Orthopedic Surgery

An orthopaedic surgeon is educated in the preservation, investigation, and restoration of the form and function of the extremities, spine, and associated structures by medical, surgical, and physical means. This specialist is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries, and degenerative diseases of the spine, hands, feet, knee, hip, shoulder, and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

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Competitiveness: EXTREME

IMG profile

Average Stats for a Matched US IMG in 2024:

Pct. that passed USMLE Step 1 on first attempt 100%
USMLE Step 2 CK score: 257
Research: 5
Abstracts/Presentations/Publications: 14
Work: 8
Volunteer: 4

Average Stats for a Matched Non-US IMG in 2024:

Pct. that passed USMLE Step 1 on first attempt 100%
USMLE Step 2 CK score: 248
Research: 4
Abstracts/Presentations/Publications: 28
Work: 5
Volunteer: 6

Speciality Factors

In March 2024, the National Resident Matching Program (NRMP) conducted its survey of directors of programs participating in the Main Residency Match® to characterize the factors that Program Directors use to select applicants for interviews and rank applicants for the Main Residency Match. See results of the Program Director Survey for Orthopedic Surgery below:

Frequency and Mean Importance Ratings of Each Factor Considered in Deciding Who to Interview

Letters of recommendation in the specialty: 88% (4.5)
Class ranking/quartile: 88% (4.3)
Personal prior knowledge of the applicant: 76% (4.8)
Grades in required clerkships: 76% (4.3)
Audition elective/rotation within your department: 76% (5.0)
Medical Student Performance Evaluation (MSPE/Dean`s Letter): 70% (4.0)
Consistency of grades: 61% (4.4)
Awards or special honors in clinical clerkships: 58% (4.1)
Alpha Omega Alpha (AOA) membership: 58% (3.9)
Grades in clerkship in desired specialty: 55% (4.3)
Gold Humanism Honor Society (GHHS) membership: 42% (3.7)
Away rotation in your specialty at another institution: 39% (4.2)
Awards or special honors in clerkship in desired specialty: 39% (4.1)
Evidence of continuous medical education without gaps: 30% (3.4)
Awards or special honors in basic sciences: 27% (3.4)
Accreditation status of applicant`s medical school: 27% (3.6)
Graduate of highly-regarded medical or osteopathic school: 24% (3.6)
Ability to work legally in the U.S. without a visa: 24% (4.0)
Sigma Sigma Phi (osteopathic honor society) membership: 18% (4.0)
Applicant was flagged with Match violation by the NRMP: 18% (4.8)
Visa status: 15% (4.3)
How applicant`s medical school handled virtual rotations: 6% (2.0)

Frequency and Mean Importance Ratings of Each Factor Considered in Deciding Who to Rank

Interactions with faculty during interview and visit: 81% (4.8)
Feedback from current residents: 81% (4.8)
Interpersonal skills: 78% (4.6)
Interactions with house staff during interview and visit: 72% (4.9)
Class ranking/quartile: 63% (4.3)
Medical Student Performance Evaluation (MSPE/Dean`s Letter): 53% (4.1)
Alpha Omega Alpha (AOA) membership: 44% (4.3)
Consistency of grades: 41% (4.5)
Grades in required clerkships: 31% (4.3)
Grades in clerkship in desired specialty: 22% (4.5)
Gold Humanism Honor Society (GHHS) membership: 22% (4.3)
Awards or special honors in clinical clerkships: 22% (4.1)
Evidence of continuous medical education without gaps: 19% (4.0)
Awards or special honors in basic sciences: 19% (3.7)
Sigma Sigma Phi (osteopathic honor society) membership: 13% (4.8)
Graduate of highly-regarded medical or osteopathic school: 13% (4.0)
Awards or special honors in clerkship in desired specialty: 13% (4.8)
Accreditation status of applicant`s medical school: 9% (4.3)
Other post-interview contact: 6% (4.5)
Applicant facility with meeting platform technology: 6% (2.5)
Second interview/visit: 3% (4.0)
How applicant`s medical school handled virtual rotations: 3% (3.0)

¹Ratings on a scale from 1 (not at all important) to 5 (very important).

% of Programs Interviewing IMGs:

US IMG: Often 0%, Seldom 64%, Never 36%
Non-US IMG: Often 0%, Seldom 48%, Never 52%

% of Programs Ranking IMGs:

US IMG: Often 3%, Seldom 53%, Never 44%
Non-US IMG: Often 0%, Seldom 44%, Never 56%

% of Programs Using USMLE to Select IMG Applicants for Interview:

Step 1: Does not consider 12%, Requires pass only 88%, Prefers but does not require target score 0%, Requires target score 0%
Step 2 CK: Does not consider 5%, Requires pass only 10%, Prefers but does not require target score 29%, Requires target score 57%
Step 3: Does not consider 71%, Requires pass only 5%, Prefers but does not require target score 19%, Requires target score 5%

Fast Facts

Total Training	5 years
Average Residency Salary	$60,000
Average Physician Salary	$560,000
Average Physician Work Week	57 Hours
Peak Interview Months	December-February
Key Organizations and Societies	American Academy of Orthopaedic Surgeons, American Academy of Orthopaedic Surgeons: Diversity in Orthopaedics, American Association of Hip and Knee Surgeons, American Board of Orthopaedic Surgery, American Orthopaedic Association, American Osteopathic Academy of Orthopedics, Clinical Orthopaedic Society, Hip Society, Knee Society, Limb Lengthening and Reconstruction Society, Orthopaedic Research and Education Foundation, Orthopaedic Research Society
Orthopaedic surgery is one of the least IMG-friendly specialties.

Match Statistics 2025

Main Residency Match

PGY-1

Main Residency Match and Post-Match Stats

22

Total IMGs Matched

216

Total Number of Available Programs

929

Positions

0

Post-Match SOAP Unfilled Positions

Post-Match SOAP

Program Track	Participating Programs	Positions Available	Filled Programs	Filled Positions
PGY-1	0	0	0	0

Subspecialties

Adult Reconstructive Orthopaedic Surgery
Foot and Ankle Orthopaedic Surgery
Hand Surgery
Musculoskeletal Oncology
Orthopaedic Sports Medicine
Orthopaedic Surgery of the Spine
Orthopaedic Trauma
Pediatric Orthopaedic Surgery

Additional Info

For the 2025 Orthopaedic Surgery residency application cycle, the key updates and guidelines are as follows:

Select Orthopeadic surgery programs may participate in program signaling (30 signals). Please visit the ERAS application webpage for information, guidance, timelines, and resources on completing the ERAS application.
For letters of recommendation to orthopaedic surgery residency applications, the American Orthopaedic Association`s (AOA) Council of Orthopaedic Residency Directors (CORD) requests an Electronic Standardized Letter of Recommendation (eSLOR) as a replacement for a traditional narrative letter of recommendation. A separate written letter of recommendation is not necessary if utilizing the eSLOR. For further information about AOA/CORD recommended guidelines including Universal Interview Offer Day, visit the the Residency Application Resource section on the AOA website.
Members of the GSA, Careers in Medicine, and Organization of Program Director Associations (OPDA) are collaborating in an effort to increase transparency in the residency application process through use of a Residency Guide template for each specialty. See guidance template here: CORD-Ortho_Program-Directors-Association-Guide-for-Residency-Applicants-06.2024.pdf (cmss.org).