Orthopedic surgery in the United States has gone through many changes over the past few centuries. Starting with a small sect of subspecialized surgeons, advances in technology and surgical skills have paralleled the growth of the specialty. To keep up with demand, the training of orthopedic surgeons has undergone many iterations. From apprenticeships to the current residency model, the field has always adapted to ensure the constant production of well-trained surgeons to take care of the growing orthopedic needs in the population. In order to guarantee this, many regulatory committees have been formed over the years to help guide the regulation and certification of orthopedic training programs. With current day residents facing new challenges, the specialty continues to adapt the way it trains its future.