Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Science




Lanting, Brent A

2nd Supervisor

Schemitsch, Emil H



Orthopedic surgery is a field which has often been talked about with regards to surgeon underemployment. This is particularly important given the paradoxical increasing demand for orthopedic care. There has not been well studied literature understanding the state of orthopedic surgery training in Ontario, Canada. Using a combination of various databases and surveying surgeons trained in Ontario we sought to provide some insight.

We demonstrated multiple important findings. More recent graduates are feeling less ready to enter practice and almost all graduates do at least 1 fellowship, with equal amount of 1 versus 2 fellowships. We showed an effect of school of graduation on likelihood of emigrating out of Ontario. More recent graduates are more likely to emigrate out of necessity, and less likely to pursue a graduate degree out of interest. Despite all the challenges, however, orthopedic surgeons remain satisfied with their work.

Summary for Lay Audience

Despite having received a significant level of training, orthopedic surgeons trained in Ontario do not feel ready to enter practice and are spending an extra two years in further training: whether it be waiting for a job or expanding their skills—significantly more than surgeons trained in the United States. More recent graduates are going to the United States out of necessity, getting graduate degrees not out of interest, and are feeling less ready to enter practice. All of which are outcomes which necessitate a re-evaluation of how surgeons are being trained in Ontario, Canada. We also showed that graduates from the University of Ottawa are more likely to work in the USA and settle farthest from their school of training, suggesting a regional mismatch of needs and resources to maintain the number of surgeons trained and raises questions worth looking into.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.