How to Become an Orthopaedic Surgeon in Australia

In Australia, orthopaedic training is run by the Australian Orthopaedic Association (AOA), to which the Royal Australasian College of Surgeons (RACS) has delegated the orthopaedic Surgical Education and Training (SET) programme (opens in a new tab). The route is a medical degree, an intern year, several prevocational years building orthopaedic experience, selection into the AOA 21 Training Program, a minimum of four years of competency-based training and the RACS Fellowship Examination, leading to Fellowship of RACS (FRACS) in orthopaedic surgery. This guide sets out each step with the AOA's and RACS's published rules. For other countries, see the guide to becoming an orthopaedic surgeon.

The Australian pathway at a glance

Internship and the prevocational years

Under the Medical Board of Australia's registration standard (opens in a new tab) in force since 2024, interns (PGY1) must complete 47 weeks full-time equivalent training, including at least four terms of at least 10 weeks in different specialties covering undifferentiated, chronic, acute and critical, and peri-procedural patient care. Completion leads to general registration.

AOA 21 does not take applicants straight from internship. The selection regulations for the 2027 intake (opens in a new tab) require orthopaedic experience at PGY3 or higher, so applicants spend the years after internship as residents and then as unaccredited (service) orthopaedic registrars. Those years are where the experience, referees and CV points for selection are earned. Our guide to building an orthopaedic portfolio early covers what to collect.

Eligibility for AOA 21

Application is a two-stage process (opens in a new tab): registration with RACS, which checks the generic eligibility criteria common to all surgical specialties, then an application to the AOA. For the 2027 intake, AOA applications opened on 18 February 2026.

The AOA's specialty-specific criteria, which must be met by the date applications open, are:

• At least 26 working weeks of orthopaedic surgical experience within the last two years, at PGY3 or higher, in a public hospital with an emergency department and an on-call roster. Terms of at least six continuous weeks can be added together, and part-time experience counts pro rata.
• A pass in the RACS Generic Surgical Sciences Examination (GSSE). A pass in the February 2026 sitting was not accepted for the 2027 intake.
• A state-licensed radiation safety course.

How AOA selection works

The 2027 regulations use five selection tools in sequence:

The OMCQ (opens in a new tab) is a single 75-minute paper of 50 questions, each a lead-in with four options marked true or false, scored out of 100 with no negative marking. It is pitched at a well-performing unaccredited registrar ready to start training and covers basic orthopaedic sciences, common conditions, surgical approaches and anatomy, and clinical examination.

Applicants are ranked nationally and invited to interview by region of preference. The regulations include initiatives for Aboriginal and Torres Strait Islander applicants, female applicants and applicants of rural origin, who can progress to later stages independent of score or rank once minimum criteria are met. Applicants who preference Queensland can also opt in to the Far North Queensland rural training rotation.

How many places? RACS publishes the number appointed each year, including deferred offers: 59 for 2020, 42 for 2021, 45 for 2022, 51 for 2023, 52 for 2024, 61 for 2025 and 57 for 2026. The AOA's careers page (opens in a new tab) describes an average of four to five applicants per available post each year.

What AOA 21 training involves

AOA 21 was launched in 2018 after a review recommended moving from time-based to competency-based training. Its curriculum framework (opens in a new tab) is built on a curriculum introduced in 2017 and informed by the CanMEDS framework, and training progresses through three stages:

1. Introduction to Orthopaedics establishes foundation competencies and basic surgical skills, with a focus on trauma care.
2. Core Orthopaedics develops assessment, management and operative skills across general orthopaedic surgery.
3. Transition to Practice prepares the trainee for independent specialist practice, with room for focused development in areas of interest.

Progression depends on demonstrated competence, not time served, but RACS's Guide to SET (opens in a new tab) sets minimums of 12, 24 and 12 months for the three stages, giving a minimum duration of four years.

Training begins with a residential Bone Camp, followed by regular Bone School sessions and prescribed courses (Training in Professional Skills, CCrISP, and EMST or ATLS). Assessment is programmatic: fortnightly workplace-based assessments and feedback entries, three-monthly performance appraisals, six-monthly progress reviews by the director of training, orthopaedic modules, an electronic logbook, and a panel stage review before each move to the next stage.

The OPBS and the Fellowship Examination

Two RACS examinations sit inside AOA 21:

• The Orthopaedic Principles and Basic Sciences (OPBS) examination, taken early in training, assesses knowledge and application of the basic sciences relevant to orthopaedic surgery.
• The Fellowship Examination (opens in a new tab) is held twice a year. In each specialty it has seven segments, most commonly two written papers and five clinical or viva segments. The written papers come about a month before the clinicals and vivas, and the standard is that of a consultant in the first year of independent practice. Candidates no longer progress automatically to the clinical segments, because the written component is a hurdle.

Our FRACS orthopaedic exam guide covers both examinations in detail.

After FRACS

Completing AOA 21 and passing the Fellowship Examination leads to FRACS in orthopaedic surgery and eligibility for consultant posts. The AOA estimates that about 1,300 orthopaedic surgeons work in Australia, most of them in private practice. Some take a subspecialty fellowship first; the AOA accredits fellowships in Australia, and our fellowship application guide covers how to choose and apply. Surgeons trained overseas are assessed through a separate specialist international medical graduate process, covered in our guide to IMG routes into orthopaedic surgery.