A comparison of orthopaedic surgery training across five English-speaking countries

Introduction: There is undocumented and unjustified variability in orthopaedic surgery training between countries. This study compares and contrasts the main features of orthopaedic training in Australia, New Zealand, the United Kingdom, United States, and Canada.

Methods: Comparisons included: competition for, and selection into, training; training pathway structures; training requirements, and; training length.

Results: Selection into orthopaedic surgery training is competitive in all countries assessed with acceptance rates ranging from 22%-26% in Australia and New Zealand to 85% in Canada. Minimum length of post-medical school training varies from 5 years in the USA and Canada, to 8 years in Australia, 9 years in New Zealand, and 10 years in the United Kingdom. All countries encourage participation in research during training, although there are varying requirements. Significant bottlenecks characterize selection into training in Australia, New Zealand, and the United Kingdom, meaning the majority of doctors take more than a decade from medical school graduation to obtaining their specialty surgery qualification.

Conclusions: There is high variability between the orthopaedic training programs of the studied countries. An awareness of these differences and similarities may help improve training, or provide solutions for identified gaps in each country.