Yes. Trainees can request an interruption to training for family, research, illness, and other reasons. Interruptions can be taken for six months, 12 months, or in some cases even longer. Requests are considered on a case-by-case basis.


Will I be sent all over the country during my training?

When you apply to the program, you will be asked to nominate the region(s) in which you would like to train. You will only be offered a training post in one of the regions of your preference. During your training, you will rotate between hospitals each term, and you will spend some time working in hospitals that are located outside of the metropolitan centres in each region. In most of these cases, the hospital will support you with accommodation, relocation and information about the local area.


Will I have to put up with long working hours and a high workload?

Orthopaedic surgery is not a standard 9-5 job, so there will be some variation in your working hours as a surgeon. You will have very long days every now and then. However, AOA strongly supports safe working hours and fair rostering practices and our expectations in relation to this are specified in our Safe Working Hours and Rostering policy.