Abstract Aims This study aimed to deepen understanding of the psychosocial impacts of adverse events on general surgical trainees and evaluate the experiences of current support mechanisms. Methods The study was conducted in two parts: a scoping review and a qualitative focus group study. The scoping review was conducted in accordance with the PRISMA-ScR guidelines and JBI methodology. These themes were taken forward for extended discussion as part of a focus group study of general surgical trainees (n = 10; split in two discrete groups of five participants). Reflexive thematic analysis using anonymised transcripts and contemporary field notes were used to analyse the data. Results The scoping review identified six themes related to the impact of adverse events on surgeons' well-being and professional performance. These were clarified and elaborated on through qualitative analysis of focus group data, developing three key themes with associated subthemes: (1) Support structures and external factors influencing responses to adverse events, (2) impact on clinical practice and professional development and (3) methods of learning from adverse events. Surgical trainees experience significant emotional and professional repercussions in the aftermath of adverse events, often exacerbated by insufficient formal support and a prevalent blame culture within hospital environments. Conclusions Substantial deficiencies exist in the support structures available to surgical trainees dealing with adverse events. It is evident that the existing systems fail to adequately address the complex needs of trainees, leading to significant emotional distress and professional insecurity. System changes are necessary for surgical trainees, including the establishment of mentorship and peer support networks.