Orthopaedic Job Market Is Changing

Published March 11th at the 2014 AAOS Annual Meeting


Academic opportunities, demand for pediatric, shoulder orthopaedists increasing

Residents attending the AAOS Annual Meeting may want to review Poster P276, “Changes in Orthopaedic Job Market Demand in the United States Over the Last Decade” before making a decision about selecting a specialty. According to the authors—Thierry Pauyo, MD; Patrick Scheffler; Mitchel B. Harris, MD; and Stephane Bergeron, MD—the orthopaedic job market has changed during the past decade.

The authors based their conclusions on an analysis of orthopaedic job opportunities advertised in The Journal of Bone and Joint Surgery–American from 2000 to 2012. Only full-time positions within the United States were included. Data collection included the following:

  • year of the original job posting
  • type of practice (community vs. academic)
  • mandatory requirements for fellowship training or prior experience.

Specialty training was recorded according to one of the following areas: arthroplasty, foot and ankle, general, hand, oncology, trauma, pediatric, shoulder and elbow, spine, and sports. Duplicate advertisements in subsequent issues were excluded, as were postings for nonsurgical positions such as orthopaedic hospitalists or basic science researchers.

A total of 4,248 orthopaedic job opportunities were recorded during the study period. Job postings that specified mandatory fellowship training increased significantly—from 42 percent of postings in 2000 to 77 percent of postings in 2012. Academic job opportunities also increased significantly, from 31 percent of postings in 2000 to 59 percent of postings in 2012.

More than a third of postings (36 percent) specified general orthopaedics, making this the most popular category. Rankings of the other specialty areas were as follows:

  • Hand—10.4 percent
  • Spine—10.2 percent
  • Arthroplasty—9.7 percent
  • Foot and ankle—9.1 percent
  • Trauma—8.4 percent
  • Pediatrics—5.9 percent
  • Sports—5.7 percent
  • Shoulder and elbow—2.5 percent
  • Oncology—2 percent

When researchers analyzed the specialty areas by year, however, they discovered that the demand for arthroplasty, pediatrics, and shoulder and elbow surgeons has increased over the past 12 years, while the demand for general orthopaedists and spine specialists has decreased. A recent study of orthopaedic trauma fellows showed an inverse relationship between the number of graduating trauma fellows and trauma-specific positions over the last 9 years.

According to the authors, orthopaedic residents’ decision to pursue additional fellowship training in an orthopaedic specialty is “influenced by role models, interest, and intellectual curiosity, independent of the potentially available information regarding the workforce supply of specialists and population demands.” In fact, no data or organized approach currently exists to help guide graduating orthopaedic residents in selecting fellowship training according to projected needs in each subspecialty area.

The authors note that determining the actual number of job opportunities for graduating orthopaedic residents is impractical due to the various types of searches that may be conducted by employers or practices. For example, positions may be posted in a general orthopaedic journal, in a specialty-specific journal, or online. Candidate searches may be conducted using recruiters or through word-of-mouth.

However, analyzing the employment opportunities in a major general orthopaedic journal may provide an excellent indicator of the changes in the orthopaedic job market. The authors hope that the results of their study can help guide senior graduating orthopaedic residents in choosing specialty training according to workforce requirements and job opportunities in different areas of the United States.

Details of the authors’ disclosure as submitted to the Orthopaedic Disclosure Program can be found in the Final Program; the most current disclosure information may be accessed electronically at