Being a Trauma and Orthopaedic (T&O) surgeon is an extremely rewarding career. There are few areas in medicine where you have the opportunity to transform people’s lives, whether you are putting them back together after severe trauma, or you are giving someone back their independence by relieving the pain from an arthritic joint. A career in T&O combines theoretical knowledge with practical skills, but also involves an interface with technology, industry and a multidisciplinary team unmatched by any other specialty. 


A career in Orthopaedic Surgery - Kat Dayananda, Trauma and Orthopaedic Surgery Specialty Trainee

Kat Dayananda, Wales Deanery, explains why she chose a career in trauma and orthopaedics and recommends, "if you, like me wish to be a real person, dealing and helping with with real people's problems, then choose a career in T&O".


A career in Orthopaedic Surgery - Interview with Deborah Eastwood

Pranai Buddhdev (Paediatric Orthopaedic Surgeon & Paedipods Founder) interviews Professor Deborah Eastwood from Great Ormond Street Hospital, London & Royal National Orthopaedic Hospital, Stanmore. Together they discuss her illustrious career, what drove her to surgery and paediatric orthopaedics and explore her ongoing contributions to international education, research and leadership at the highest level.

What does T&O cover?

Trauma and orthopaedic surgeons diagnose and treat a wide range of conditions of the musculoskeletal system which includes bones, joints and their associated soft tissues including tendons, nerves and muscles. Trauma work involves  dealing with fractures and other injuries from accidents and sports injuries but also fragility fractures such as fractured hips in older patients. Specialist areas include lower-limb joint reconstruction (hip or knee, foot and ankle), upper limb (shoulder, elbow or hands), spine, bone tumours, paediatric orthopaedics, rheumatoid surgery, and sports and exercise surgery. 

Why should I do T&O?

T&O surgery is a rewarding specialty and one where you can feel you are genuinely making a difference to people's by improving their quality of life.  Patients are usually grateful when you replace a joint to alleviate painful arthritis or repair multiple fractures following an accident. 

T&O surgery is also seen as a sociable specialty and the support you’ll receive from other colleagues adds to your job satisfaction.

T&O offers many research opportunities. The technology in T&O is developing rapidly and new therapeutic techniques greatly benefit patients. Surgical techniques are always moving forward with minimally invasive surgery increasingly aiding reduced scarring and faster recovery times.

T&O surgeons comprise a significant proportion of the UK's surgical workforce. There is a growing demand for their services as a result of our increasingly ageing population coupled with the UK’s obesity epidemic. 

Where can a role in T&O lead?

T&O surgery is a highly competitive specialty, with varied and interesting career opportunities.

Consultant roles

You can apply for consultant roles six months prior to achieving your Certificate of Completion of Training (CCT). You will receive your CCT at the end of your T&O training.

SAS doctor roles

There are also opportunities to work at non-consultant level, for example as a SAS (Specialist and Associate Specialist) doctor.

SAS surgeons (Staff, Associate Specialists and Specialty Doctors) work as career grade specialty doctors who are not in training or in consultant posts. You will need at least four postgraduate years training (two of those being in a relevant specialty) before you can apply for Specialty Doctor roles.

Other non-training grade roles

These roles include:

  • clinical fellows 
  • academic surgical careers (combinking clinical training with research or teaching in a higher education setting)


Training pathway

Below is the most common pathway to pursue a career in surgery:

Medical Degree (4-6 years)

Entry method: Application, admission test and interview

Prerequisites: At least three very good A-Levels in relevant subjects, plus good GCSEs

Examination: MBBS, MBCHB

On completion: Provisional registration with the GMC

Foundation Training (2 years)

Entry method: Online application (ranked)

Prerequisites: Provisional registration with the GMC

Examination: Part A of the MRCS may be taken

Full registration with the GMC occurs at the end of FY1

Core Training (2 years)

Entry method: Central recruitment with application and selection centre or interview

Prerequisites: Full GMC registration and completion of foundation competencies

Examination: MRCS (must complete Part A and Part B during core training)

On completion: MRCS qualification

Improving Surgical Training Project (2 years leading the Run Through training)

This is currently only a pilot project starting in T&O in 2020

The aim is to deliver an enhanced experience in surgical training compared with the current core training.

Candidates on this scheme starting this year will be on a run through path to CCT so potentially an eight year programme

Specialty Training (approx. 6 years)

Entry method: Application form, selection centre and interview

Prerequisites: MRCS examination, successful completion of core training

Examination: Intercollegiate specialty exam (FRCS)

On completion: Award of a Certificate of Completion of Training (CCT)

On receipt of a CCT on T&O candidates are entered onto the Specialist register of the GMC and are eligible to apply for Consultant posts in the UK

Specialties in orthopaedics include:

  • Hip surgery
  • Knee surgery
  • Foot and ankle surgery
  • Shoulder and elbow surgery
  • Hand surgery
  • Spine surgery
  • Oncology
  • Trauma
  • Paediatrics

Please view our specialist society page if you would like more information in a particular specialty of orthopaedics here.

Alternative career paths

There are various alternative career paths and working options available throughout a career in T&O surgery. More information on some of the option is provided below:

  • Specialty and associate specialist surgeons (SAS)

Becoming an SAS surgeon is an alternative career path you may wish to consider if you have entered surgical training from another country or medical field, or have decided to leave the traditional training route. Full registration with the GMC and a minimum of four years’ postgraduate training including two years in the relevant specialty are required to become a specialty doctor. SAS doctors work at various career grades in hospitals and form an integral part of the UK's medical workforce with responsibilities and training varying greatly. They work in key service roles within the NHS which usually offer the opportunity to focus predominantly on providing direct surgical care in wards, outpatient clinics and operating theatre and less on the other clinical and non-clinical responsibilities required of a consultant or trainee. 

  • Academic surgery

If you are particularly interested in undertaking research and are familiar with research methodologies then you may wish to choose to pursue a formal academic career path. An academic surgical career combines clinical training with research or teaching in a higher education setting. There is no single pathway to an academic surgical career but the two essential requirements are to complete surgical training and to acquire a solid research training. These can be undertaken completely separately or with some degree of overlap or integration by holding a Clinical Lecturer post in the later stages of training. 

Less Than Full Time Training (LTFT)

There are a number of opportunities to train flexibly during a surgical career.  Any trainee can request to train less than full time and although more female
trainees are taking part in LTFT the option is available to all genders. Requests, however are prioritised based on need, especially for those with dependants, although many trainees also train part time to pursue sport at a national level or to undertake research. Once you are qualified, you will be able to consider a number of flexible working options subject to agreement with your employer. These options include:

  • Annualised contracts
  • Compressed hours
  • Early/late contracts
  • Part time
  • Flexible retirement options
  • Term time working