In order for an orthopedic surgeon to be board-certified, they must have a valid medical license. Board certification is not absolutely necessary for licensure. However, it sets apart the surgeon from their peers and helps get them recognized as a specialist by their patients, employers, hospitals, and insurers. To date, there are 29,908 board-certified orthopedic surgeons. The orthopedic surgeon must have completed their accredited residency before applying to become board-certified. They must take a computer-based examination that is absolutely secure, computer-administered, and timed. The exam is made up of 320 multiple choice questions that revolve around the orthopedic specialty. Candidates take the exams at Prometric testing sites. The test is divided into seven sections and must be completed within eight hours. The exam is created by the national board of medical examiners and each question must be supported by at least two peer-reviewed references. All the questions are also reviewed by at least three different surgeons before they appear on the exam. Once the surgeon passes the part one multiple-choice question examination, they can then be eligible for the part two oral examination. Within a five-year time period, candidates can be admitted to the oral examination after they've been in practice for 17 months at one location. In the oral examination, 12 cases are selected and presented to the test applicant. The exam is two hours long and divided into four parts with two different examiners for each period. The oral examination evaluates the test candidate regarding how they handle complications, their level of professionalism, their ethics, and surgical indications of variability. If they pass the examination, they become board-certified for ten years before renewal.