Why Is Orthopedic Surgery So Competitive?

Orthopedic surgery is one of the most competitive specialties in medicine. It’s a highly sought-after field with excellent pay and a great lifestyle. But what makes it so competitive? And how can you make sure you have what it takes to be successful in this career? 

This article will look at why orthopedic surgery is so competitive and guide you on how to increase your chances of matching into an orthopedic residency.

Why Is Orthopedic Surgery So Competitive?

Orthopedic surgery is one of the most competitive medical specialties in the United States. And for good reason: Orthopedists play a critical role in helping patients recover from injuries, diseases, and other conditions that affect the musculoskeletal system. 

Since orthopedic surgery is a demanding field, it requires long hours, intense concentration, and excellent physical stamina. As a result, the specialty only accepts individuals with extremely high Step 1 and Step 2 scores who must finish a 5-year orthopedic surgery residency program after medical school.

Here are some of the specialty demands that make orthopedic surgery so competitive:

1. Academic Performance

Over the years, preclinical grades have been used as a major determining factor when accepting applicants to orthopedic surgery using the Alpha Omega Alpha (AOA) Honor Society selection process. Therefore, you stand a better chance of acceptance in orthopedic residency as an AOA member.

However, medical schools are now adopting the pass/fail curriculum, eliminating the AOA selection process. If you are already studying under the new curriculum, you should participate in relevant extracurricular opportunities to make your CV stand out among other qualified applicants.

2. USMLE Step 1 and 2 Exam Scores

Medical schools are transitioning from preclinical grade curriculum to pass/fail curriculum. Under the new curriculum, USMLE Step 1 exams are graded as pass/fail. Therefore, the orthopedic surgery elimination process will depend on USMLE Step 2 CK scores.

To beat other qualified applicants, students should score outstanding grades in Step 2. Applicants stand a better chance of matching with a Step 1 score of >240 and a Step 2 score of >250.

However, the Step score is not the only thing program directors are interested in. The selection process is holistic, and they will also consider your work ethic, leadership qualities, and dedication to orthopedic surgery. 

A low score does not define you, but you must meet the cut-off score to earn an interview.

3. Research

Research is an important part of orthopedic surgery, and qualifying applicants must prove their understanding of the research process. In past applications, matching applicants usually have more than five research experiences.

Your research does not have to be on orthopedics, but orthopedic research projects prove your commitment to the field, giving you a better chance of acceptance than your competitors.

The project managers do not expect your research papers to appear in first-author publications, but you must have a strong research track record.

4. Clinical Rotations

Most orthopedic residency programs prefer interviewing applicants who have completed at least two rotations before applying. A great rotator demonstrates their ability as a team player and a hard worker.

Your good grades and first-author publications research papers play a major role in the selection process. Still, some programs will opt to accept an applicant with a weaker application who has pursued several rotations.

Therefore, if you want to specialize as an orthopedic surgeon after medical school, identify hospitals with orthopedic surgery residency programs and pursue rotations.

5. Physical Talent

In addition to good hands and visuals, orthopedic surgery demands strength and stamina. Some orthopedic surgeries like hip reduction are better done by someone of a certain height and stamina because it is a lot of work.

Physical talent is a major consideration during the interviews, but you will be trained to use your body size appropriately for the tasks ahead.

How Can You Increase Your Chances Of Matching Into Orthopedic Residency?

In addition to meeting the academic requirements, Step exam scores, and extracurricular activity requirements, here are other ways to increase your chances into orthopedic residency:

1. Apply Broadly

The number of orthopedic surgery applications is more than the placements. Therefore you should try your luck by sending applications to several institutions.

Orthopedic residency is a five years commitment; therefore, consider residencies in a location where you can comfortably spend the next five years.

Also, consider coordinating your applications with your peers. If a large chunk of your class wants to specialize in orthopedic surgery, share details on where you would love to be placed to reduce the number of people sending applications to your dream program residency.

Related: 6 Best General Surgery Residency Programs (Key Info & Data)

2. Letters Of Recommendations

Most medical schools are using the pass/fail metrics, so letters of recommendation from your faculty, rotation, or mentors are very important.

Strong letters of recommendation do not just come by. They are earned through excellent work on rotations, dedication to research with your school, and good relations with the directors of your school’s Orthopedic Surgery.

3. Community Service Experience

Community service experience puts you ahead of other qualifying applicants. Therefore, look for ample opportunities to serve your community with medical knowledge. You can participate in medical camp travels or volunteer at your local clinic.

Keep track of all the community involvement and boldly talk about them and the impact you have brought to society during the orthopedic surgery residency interviews.

What are the Advantages And Disadvantages Of Being An Orthopedic Surgeon?

Orthopedic surgery is a competitive but highly sought career. It comes with numerous benefits, but there are some aspects of it you will not love, as discussed below:


  • Satisfaction of fixing distinct problems- Unlike some medical specialists who manage conditions, orthopedic surgeons fix conditions through successful surgeries for most patients.
  • Orthopedic surgeries are fun- because they involve many open cases, exposing the surgeons to the unique human anatomy. While non-invasive surgeries are becoming more popular, most surgeons do not enjoy them.
  • High compensations and work stability- Orthopedic surgeons are on the list of the top compensated surgeons despite the hard work and tight working schedules.


  • Length of education- in addition to medical school years, you must complete your internship and five years residency to become an orthopedic surgeon.
  • Demanding working hours- the lifestyle of an orthopedic surgeon revolves around work, especially after residency. Be ready to give up a lot of your social and family life.

Is Orthopedic Surgery The Right Field For You?

Orthopedic surgery is open to everyone with a passion for musculoskeletal anatomy who meets all residency requirements. However, it is a very competitive specialty, so you should be able to work for top scores in medical school, pursue numerous rotations, get involved in community service, and be involved in medical research to stand out among hundreds of qualifying applicants.

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