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Orthopedic surgeons saw a median compensation of $381,429 in 2004, an increase of 7.6% from the previous year, according to the AMGA 2005 Medical Group Compensation and Financial Survey. Already one of the top-paid specialties-behind only cardiac/thoracic surgery and diagnostic radiology, according to the AMGA report-orthopedic surgery is on the brink of a physician shortage that may drive wages to record highs in coming years. The shortage is certainly fueling pay increases. Just look at data from the April 2006 Delta Medical Consulting Physician Recruiting Standard Survey, which shows that orthopedic surgery has had the highest demand of any specialty thus far in 2006 and the highest average sign-on bonus ($36,622) of any specialty.