This article is more than 5 years old. Information may no longer be current.
The role of mentorship
Is there a need for strong mentorship during residency? What problems may arise related to mentorship programs?
Click Here to Manage Email Alerts
Devote resources to develop mentors
Many scholarly and professional articles would suggest mentoring is valuable to organizations and the participants in the mentoring relationship. Mentoring can be thought of as the formal transfer of life skills, career skills and people skills from a more knowledgeable person to someone who is typically younger and less knowledgeable. Some would argue it is an invaluable part of one’s professional maturation. It allows young protégés to be shepherded through the early, landmine-filled parts of an academic or clinical career. Indeed, some professionals who have not had mentors may progress more slowly through their respective professional ranks. Open-minded mentees can learn valuable career lessons from the mistakes of a trusted advisor. My chairman from residency remains my mentor, some 13 years later. Mentoring is therefore a wonderful thing, when it goes well. However, it can also go very badly.
A problem in many mentoring programs is the presence, to some degree, of a forced relationship between the parties involved. Often, mentoring relationships are begun sight unseen and established based on some type of distinguishing characteristic as if that particular characteristic myopically defines the entire group of people who possess it. Female residents are assigned to female faculty members. African-American or Hispanic residents are assigned to faculty of the same racial background or to any minority faculty on staff. This may mean the parties have little in common on which to base a lasting relationship. In addition, the optics of such a matching algorithm for mentoring might lead to a misinterpretation of the program as one that is biased or conducted to simply check a box on a form.
Mentoring programs needed
In addition, many mentoring programs assume a level of competence or ability in the mentor that may not exist. Given the relatively new phenomenon of mentoring in health care, there is a paucity of programs that teach one how to mentor. Clearly, some individuals have the innate ability to be an excellent mentor and others do not. At its best, this can lead to tremendous variability in the quality of a mentoring program, as well as jealousy among its participants towards those who lucked out and made their way on to a better team. At its worse, unhealthy or destructive relationships can be created against the backdrop of a tremendous asymmetry of power. Young residents are wholly dependent upon attendings for their professional education, the clinical exposure on which their orthopedic education is based and letters of recommendation needed to progress to the next level of learning. Problematic mentoring programs may result in a mentee’s reputation being irreparably besmirched over nothing more than a personality difference.
Lastly, generational differences dominate many discussions on teaching and mentoring at major academic meetings. It seems that, despite the never-ending need for mentoring, the attendings who may be in the best position to give of themselves may also be ill-equipped to easily relate to millennials.
Screen for active mentees
These pitfalls and others may potentially undermine many valid reasons why mentoring programs should be entertained. Moreover, the resources to start and maintain a scripted, forced mentoring program may be better spent elsewhere. A potential solution may lie in assessing the culture of mentoring at our institutions. The positives of a mentoring relationship should be conveyed to young residents, who should be encouraged to seek a mentor within the faculty and staff. Applicants to programs may also be screened for past mentoring activities (e.g., community service programs, mission trips or tutoring programs), instances in which they received prolonged constructive criticism and construction (e.g., military service or collegiate athletics) or be asked to identify a current mentor. The results of such investigations may indicate who has the potential or ability to be an active mentee. Also, the staff must be encouraged to be receptive to the formal or informal solicitations of their residents for this type of a relationship and department leadership should lead by example in this area. Resources earmarked to simply start a mentoring program may be better used to teach eager faculty how to be more effective mentors. This may ultimately yield a culture shift that is more lasting than any forced or scripted mentoring program.
Formal evaluations may undermine efforts to promote a natural maturation of the environment of our programs towards mentoring. To this end, the evaluation of the mentee may differ from that of the mentor. For example, mentees could be surveyed for subjective assessments of the value of the mentor and the mentoring relationship. In contrast, the mentor may have additional metrics designed to gently encourage more interaction, such as indicating how many times he or she meets with the mentee during a given time period or writing a summary of the nature of their meetings. All in all, a mentoring environment should be sought whenever possible as its benefits far outweigh the risks.
- For more information:
- Scott E. Porter, MD, MBA, FACS, FAOA, can be reached at Greenville Health System, 701 Grove Rd., Greenville, SC 29605; email: sporter@ghs.org.
Disclosure: Porter reports no relevant financial disclosures.
Strong mentorship breaks down barriers
Most of us had an orthopedist influence our selection of our specialty through a salient moment or shared experiences. I think of mentorship as guidance and influence that impacts the education, career direction and professional expectations of those we educate. This is how mentorship impacted me and some of the ways it can be manifested.
What struck me with my exposures to my first orthopedic surgeon, Thomas R. Peterson, MD, after my “unhappy triad knee injury” in 1970, was his enthusiasm, positive attitude, charisma and genuine interest in me. When Peterson learned I was interested in becoming a doctor, he lent me Treatment of Injuries to Athletes, by Don H. O’Donoghue, MD. As a high school senior, I poured through the chapters on knee ligament injuries and wrote a paper for my biology class. Something clicked. After my injury, in an interview with a Detroit newspaper for a scholar-athlete profile, I said I wanted to become an orthopedic surgeon who did knee surgery and took care of athletes. Fast forwarding to my undergraduate years at Harvard, Thomas B. Quigley, MD, become a mentor and a surgeon to my other knee in my junior year. He allowed me to shadow in the office, observe surgeries. I approached “Quigs” to be my senior thesis advisor. He took me under his wing, invited me to his home for Easter dinner and when he retired gave me most of his textbooks and his old leather briefcase. Much of his office furniture comprised the furnishings of my first apartment in Boston. He even helped me get a job at the Brigham and Women’s Hospital as a pathology diener and a summer lab technician position.
Lasting relationships
While at the /University of Cincinnati (UC) College of Medicine, Peterson told me about rising superstar Frank R. Noyes, MD. I approached Noyes about a summer research position. Timothy M. Hosea, MD, and I became the first students to work with Noyes his first few years on staff at UC. I was impressed with Noyes’ scientific rigor and saw first-hand how his basic science studies legitimized sports medicine in its infancy. During my fourth-year visiting rotation back at Harvard with Arthur L. Boland Jr., MD, who succeeded Quigs as head team physician, I immediately sensed his warmth, kindness, friendship, and scholarly approach to problems. My first day at the Harvard fieldhouse he took me, a visiting medical student, out to dinner. That began a dear friendship that has endured since 1978.
Someone else who took an interest in me, educated me and was a role model was Russell F. Warren, MD, my sports fellowship director at Hospital for Special Surgery from 1985 to 1986. Warren singlehandedly rekindled my academic aspirations by demonstrating the fun of academic inquisitiveness. He always asked research questions. On rounds, he generated multiple research projects. His surgical skills were spectacular. Warren molded me academically, providing me with the confidence to pursue academics because I truly enjoyed teaching. He was like a coach — pushing, cajoling, and encouraging.
My mentors all took an interest in me, encouraged me, guided me, educated me and taught me to expect more of myself.
Mentorship in action
I have been at Rush University Medical Center since 1986. I have tried to act as a mentor to everyone from high school students (mostly patients) to orthopedic residents, primary care and orthopedic sports fellows. One of our current fellows interviewed me about sports medicine when he was in the 7th grade, worked 4 years with me during college and medical school, did his residency at Rush and is now completing his fellowship and just took an academic position.
Whether we are teaching, in the office or OR, or covering sports events, our trainees are observing us. Therefore, be cognizant of how you act, whether you are calm in the OR and the empathy you show your patients. Dress professionally, use consistency, ethics and integrity in all your interactions.
Consider these examples of mentorship: Advising a resident that his/her skills and personality would translate well into to a sports medicine career, purchasing textbooks, sending trainees to courses, involving them in research, showing them you care by being available, listening, asking the residents we are mentoring about their personal lives and interests and demonstrating how you balance career with your personal life. Taking them out for dinner, giving them pep talks and talking to them about life after residency or fellowship, as well as providing them with sage counsel about the real world and the business of medicine, as well as teaching them doctor-patient communication skills, are critical components of mentoring. It is easy for trainees to be intimidated by our successes. This is a barrier we must break to better educate and mentor trainees. Furthermore, we need to be aware that mentorship needs can vary based on the level of training.
When we fail to be a mentor, we do our profession a disservice. We owe it to our patients and trainees to be the best mentors possible. The influence we can have on a young person in high school or medical school, or on a resident or trainee when we mentor them can dramatically impact that individual’s career. In fact, it may change them forever.
- For more information:
- Bernard R. Bach Jr., MD, can be reached at 1611 W. Harrison, Suite 300, Chicago, IL 60612; email: brbachmd1952@gmail.com.
Disclosure: Bach reports no relevant financial disclosures.