Background: Sport-related, isthmic spondylolysis is a common cause of low back pain in adolescent athletes (1). While previous studies have reported prevalence rates, there is limited evidence of the factors that contribute to its occurrence. The Spine/Spondylolysis Research Interest Group of PRiSM conducted a systematic review to estimate the prevalence of isthmic spondylolysis in athletes aged 10-19 years and sought to investigate the association between prevalence and various factors including sex, age, race, ethnicity, geographic location, sport type, year of publication, imaging modalities, and treatment methods. Hypothesis: The overall prevalence of isthmic spondylolysis in young athletes is approximately 30%. Methods: A systematic review was conducted in PubMed, Elsevier Embase, EBSCOhost SportDiscus, and the Wiley Cochrane Central Register of Controlled Trials, covering studies published from inception to March 2024. Keywords included “spondylolysis”, “pars interarticularis”, and a complete list of specific sports. All studies reporting the prevalence of isthmic spondylolysis in athletes aged 10-19 years, including cross-sectional and cohort studies were considered, while case reports, case series, case-control and narrative reviews were excluded. Two reviewers independently screened studies for eligibility and extracted data. Data were synthesized through meta-analysis using random-effects models, with the calculations of prevalence and its 95% confidence interval (CI). Results: A total of 1864 studies were identified, and 93 studies met the inclusion criteria. The overall prevalence of sport-related isthmic spondylolysis was found to be 28% (95% CI: 24-32%). Subgroup analyses indicated higher prevalence rates in baseball [45% (95% CI: 30-60%)], hockey [43% (95% CI: 27-59%)], track & field [36% (95% CI: 19-52%)], and cricket [35% (95% CI: 23-47%)] (Figure 1). Male athletes exhibited a higher prevalence compared to females [33% (95% CI: 27-39%) vs. 15% (95% CI: 11-20%)]. The mean age for isthmic spondylolysis was 15.4 years (95% CI: 13.97-16.88). Countries with the highest prevalence include Japan [36% (95% CI: 29-42%)], New Zealand [32% (95% CI: 22-42%)], United Kingdom [31% (95% CI: 17-44%)], and the United States [30% (95% CI: 22-39%)]. Recent studies suggest an increasing prevalence over time. Conclusion: This systematic review represents the largest known study reporting the overall prevalence of isthmic spondylolysis in adolescent athletes, highlighting the influence of factors such as sport type, sex, age, country, and year of publication. The findings suggest the need for clinicians to have a high index of suspicion in young athletes with low back pain. Future research should explore long-term outcomes and the effectiveness of different treatments.

Background: Many researchers benefit from training and assistance with their data management practices. The release of the Office of Science and Technology Policy’s Nelson Memo and the National Institutes of Health’s new Data Management and Sharing Policy created opportunities for librarians to engage with researchers regarding their data workflows. Within this environment, we—an interdisciplinary team of librarians and informationists at the University of Michigan (U-M)—recognized an opportunity to develop a series of data workshops that we then taught during the summer of 2023. Case Presentation: The series was primarily aimed at graduate students and early career researchers, with a focus on the disciplines served by the authors in the Health Sciences - Science, Technology, Engineering, and Mathematics (HS-STEM) unit of the U-M Library. We identified three topics to focus on: data management plans, organizing and managing data, and sharing data. Workshops on these topics were offered in June, July, and August 2023. Conclusion: The number of registrants and attendees exceeded our expectations with 497 registrations across the three workshops (174/169/154, respectively), and 178 attendees (79/49/50, respectively). Registrants included faculty, staff, students, and more, and were primarily from the health sciences clinical and academic units. We received a total of 45 evaluations from the three workshops which were very positive. The slides and evaluation forms from each workshop are available through U-M’s institutional repository. We developed these workshops at an opportune time on campus and successfully reached many researchers.

PURPOSE While the diversity of the surgical workforce has well-studied benefits for patient care, surgical subspecialties have historically been unsuccessful in recruiting diverse trainees. Although surgical programs have made substantial efforts to address this problem, to progress, we need to (1) synthesize the evidence for successful strategies for recruiting diverse surgical trainees and (2) identify the dimensions of diversity that have not been studied. This scoping review assesses strategies for the effective recruitment of diverse surgical trainees, identifies the level of evidence supporting these strategies, and examines the current gaps in the literature. METHODS NLM PubMed, Elsevier Embase, and Clarivate Web of Science were searched on September 4, 2024. We included studies reporting original data assessing interventions to recruit diverse trainees, defined broadly, e.g., gender and sexual minorities, ethnic and racial minorities, persons with disabilities, and veterans, into graduate surgical training programs (general surgery, otolaryngology, orthopedic surgery, plastic surgery, urology, neurosurgery, vascular surgery, oral and maxillofacial surgery, and cardiothoracic surgery). RESULTS In this scoping review of 25 articles, we found the most common interventions included early exposure programs (11 of 25 included studies; 44%), efforts to reduce bias in the interview process (8 of 25; 32%), and improving programmatic structure to promote inclusion (6 out of 25; 24%). We found that the highest level of evidence achieved in the literature was level 3 (20 out of 25 included studies; 80%). Studies most commonly intervened to increase racial and ethnic minority representation (19/25; 76%) and women's representation (11/25; 44%). CONCLUSION This scoping review summarizes and assesses the literature on evidence-based practices for recruiting a diverse surgical workforce. This work outlines interventions institutions can develop to promote diversity within the surgical workforce. Furthermore, it provides areas for advancing the recruitment of an inclusive surgical workforce.

BACKGROUND:Thoracic aortic aneurysm (TAA) is an indolent, potentially fatal disease, which progresses at variable rates that are influenced by pathogenesis and patient characteristics. We conducted a systematic review and meta-analysis to synthesize the current evidence on growth rate (GR) and predictive factors among patients with syndromic and nonsyndromic heritable thoracic aortic disease, bicuspid aortic valve, and sporadic TAA. METHODS AND RESULTS:Online databases were searched for studies that reported aortic growth on adult patients with asymptomatic TAA. Pooled GRs were calculated for 3 different TAA groups: syndromic heritable thoracic aortic disease, bicuspid aortic valve, and sporadic TAA. The search yielded 6297 studies, of which 85 were included in the systematic review, and 55 in the meta-analysis of growth rate (10 syndromic heritable thoracic aortic disease, 31 bicuspid aortic valve, and 34 sporadic subgroups). Mean observed TAA GR was 0.25 mm/y (95% CI, -0.18 to 0.68) in Turner syndrome, 0.45 mm/y (95% CI, 0.00-0.90) in Marfan syndrome, and 0.81 mm/y (95% CI, -0.46 to 2.08) in Loeys-Dietz syndrome. The mean observed GR in patients with bicuspid aortic valve before aortic valve surgery was 0.37 mm/y (95% CI, 0.29-0.46), compared with 0.18 mm/y (95% CI, 0.14-0.33) in postsurgical studies. Mean observed GR in sporadic ascending TAA was 0.33 mm/y (95% CI, 0.13-0.52) and 2.71 mm/y (95% CI, 0.53-4.88) in descending TAA. CONCLUSIONS:Considering all pathogeneses, ascending TAAs typically grow at 0.25 to 1 mm/y, and thus annual surveillance is likely too frequent to detect growth in most patients. Studies vary widely in populations, methodology, and outcomes, with few high-quality longitudinal studies and no predictors of aortic GR.

Objective: While several studies have examined the effectiveness of librarian interactions with clinicians and impact of librarians on patient care, no studies have explored a library’s effects on population care. The goal of this study was to investigate the library’s impact on both patient and population care. Methods: Using a sequential exploratory mixed-methods design, we first interviewed a small set of clinicians and researchers active in patient and population care. Based on the themes that we discovered through coding the interviews, we created a survey that was sent to faculty in the health sciences and the health system. Results: We collected data from a representative sample of our population. We discovered that all respondents value the library and informationists, using our services most for teaching, publishing, presenting, and professional development. Conclusion: We now have data to support our value to our population and to show where we can do more work to improve the use of our services. Our study shows the value of doing a mixed-methods sequential exploration in which themes that are important to our user community were identified prior to launching a large-scale survey.

Objective: We aimed to understand how medical and health sciences librarians engage with research reproducibility (RR) at their institutions. Methods: We conducted 11 semi-structured interviews with medical and health sciences librarians from different institutions across the United States who are engaged in RR work. We used template analysis to identify eight themes related to librarian engagement with RR. Results: Within medical and health sciences libraries, research reproducibility work and services are seldom described in those terms, and are often hidden within other data services. RR work is highly dependent on institutional context, such as availability of partners and institutional needs. Most of the RR work is handled by individuals or teams who tend to focus on data services broadly. Meaningful assessment of the work is not done well at present. Getting administrators, researchers, and other stakeholders to associate the library with RR is a particular challenge. Librarians who are interested in RR could learn from others who are doing the work, understand their institutional context, identify relevant institutional partners, and model RR practices in their own work.Conclusion: There are a variety of research reproducibility services in health sciences libraries. These services are dependent on institutional context and partners, and often integrated in other data services. More research is needed to understand various aspects of this work, including the impact of the NIH Data Management and Sharing Policy.Author Contributions: [PI initials MM]: Conceptualization, Project administration, Methodology, Investigation, Formal Analysis, Writing – original draft, Writing – review & editing; [Co-PI initials SS]: Methodology, Investigation, Formal Analysis, Data curation, Writing – original draft, Writing – review & editing

Background:This study reviews and appraises the articles published about anesthesiology education in 2020. The objective is to highlight high-quality evidence while showcasing articles with innovative ideas and high relevance to the practices of the anesthesiology education community.Methods:Three Ovid MEDLINE databases, Embase.com, ERIC, PsycINFO, and PubMed were searched, followed by a manual review of articles published in the highest impact factor journals in both the fields of anesthesiology and medical education. Abstracts were double screened, and quantitative articles were subsequently scored by 3 randomly assigned raters. Qualitative studies were scored by 2 raters. Two different rubrics were used for scoring quantitative and qualitative studies. In addition, reviewers rated each article on its overall quality to create an additional list of top articles based solely on the opinion of the reviewers.Results:A total of 2,491 citations were identified through the search criteria and the manual review. Of those, 61 articles met the inclusion criteria (57 quantitative and 4 qualitative). The top 12 quantitative papers and the top qualitative papers with the highest scores are reported and summarized.Conclusions:We found that teaching clinical procedures continues to be a topic of interest, with more studies of improved rigor identified. New trends in wellness studies and increasing attention to distance learning and technology-assisted instructional methods were additional topics covered over the year.

Introduction: Timely colorectal cancer (CRC) screening has been shown to improve CRC -related morbidity and mortality rates. However, even with this preventative care tool, CRC screening rates remain below 70% among eligible United States (US) adults, with even lower rates among US immigrants. The aim of this scoping review is to describe the bar-riers to CRC screening faced by this unique and growing immigrant population and discuss possible interventions to improve screening. Methods: Four electronic databases were systematically searched for all original research articles related to CRC screening in US immigrants published after 2010. Following a full -text review of articles for inclusion in the final analysis, data extraction was conducted while coding descriptive themes. Thematic analysis led to the organization of this data into five themes. Results: Of the 4637 articles initially identified, 55 met inclusion criteria. Thematic anal-ysis of the barriers to CRC screening identified five unique themes: access, knowledge, culture, trust, health perception, and beliefs. The most cited barriers were in access (financial burden and limited primary care access) and knowledge (CRC/screening knowledge). Conclusions: US immigrants face several barriers to the receipt of CRC screening. When designing interventions to increase screening uptake among immigrants, gaps in physician and screening education, access to care, and trust need to be addressed through culturally sensitive supports. These interventions should be tailored to the specific immigrant group, since a one-size-fits approach fails to consider the heterogeneity within this population. (c) 2022 Elsevier Inc. All rights reserved.

Autologous fat grafting (AFG) has traditionally been used for facial rejuvenation and soft tissue augmentation, but in recent years, its use has expanded to treat diseases of the hand. Autologous fat grafting is ideal for use in the hand because it is minimally invasive, can restore volume, and has regenerative capabilities. This review summarizes the emerging evidence regarding the safety and efficacy of AFG to the hand in several conditions, including systemic sclerosis, Dupuytren disease, osteoarthritis, burns, and traumatic fingertip injuries. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant literature search on the use of AFG in hand pathologies was performed on October 8, 2020, in Ovid MEDLINE, Elsevier Embase, Clarivate Web of Science, and Wiley Cochrane Central Register of Controlled Trials. The retrieved hits were screened and reviewed by 2 independent reviewers and a third reviewer adjudicated when required. Reviewers identified 919 unique hits. Screening of the abstracts identified 22 manuscripts which described the use of AFG to treat an identified hand condition. Studies suggest AFG in the hands is a safe, noninvasive option for the management of systemic sclerosis, Dupuytren contracture, osteoarthritis, burns, and traumatic fingertip injuries. While AFG is a promising therapeutic option for autoimmune, inflammatory, and fibrotic disease manifestations in the hand, further studies are warranted to understand its efficacy and to establish more robust clinical guidelines. Studies to date show the regenerative, immunomodulatory, and volume-filling properties of AFG that facilitate wound healing and restoration of hand function with limited complications.

Objectives To assess the body of literature examining episode-based bundled payment models effect on health care spending, utilization, and quality of care for surgical conditions. Background summary Episode-based bundled payments were developed as a strategy to lower healthcare spending and improve coordination across phases of healthcare. Surgical conditions may be well-suited targets for bundled payments because they often have defined periods of care and widely variable healthcare spending. In bundled payment models, hospitals receive financial incentives to reduce spending on care provided to patients during a predefined clinical episode. Despite the recent proliferation of bundles for surgical conditions, a collective understanding of their effect is not yet clear. Methods A scoping review was conducted, and four databases were queried from inception through September 27, 2021, with search strings for bundled payments and surgery. All studies were screened independently by two authors for inclusion. Results Our search strategy yielded a total of 879 unique articles of which 222 underwent a full-text review and 28 met final inclusion criteria. Of these studies, most (23 of 28) evaluated the impact of voluntary bundled payments in orthopedic surgery and found that bundled payments are associated with reduced spending on total care episodes, attributed primarily to decreases in post-acute care spending. Despite reduced spending, clinical outcomes (e.g., readmissions, complications, and mortality) were not worsened by participation. Evidence supporting the effects of bundled payments on cost and clinical outcomes in other non-orthopedic surgical conditions remains limited. Conclusions Present evaluations of bundled payments primarily focus on orthopedic conditions and demonstrate cost savings without compromising clinical outcomes. Evidence for the effect of bundles on other surgical conditions and implications for quality and access to care remain limited.

Background Postsurgical pain is a key component of surgical recovery. However, the genetic drivers of postsurgical pain remain unclear. A broad review and meta-analyses of variants of interest will help investigators understand the potential effects of genetic variation. Methods This article is a systematic review of genetic variants associated with postsurgical pain in humans, assessing association with postsurgical pain scores and opioid use in both acute (0 to 48 h postoperatively) and chronic (at least 3 months postoperatively) settings. PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from 2000 to 2022 for studies using search terms related to genetic variants and postsurgical pain in humans. English-language studies in adult patients examining associations of one or more genetic variants with postsurgical pain were included. The primary outcome was association of genetic variants with either acute or chronic postsurgical pain. Pain was measured by patient-reported pain score or analgesic or opioid consumption. Results A total of 163 studies were included, evaluating 129 unique genes and 594 unique genetic variants. Many of the reported significant associations fail to be replicated in other studies. Meta-analyses were performed for seven variants for which there was sufficient data (OPRM1 rs1799971; COMT rs4680, rs4818, rs4633, and rs6269; and ABCB1 rs1045642 and rs2032582). Only two variants were associated with small differences in postsurgical pain: OPRM1 rs1799971 (for acute postsurgical opioid use standard mean difference = 0.25; 95% CI, 0.16 to 0.35; cohort size, 8,227; acute postsurgical pain score standard mean difference = 0.20; 95% CI, 0.09 to 0.31; cohort size, 4,619) and COMT rs4680 (chronic postsurgical pain score standard mean difference = 0.26; 95% CI, 0.08 to 0.44; cohort size, 1,726). Conclusions Despite much published data, only two alleles have a small association with postsurgical pain. Small sample sizes, potential confounding variables, and inconsistent findings underscore the need to examine larger cohorts with consistent outcome measures. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Background:Alcohol accounts for a large disease burden in hepatology and liver transplantation (LT) and across the globe. Clinical evaluations and decisions about LT candidacy are challenging because they rely on detailed psychosocial assessments and interpretations of psychiatric and substance use disorder data, which often must occur rapidly according to the acuity of end-stage liver disease. Such difficulties commonly occur during the process of candidate selection and liver allocation, particularly during early LT (eLT) in patients with acute alcohol-associated hepatitis (AAH). Patients with AAH commonly have very recent or active substance use, high short-term mortality, psychiatric comorbidities, and compressed evaluation and treatment timetables. LT clinicians report that patients' alcohol-associated insight (AAI) is among the most relevant psychosocial data in this population, yet no studies exist examining how LT teams define and use AAI in eLT or its effect on clinical outcomes. In April 2022, we searched Ovid MEDLINE, Elsevier Embase, EBSCOhost PsycInfo and CINAHL, and Wiley Cochrane Central Register of Controlled Trials for reports describing AAH populations who underwent eLT, which also described psychosocial evaluation parameters. The searches retrieved 1603 unique reports. After eligibility screening, 8 were included in the qualitative analysis. This systematic review reveals that AAI is a poorly defined construct that is not measured in a standardized way. Yet it is a commonly cited parameter in articles that describe the psychosocial evaluation and decision-making of patients undergoing eLT for AAH. This article also discusses the general challenges of assessing AAI during eLT for AAH, existing AAI definitions and rating scales, how AAI has been used to date in the broader hepatology and LT literature, and future areas for clinical and research progress.

Background: We conducted this scoping review to (1) comprehensively compile the published literature on interprofessional education focused on climate change and health, (2) assess the quality and outcomes of the existing curriculum interventions, and (3) highlight potential areas for further growth. By evaluating published curricular interventions, our goal was to highlight effective and validated developments that could be utilized by health professional educators seeking to include topics on climate change in the curriculum. Methods: We searched Ovid MEDLINE databases (MEDLINE, In-Process, In-Data-Review and Other Non-Indexed Citations, and Epub Ahead of Print), Embase, Clarivate Web of Science, and EBSCOhost Education Abstracts from inception through March 2023. Resulting articles were screened for relevance, and data were extracted from the included studies. The Medical Education Research Study Quality Instrument (MERSQI) was used to assess the quality of each included study. Findings: We screened 688 unique articles, and 6 met inclusion criteria. Publications dated from 2013 to 2023. Three studies included students or healthcare professionals from at least three health profession education programs. The mean MERSQI score was 8·17 (SD = 1·34; range 6–10). Curricular interventions varied by study, and topics included effects of climate change on human health, effect of climate change on extreme weather events and infectious disease exposures, and role of health professionals in climate change communication. Studies did not utilize a two-group comparison design. Most studies used an assessment tool with content validity evidence, but no study provided evidence of validity for internal structure or relationships to other variables. Studies reported that curricular interventions improved outcomes related to both climate change and interprofessional education. Interpretation: Despite the growing call for health professional education focused on climate change and health, there remains a gap in the interprofessional curricular interventions that have been assessed.

Background Recent advocacy efforts and expanded insurance coverage has increased health care utilization among transgender patients. Therefore, it is pivotal that surgical residents are properly trained to care for transgender patients in both clinical and surgical settings. Yet, no formal curriculum or training requirements exist for surgical residents. The aim of this systematic review is to understand the surgical trainee's postgraduate education and training with respect to transgender health and gender-affirming surgeries (GAS). Methods A Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-compliant literature search was performed on December 04, 2020 in PubMed, Elsevier Embase, and Wiley Cochrane Central Register of Controlled Trials. The retrieved hits were screened and reviewed by two independent reviewers. Results Our literature search identified 186 unique publications, of which 14 surveys and one interventional study from various surgical specialties including plastic surgery, urology, otolaryngology, oral and maxillofacial surgery (OMS), dermatology, and obstetrics and gynecology (OBGYN) were included in this study. The majority of residents and program directors in surgical specialties believe education related to transgender health is important, and the current exposure in surgical training does not sufficiently prepare surgical residents to care for this marginalized population. Conclusion Current postgraduate surgical training in gender-affirming surgery is nonuniform across surgical specialty, geographical region, and individual program. Incorporating training modules and hands-on experiences into surgical trainee education will better prepare residents for the numerous clinical and surgical interactions with transgender patients. Further research is required to better understand how to best incorporate these experiences into existing surgical curriculums.

BackgroundThe utility of procalcitonin to identify obstetric sepsis is unknown. ObjectiveTo calculate the mean (range) procalcitonin in pregnancy among healthy women not in labor (group 1), healthy women in labor (group 2), and women with preterm prelabor rupture of membranes (PPROM) without clinical chorioamnionitis (group 3). Search StrategyNLM PubMed, Elsevier Embase, and Wiley Cochrane Central Register of Controlled Trials from inception to February 21, 2022. Selection CriteriaTen or more pregnant women with procalcitonin reported at more than 20 weeks of pregnancy, with information on labor, PPROM, and infection. Exclusions were major medical comorbidities. Data Collection and AnalysisEach abstract and full-text review was independently reviewed by the same two authors. Quality was reviewed using the Newcastle-Ottawa Scale. A meta-analysis was performed using a random effects model. Main ResultsThe systematic review included 25 studies: 10 (40%) of good quality and 15 (60%) of poor quality. The meta-analysis included 21 studies. Mean procalcitonin in group 1 was 0.092 ng/mL (range 0.036-0.049 ng/mL), in group 2 it was 0.130 ng/mL (range 0.049-0.259 ng/mL), and in group 3 it was 0.345 ng/mL (range 0.005-1.292 ng/mL). ConclusionsAmong healthy pregnant women not in labor, procalcitonin levels are comparable to those in non-pregnant adults and may be useful in identifying infection. Procalcitonin levels in other groups overlap abnormal values of procalcitonin in non-pregnant adults, and may not discriminate infection among women in labor or with obstetric comorbidities. ProsperoCRD42020157376, registered 4/28/2020.

Background:This study reviews and appraises the articles published about anesthesiology education in 2019. Through this critical appraisal, those interested in anesthesiology education are able to quickly review literature published during this year and explore innovative ways to improve education for all those involved in the practice of anesthesiology.Methods:Three Ovid MEDLINE databases, Embase.com, ERIC, and PsycINFO were searched followed by a manual review of articles published in the highest impact factor journals in both the fields of anesthesiology and medical education. Abstracts were double-screened and quantitative articles were subsequently scored by 3 randomly assigned raters. Qualitative studies were scored by 2 raters. Two different rubrics were used for scoring quantitative and qualitative studies; both allowed for scores ranging from 1 to 25. In addition, reviewers rated each article on its overall quality to create an additional list of top articles based solely on the opinion of the reviewers.Results:A total of 2374 unique citations were identified through the search criteria and the manual review. Of those, 70 articles met the inclusion criteria (62 quantitative and 8 qualitative). The top 12 quantitative papers and the top 2 qualitative papers with the highest scores were reported and summarized.Conclusions: This critical appraisal continues to be a useful tool for those working in anesthesiology education by highlighting the best research articles published over the year. Highlighting trends in medical education research in anesthesiology can help those in the field to think critically about the direction of this type of research.

Objective: Through a systematic review and mixed-methods meta-synthesis of the existing literature on surgeon well-being, we sought to identify the specific elements of surgeon well-being, examine factors associated with suboptimal well-being, and highlight opportunities to promote well-being. Background: Suboptimal surgeon well-being has lasting and substantial impacts to the individual surgeon, patients, and to society as a whole. However, most of the existing literature focuses on only 1 aspect of well-being—burnout. While undoubtedly a crucial component of overall well-being, the mere absence of burnout does not fully consider the complexities of being a surgeon. Methods: We performed a literature search within Ovid Medline, Elsevier Excerpta Medica dataBASE, EBSCOhost Cumulative Index to Nursing and Allied Health Literature, and Clarivate Web of Science from inception to May 7, 2020, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies with primary data examining surgeon well-being were included. Using a predetermined instrument, data were abstracted from each study and compared using thematic analysis. Results: A total of 5369 abstracts were identified and screened, with 184 full articles (172 quantitative, 3 qualitative, 9 mixed methods) selected for analysis. Among these, 91 articles measured burnout, 82 examined career satisfaction, 95 examined work-related stressors, 44 explored relationships and families, and 85 assessed emotional and physical health. Thematic analysis revealed 4 themes: professional components, personal components, work-life balance, and impacts to well-being. Conclusions: Surgeon well-being is complex and multifaceted. This nuanced examination of surgeon well-being highlights the critical need to develop and provide more long-term support to surgeons—with interventions being tailored based on individual, institutional, and systemic factors.