Overview

AOA 21 is the Australian Orthopaedic Association training program in orthopaedic surgery, introduced in 2018
Trainees progress when they show competence, within minimum and maximum times set by AOA
Average length about five years, rotating through one of seven regional networks
Graduates apply for FAOrthA and FRACS
Curriculum built on the CanMEDS approach

Stages of Training

Stage	Minimum time	Milestones
Introduction to Orthopaedics	12 months	Bone Camp, CCrISP and TIPS. OPBS examination. Introduction to Trauma module. Workplace-based assessments and the eLog begin
Core Orthopaedics	24 months, usually about 3 years	ATLS. Weekly Bone School. All orthopaedic modules. Fellowship Examination
Transition to Practice	12 months	AOA workshops and ethics and professionalism sessions. CPD-based learning plan. Research pathway completed

A stage review panel assesses the trainee portfolio before each progression.

Assessment

Category	Examples
Ongoing	Feedback entries at least fortnightly. Patient consultation, management plan, case-based discussion and surgical skills assessments. eLog
Periodic	Three-monthly performance appraisal with the trainee supervisor. Six-monthly progress review with the director of training
Stage-linked	Orthopaedic module completion, OPBS, Fellowship Examination and stage review

Curriculum

Foundation Competencies

Communication
Teamwork and conflict management
Professionalism
Leadership and organisational skills
Advocacy, including cultural awareness
Education and research

Study History, History & Examination, Level of Evidence, Grades of Recommendation. See Professional Practice. Ethics, cultural safety and professionalism are taught through Bone School and the RACS Professional Skills Curriculum.

Medical and Surgical Expertise

Orthopaedic principles and basic sciences, tested in the OPBS
Medical expertise, covering applied science, assessment and management
Surgical expertise, covering pre, intra and post operative care

Orthopaedic Modules

The Introduction to Trauma module is signed off in Introduction to Orthopaedics. The topic modules are completed by the end of Core Orthopaedics, supported by workplace-based assessments and the eLog.

Module	Study on Orthofracs
Trauma and injury	Adult Trauma and Fractures, Paediatric Fractures & Trauma, Adult Trauma Principles, Approach to the Multi-trauma Patient
Shoulder	Adult Shoulder & Pectoral Girdle Disorders, Shoulder, upper arm and elbow fractures, Examination of the Shoulder, Shoulder approaches
Elbow	Adult Elbow Disorders, Examination of the Elbow, Elbow approaches
Hand and wrist	Adult Wrist & Hand Disorders, Adult Hand & Wrist Trauma, Examination of the Hand, Hand and wrist approaches
Hip	Adult Hip Disorders, Adult Hip Fractures, Examination of the Hip, Hip approaches
Knee	Adult Knee Disorders, Knee and Tibia, Examination of the Knee, Knee approaches
Foot and ankle	Adult Foot & Ankle Disorders, Adult Foot Fractures, Adult Ankle Fractures, Examination of the Foot & Ankle, Ankle and foot approaches
Spine	Adult Cervical Spine Disorders, Adult Thoracolumbar Spine Disorders, Adult Spine Trauma, Examination of the Cervical Spine, Spine approaches
Tumour and tumour-like conditions	Tumour, Basic Principles of Neoplasms, Specific Tumours
Paediatrics	Paediatric Elective Orthopaedics, Paediatric Fractures & Trauma
Systemic medical conditions	Metabolic & Endocrine Disorders, Rheumatic Disorders & Tendinitis, Diabetes, Genetic Disorders, Skeletal Dysplasias & Malformations

Examinations

GSSE

Generic Surgical Sciences Examination, passed before selection
Revise Anatomy, Pharmacology, GSSE Questions

OPBS

Orthopaedic Principles and Basic Sciences examination, run by RACS and sat during Introduction to Orthopaedics
Maximum four attempts, completed by the second sitting in the second year of training

Area	Study on Orthofracs
Musculoskeletal tissues	Normal Tissues, Anatomy, Embryology, Bone as a biomaterial
Pathology	Metabolic & Endocrine Disorders, Genetic Disorders, Skeletal Dysplasias & Malformations, Basic Principles of Neoplasms, Osteonecrosis \| Avascular Necrosis, Crystal Deposition Disorders, Osteoarthritis
Biomechanics and motion	Biomechanics, Gait & Basic Foot Kinematics, Biomechanics of fracture healing & fracture stability
Materials and engineering	Biomaterials, Bone Cement (Polymethylmethacrylate), Metals, Material Properties, Bone Grafts and Substitutes
Infection, immunology and inflammation	Infection, Septic Arthritis, Acute Osteomyelitis, Antibiotics, Rheumatic Disorders & Tendinitis
Neurovascular	Peripheral Nerve Injuries, Pathology of Peripheral Nerve Injuries, Electrophysiological Studies, Complex Regional Pain Syndrome
Pharmacology	Pharmacology, Antibiotic Therapy for Musculoskeletal Infections, Bisphosphonates, NSAIDS
Radiology and investigations	Investigations, Orthopaedic Radiological Investigations, MRI, CT Scanning
Research methodology	Statistics, Level of Evidence, Grades of Recommendation

Fellowship Examination

RACS Fellowship Examination in Orthopaedic Surgery, sat during Core Orthopaedics
Standard is a consultant in the first year of independent practice, blueprinted to the AOA 21 curriculum
Written papers in April or August, clinical and viva segments about a month later
Seven segments. Passing all seven leads to a recommendation to pass

Segment	Format	Study on Orthofracs
Written paper one	75 X-type MCQs, 130 minutes	FRACS Orthopaedic Examination, Useful Lists to Remember for the FRACS Orthopaedic Examination
Written paper two	Two essays, ten ISAWEs and two generic competency short answers, 150 minutes	iSAWE, Useful Lists to Remember for the FRACS Orthopaedic Examination
Clinical cases 1	Four video scenarios, 9 minutes each	Examinations, History
Clinical cases 2	Three live patients, 12 minutes each	Examination of the Shoulder, Examination of the Hip, Examination of the Knee, Examination of the Cervical Spine, Examination of the Hand, Examination of the Foot & Ankle
Clinical investigation and management viva	Five scenarios, 30 minutes	Investigations, Classification Systems, Orthopaedic Classifications
Operative surgery vivas 1 and 2	Five scenarios each, 30 minutes	Surgical Approaches, Operations, Weight-bearing After Surgery, Multimodal Pain Management

Official Sources

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.