Orthopedic Surgeon Job Description

BLS describes the specialty plainly: orthopedic surgeons diagnose and treat conditions of or injuries to the musculoskeletal system, which includes bones, muscles, ligaments and tendons. In practice that means everything from a displaced distal radius fracture in a teenager who fell off a skateboard to a worn-out knee in a retired carpenter to a lumbar stenosis that has made walking a block impossible.

The operating room

Surgery is the part of the job that defines the specialty. A general orthopedist's schedule might combine hip and knee replacements, fracture fixation with plates and intramedullary nails, carpal tunnel releases and knee arthroscopy. Subspecialists narrow that list. A joint replacement surgeon lives in primary and revision arthroplasty; a spine surgeon handles decompressions and fusions; a hand surgeon works on tendons, nerves and small bones; a foot and ankle surgeon corrects bunions, flatfoot and ankle arthritis; a sports surgeon rebuilds ligaments and repairs labral and rotator cuff tears.

Much of the work is mechanical judgment under constraints. Reducing a fracture under fluoroscopy, balancing a knee replacement so it tracks and feels stable, or placing pedicle screws without breaching the canal all demand spatial reasoning and physical steadiness, often for hours. Surgeons work with implant representatives, scrub technicians, circulating nurses and anesthesiologists, and they carry responsibility for implant selection, positioning and the complications that follow.

The clinic

Clinic days balance the schedule. New patients arrive with radiographs and MRI reports, postoperative patients come back for wound checks and range-of-motion assessments, and others return for injections. The core question in every new visit is whether surgery will actually change the patient's function, and whether it needs to happen now. Plenty of patients do better with a brace, a corticosteroid injection, weight loss or a structured therapy program, and a large part of the job is explaining that honestly.

Call and trauma

Emergency call brings a different caseload. At a community hospital that might mean hip fractures in older patients and ankle fractures from falls; at a trauma center it means polytrauma, open fractures, pelvic injuries and compartment syndrome, often in coordination with general and trauma surgery. How much call a job carries is one of the first things to ask about in any offer.

Paperwork, payers and teams

Outside the operating room, surgeons write operative notes, complete prior authorizations for imaging and procedures, track patient-reported outcomes, and answer to hospital quality committees. Where a hospital is paid by the surgical episode, the surgeon's choices about length of stay, discharge destination and readmission risk get close review. In teaching hospitals the role also includes supervising residents, running conferences and, for academic surgeons, research.

Education and residency

The path starts like any physician's: a bachelor's degree with premedical coursework, then a four-year MD or DO program. Orthopaedic surgery residency typically runs five years after medical school. Residents rotate through trauma, adult reconstruction, spine, sports, hand, foot and ankle, pediatrics and oncology, with growing operative autonomy each year. Applicants typically strengthen their case with licensing exam performance, research and away rotations.

Many surgeons then add a one-year fellowship. Options include sports medicine, adult reconstruction (joint replacement), spine, hand and upper extremity, foot and ankle, trauma, pediatric orthopaedics and musculoskeletal oncology. Fellowship choice largely decides which cases fill a surgeon's schedule for the rest of a career.

Board certification

Certification comes from the American Board of Orthopaedic Surgery (ABOS) in two steps. First-time takers sit for the Part I examination in the fifth year of residency, at a Pearson VUE test center. The Part II examination is an oral examination, and candidates submit a case list as part of the process. A surgeon who has passed Part I but not Part II is board eligible, and ABOS caps that status at five years.

After initial certification, surgeons keep it current through ABOS requirements; ABOS offers the ABOS Web-Based Longitudinal Assessment (ABOS WLA) pathway as one route. ABOS also awards subspecialty certificates in Orthopaedic Sports Medicine and Surgery of the Hand for surgeons who complete the required fellowship training and examinations.

Licensing and credentialing

Practice requires a full medical license from a state medical board, which in turn requires passing the USMLE, owned by the Federation of State Medical Boards and the National Board of Medical Examiners (for MDs), or COMLEX-USA from the National Board of Osteopathic Medical Examiners (for DOs). Surgeons prescribing controlled substances need a registration from the Drug Enforcement Administration. Every hospital and surgery center then credentials the surgeon separately, granting privileges procedure by procedure, and may require documented training before a surgeon uses a robotic or navigation platform.

Skills that matter

Beyond technical skill, the surgeons who do well tend to share a few traits: good judgment about when not to operate, calm under trauma-call pressure, clear communication with patients about realistic outcomes, and physical stamina for long cases. Comfort with outcome data also helps when quality committees review length of stay, readmissions and patient-reported outcomes.

BLS projects employment of physicians and surgeons as a group to grow 4 percent from 2025 to 2035, about as fast as the average for all occupations, with about 22,100 openings a year over the decade. BLS expects many of those openings to come from replacing physicians who change occupations or leave the labor force, such as through retirement. BLS counted 14,100 people employed as orthopedic surgeons, except pediatric, in May 2025, and for a specialty that size, local demand, call coverage needs and hospital service-line strategy shape individual job markets.

Pay

The May 2025 BLS figures put the median wage for orthopedic surgeons (except pediatric) at $358,550, the mean at $373,570, and the 75th percentile at $530,700. Owners in independent groups, surgery center investors and surgeons paid through production arrangements can see income structured quite differently, so offer letters should be compared on base, productivity terms, call pay and benefits rather than a single headline figure.

Medicare's episode payments reach orthopaedics

A major regulatory shift for the specialty is how Medicare pays for surgical episodes. The Transforming Episode Accountability Model (TEAM) is a mandatory CMS model that runs for five performance years, from January 1, 2026, to December 31, 2030, in selected Core-Based Statistical Areas. Hospitals paid under the inpatient prospective payment system in those areas are accountable for episodes that include lower extremity joint replacement, surgical hip femur fracture treatment and spinal fusion, alongside coronary artery bypass graft and major bowel procedures.

CMS then went further. The CJR Expanded (CJR-X) Model was finalized in the Fiscal Year 2027 IPPS final rule on July 31, 2026. It covers hip, knee and ankle replacements performed in inpatient and outpatient hospital settings, holds hospitals accountable from the procedure through the first 90 days of recovery, and will be mandatory nationwide beginning January 1, 2028. For surgeons, the practical consequence is that hospitals are accountable for joint replacement care through the 90-day recovery window, so choices about discharge destination and post-acute care are likely to get closer review.

Technology and AI

A February 2026 study of FDA-cleared AI medical devices in orthopaedic surgery in JAAOS Global Research and Reviews, found the three-year moving average of clearances rose from 3.0 devices a year in 2017 to 2019 to 16.6 from 2022 to 2024. The same study found 22.8% of these devices lacked clinical testing and only 8.6% were validated through a formal, prospective clinical trial, and the authors called for improved regulatory safeguards and clinical evaluation standards. For a practicing surgeon, that means reading the validation data before trusting an AI planning or imaging tool, not after.

Where the jobs are

Openings exist across hospital-employed service lines, independent and multispecialty groups, academic departments and ambulatory surgery centers. Each carries different trade-offs in call, autonomy, case mix and how pay is structured, and the right fit depends on subspecialty and where a surgeon wants to live.

Dear Dr. Ramirez and the Search Committee,

I am applying for the orthopaedic surgeon position with the Lakeshore Regional Health adult reconstruction service. I will finish my adult reconstruction fellowship at Midwestern University Hospital in June, and I passed the ABOS Part I examination during my final year of residency.

My fellowship has centered on primary and revision hip and knee arthroplasty. I have planned and performed cases with both robotic-arm assistance and conventional instrumentation, and I have learned to choose between them based on anatomy, deformity and the patient's goals rather than habit. Revision work has been the most valuable part of my training: managing bone loss, extracting well-fixed components and staging infected joints taught me to plan for the second and third option before the first incision.

I also run our fellowship's rapid-recovery pathway meetings with physical therapy, anesthesia and case management. We rewrote our discharge criteria together, and I now think of length of stay and discharge destination as part of the surgical plan rather than something that happens after it. I understand your hospital participates in Medicare episode payment programs, and I would welcome the chance to help the joint program meet those targets without cutting corners on patient selection.

During residency I took trauma call at a Level I center, and I am comfortable sharing general call, including hip fractures and periprosthetic fractures, which I know are a steady part of the work at a regional hospital.

I would be glad to share my case logs, fellowship evaluations and references from my program director. Thank you for considering my application.

Sincerely, Dana Okafor, MD