Orthopedic residency is known for its intensity, long hours, and steep learning curve — but many residents agree that PGY-2 (Postgraduate Year 2) is often the hardest. As the transition from medical school to real-world clinical responsibilities kicks in, interns face the pressure of adapting quickly. This year is packed with demanding work hours, on-call duties, and a wide range of rotations that introduce residents to various subspecialties within orthopedics.

PGY-2 is also when residents must develop foundational surgical skills, manage emergency cases, and master essential orthopedic principles, all while learning how to function effectively as part of a surgical team. Balancing clinical work with studying for in-training exams adds to the stress.

While the workload slightly eases in later years as residents become more confident and skilled, the pressure of board exams, surgical responsibilities, and complex cases in PGY-4 or PGY-5 can also be tough. Still, most agree the first year’s emotional and physical adjustment is the greatest hurdle.

Ultimately, every stage of orthopedic residency has its challenges — but with determination, strong mentorship, and a solid work ethic, each year becomes a stepping stone toward becoming a skilled orthopedic surgeon.