During this four-year period, training includes patient care, trauma, metabolic bone disease, benign and malignant tumors, laboratory tests, radiology, orthotics and reconstructive surgery. Basic science such as biomechanics, physiology and pathology are included. A resident's effectiveness as a physician is evaluated and refined during these years. An application to complete Part II can be submitted following three years of practice. Certificates are valid for 10 years.
Many orthopaedic surgeons are Fellowship trained.
This means they have received in depth training beyond their residency in a super-specialty such as the spine. Fellowships usually involve clinical experience combined with research in the super-specialty for one to two years.