Supplemental Digital Appendix 1. Search strategy
DATABASE SEARCH STRATEGY PubMed
("Specialties, Surgical/education"[Mesh] OR “surgical training” OR “surgical residency” OR “general surgery” OR “gynecologic surgery” OR “obstetric surgery”
OR “obstetrics/gynecology” OR “obstetrics & gynecology” OR “obstetrics and gynecology” OR ob/gyn OR neurosurgery OR “neurological surgery” OR
“ophthalmologic surgery” OR ophthalmology OR “orthognathic surgery” OR orthosurgery OR “ortho surgery” OR “orthopedic surgery” OR “otolaryngologic surgery” OR ENT OR otolaryngology OR “head and neck surgery” OR “head & neck surgery” OR “neurotologic surgery” OR “plastic surgery” OR “plastic and
reconstructive surgery” OR “plastic & reconstructive surgery” OR “urologic surgery”
OR urology OR “vascular surgery” OR “cardiothoracic surgery”) AND (training OR education OR residency OR residents OR “Internship and Residency”[Mesh]) AND ("Well being" OR wellbeing OR "well-being" OR "Resilience, Psychological"[mesh]
OR resilience OR "Occupational Stress"[mesh] OR "occupational stress" OR
"Depression"[mesh] OR depression OR "Personal Satisfaction"[mesh] OR "personal satisfaction" OR "Work-Life Balance"[mesh] OR "work-life balance" OR flourishing OR thriving OR "Mindfulness"[Mesh] OR mindfulness OR "workplace support" OR
"workplace control" OR "personal accomplishment" OR "Achievement"[Mesh] OR achievement OR grit OR distress OR "Psychological Distress"[Mesh] OR "emotional exhaustion" OR "Depersonalization"[Mesh] OR depersonalization OR "Burnout, Professional"[mesh] OR burnout OR "Suicidal Ideation"[Mesh] OR "suicidal ideation"
OR suicidality OR "Anxiety"[Mesh] OR anxiety OR "Stress, Psychological"[Mesh]
OR stress OR ("Alcohol Drinking"[Mesh] AND excessive) OR "excessive alcohol"
OR "excessive drinking" OR "workplace demands") AND ("Personnel Turnover"[mesh] OR turnover OR attrition OR "intent to leave" OR "leave of absence" OR "Sick Leave"[Mesh] OR "sick leave" OR "personal time off" OR
"reduced work hours" OR "reduced hours" OR absenteeism OR presenteeism OR absences OR efficiency OR "Efficiency"[Mesh] OR productivity OR "Quality of Health Care"[Mesh] OR "quality of care" OR "Medical Errors"[Mesh] OR "medical errors" OR "patient errors" OR "Patient Harm"[Mesh] OR "patient harm" OR "Patient Safety"[Mesh] OR "patient safety" OR "patient experience" OR "Patient
Satisfaction"[Mesh] OR "patient satisfaction" OR "unprofessional behavior" OR
"unprofessional behaviors" OR "Malpractice"[Mesh] OR malpractice OR lawsuits) AND ("Costs and Cost Analysis"[Mesh] OR costs OR "Economics"[Mesh] OR economics OR "economics" [Subheading] OR "financial impact" OR "fiscal impact"
OR "cost savings" OR "cost-benefit analysis" OR "direct cost" OR "direct costs" OR
"hard costs" OR "fiscal health" OR "hospital costs" OR "return on investment" OR ROI OR "Cost of Illness"[Mesh] OR "lost income" OR "lost revenue" OR value OR
“resident replacement cost” OR “economic cost” OR “program cost” OR “economic costs” OR “program costs” OR “net benefit” OR “financial investment” OR
“economic analysis” OR revenue OR money OR “attributable cost” OR “business case” OR “financial cost” OR “financial value” OR “economic value” OR “return on cost”)
Web of
Science (“surgical training” OR “general surgery” OR “obstetrics and gynecology” OR neurosurgery OR “neurological surgery” OR “ophthalmologic surgery” OR
ophthalmology OR orthosurgery OR “ortho surgery” OR “orthopedic surgery” OR ENT OR otolaryngology OR “head and neck surgery” OR “plastic surgery” OR
“plastic and reconstructive surgery” OR “urologic surgery” OR urology OR “vascular surgery” OR “cardiothoracic surgery”) AND (training OR education OR residency OR residents) AND ("Well being" OR wellbeing OR "well-being" OR resilience OR
"occupational stress" OR depression OR "personal satisfaction" OR "work-life balance" OR flourishing OR thriving OR mindfulness OR "workplace support" OR
"workplace control" OR "personal accomplishment" OR grit OR distress OR
"emotional exhaustion" OR depersonalization OR burnout OR "suicidal ideation" OR suicidality OR anxiety OR stress OR "excessive alcohol" OR "excessive drinking" OR
"workplace demands") AND (turnover OR attrition OR "intent to leave" OR "leave of absence" OR "sick leave" OR "personal time off" OR "reduced work hours" OR
"reduced hours" OR absenteeism OR presenteeism OR absences OR efficiency OR productivity OR "quality of care" OR "medical errors" OR "patient errors" OR "patient harm" OR "patient safety" OR "patient experience" OR "patient satisfaction" OR
"unprofessional behavior" OR "unprofessional behaviors" OR malpractice OR lawsuits) AND ("Costs and Cost Analysis" OR costs OR economics OR "financial impact" OR "fiscal impact" OR "cost savings" OR "cost-benefit analysis" OR "direct costs" OR "fiscal health" OR "hospital costs" OR "return on investment" OR ROI OR
"lost income" OR "lost revenue" OR value OR “resident replacement cost” OR
“economic costs” OR “program costs” OR “net benefit” OR “financial investment”
OR “economic analysis” OR revenue OR “attributable cost” OR “business case” OR
“financial cost” OR “financial value” OR “economic value”)
Embase
('surgical subspecialties' OR 'general surgery'/exp OR 'general surgery' OR 'gynecologic surgery'/exp OR 'gynecologic surgery' OR 'neurosurgery'/exp OR neurosurgery OR ‘neurological surgery’ OR 'obstetric operation'/exp OR 'obstetric operation' OR ‘obstetrics and gynecology’ OR ‘obstetrics & gynecology’ OR ‘ob/gyn’
OR ‘obstetrics/gynecology’ OR 'eye surgery'/exp OR 'eye surgery' OR 'ophthalmology'/exp OR ophthalmology OR 'orthognathic surgery'/exp OR
'orthognathic surgery' OR orthosurgery OR 'orthopedic surgery'/exp OR 'orthopedic surgery' OR 'otolaryngologic surgery' OR 'otorhinolaryngology'/exp OR
otorhinolaryngology OR ENT OR ‘head and neck surgery’ OR ‘head & neck surgery’
OR 'neurotologic surgery' OR 'plastic surgery'/exp OR 'plastic surgery' OR ‘plastic and reconstructive surgery’ OR ‘plastic & reconstructive surgery’ OR 'urologic
surgery'/exp OR 'urologic surgery' OR urology OR 'vascular surgery'/exp OR 'vascular surgery' OR 'thorax surgery'/exp OR 'thorax surgery') AND ('training'/exp OR training OR 'education'/exp OR education OR 'residency'/exp OR residency OR 'residency education'/exp OR 'residency education' OR 'resident'/exp OR resident) AND ('wellbeing'/exp OR wellbeing OR 'psychological resilience'/exp OR 'psychological resilience' OR 'resilience'/exp OR resilience OR 'job stress'/exp OR 'job stress' OR 'depression'/exp OR depression OR 'satisfaction'/exp OR satisfaction OR 'work-life balance'/exp OR 'work-life balance' OR 'flourishing'/exp OR flourishing OR thriving OR 'mindfulness'/exp OR mindfulness OR 'workplace support' OR 'workplace control' OR 'personal accomplishment'/exp OR 'personal accomplishment' OR
'achievement'/exp OR achievement OR 'grit'/exp OR grit OR 'distress'/exp OR distress OR 'distress syndrome'/exp OR 'distress syndrome' OR 'emotional stress'/exp OR 'emotional stress' OR 'depersonalization'/exp OR depersonalization OR 'burnout'/exp OR burnout OR 'suicidal ideation'/exp OR 'suicidal ideation' OR 'suicidal
behavior'/exp OR 'suicidal behavior' OR 'anxiety'/exp OR anxiety OR 'mental stress'/exp OR 'mental stress' OR 'excessive alcohol' OR 'heavy drinking'/exp OR 'heavy drinking' OR 'workplace demands' OR (('alcohol'/exp OR alcohol) AND excessive)) AND ('turnover rate'/exp OR 'turnover rate' OR 'attrition'/exp OR attrition OR 'intent to leave' OR 'leave of absence' OR 'medical leave'/exp OR 'medical leave' OR 'personal time off' OR 'reduced work hours' OR 'reduced hours' OR
'absenteeism'/exp OR absenteeism OR 'presenteeism'/exp OR presenteeism OR absences OR 'productivity'/exp OR productivity OR 'health care quality'/exp OR 'health care quality' OR 'medical error'/exp OR 'medical error' OR 'patient errors' OR 'patient harm'/exp OR 'patient harm' OR 'patient safety'/exp OR 'patient safety' OR 'patient experience'/exp OR 'patient experience' OR 'patient satisfaction'/exp OR 'patient satisfaction' OR 'professional misconduct'/exp OR 'professional misconduct' OR 'malpractice'/exp OR malpractice OR 'law suit'/exp OR 'law suit') AND ('cost'/exp OR cost OR 'cost effectiveness analysis'/exp OR 'cost effectiveness analysis' OR 'economic aspect'/exp OR 'economic aspect' OR 'health economics'/exp OR 'health economics' OR 'financial impact' OR 'fiscal impact' OR 'cost control'/exp OR 'cost control' OR 'cost benefit analysis'/exp OR 'cost benefit analysis' OR 'direct cost'/exp OR 'direct cost' OR 'health care cost'/exp OR 'health care cost' OR 'hard costs' OR 'fiscal health' OR 'hospital cost'/exp OR 'hospital cost' OR 'return on investment'/exp OR 'return on investment' OR roi OR 'cost of illness'/exp OR 'cost of illness' OR 'lost income' OR 'lost revenue' OR 'value'/exp OR value OR 'resident replacement cost' OR 'economic cost'/exp OR 'economic cost' OR 'economic costs' OR 'program cost' OR 'program cost effectiveness'/exp OR 'program cost effectiveness' OR 'program costs' OR 'net benefit' OR 'financial investment' OR 'economic analysis'/exp OR 'economic analysis' OR 'revenue'/exp OR revenue OR 'money'/exp OR money OR 'attributable cost' OR 'business case' OR 'financial cost' OR 'financial value' OR 'economic value'/exp OR 'economic value' OR ‘return on cost’)
