Strategies For Building An Effective Mentoring Relationship

Mentoring has been recognized as a critical aspect of the professional and/or personal development of the student, resident and faculty member. This career development resource discusses strategies for building effective mentoring relationships and outlines some of the challenges to contemporary mentoring.

The first account of a mentoring relationship can be traced back to The Odyssey of Homer, when the goddess Pallas Athena assumed the form of a family friend, Mentor, to support Odysseus’ son Telemachus.¹ The term mentoring is used to describe an activity in which a more senior or experienced person who has earned respect and power within their field takes a more junior or less experienced person (known as a mentee or protege) under their wing to teach, encourage and ensure their success. This career development resource will discuss the types of mentoring relationships and the mentorship process. In addition, choosing a mentor, the responsibilities of the mentee and mentor and challenges to contemporary mentoring will be reviewed.

There is a wealth of literature in support of the benefit of mentorship to career advancement. An early mentor reference regarding surgical training indicates that Halsted’s residency system intended to “produce not only surgeons, but surgeons of the highest type, men who will stimulate the first youths of our country to study surgery and to devote their energies and their lives to raising the standard of surgical science.”² Halsted could never have envisioned the challenges faced by surgeons today, including ever-advancing technology, on-line social networking, multidisciplinary team-based approaches, outcome assessments, and financial and regulatory challenges. Contemporary surgeons reflect the gender and ethnic diversity of the population,³ and need to be coached to excel in the more rigid and homogeneous surgical culture.

Although there are no randomized controlled trials, the literature shows that mentored individuals are promoted earlier^4-6 and are more likely to publish.⁷ They also are more likely to follow initial career goals,⁸ and enjoy greater career satisfaction compared with individuals without a mentor. Conversely, lack of a mentor is frequently cited as the greatest deficiency in career development particularly among women.¹¹

HOW TO CHOOSE A MENTOR AND DEVELOP A MENTORING RELATIONSHIP

A mentoring relationship may begin serendipitously from a common interest or goal. One partner will generally take the initiative to formalize the relationship. At the onset, the mentee needs to have clear goals; is the priority finding someone to help with basic science research, finding a job, achieve work-life balance or overcome political obstacles? It is equally important for the mentee to appreciate their own personal work style, strengths and weaknesses. Generally the mentor should be an individual who is at least a step (or two) ahead of where the mentee hopes to be professionally. They should be approachable, available and enthusiastic with good interpersonal skills. Other desirable attributes are dependent on the level of the mentee’s professional training.

One way to initiate a mentoring relationship is to begin by asking for specific advice and then assess whether or not the relationship is likely to be fruitful in the long term. A personal fit is important since differences in values can seriously undermine a mentoring relationship. Successful mentoring relationships have an altruistic mentor with both significant mentoring experience and an extensive professional network.¹² Qualities of the successful relationship include honesty, active listening, flexibility, reciprocity, mutual respect, a personal connection and shared values.

In seeking a mentor, medical students should familiarize themselves with the faculty (and residents) in their institution by researching departmental Websites and talking to other students. It is helpful to evaluate the potential mentor’s interactions with peers and medical students during teaching conferences or on rounds. When selecting a career mentor, residents should also take into consideration the reputation of the faculty member at a national level, track records of former mentees, areas of expertise and research opportunities.

Faculty may need to have more than one mentor as it is difficult to find a single individual in the mentee’s area of interest who is an outstanding teacher, clinician and researcher with the additional time to be a mentor. The mentee will likely need to develop multiple mentoring relationships over the course of their career in order to be successful. The workaholic mentor without any personal life may be a great research advisor but not be someone to emulate for life-balance. Mentors need not be at one’s home institution. For example, a mentor for overall career development may be a senior surgeon that is in a position of power or leadership at the mentee’s local institution while a mentor for advancement within the mentee’s specialty may be a more senior surgeon outside the institution. Choosing a mentor from outside the mentee’s department is acceptable and may be an advantage in establishing interdepartmental projects. Mentors can also be leaders in the community that have achieved success in an area aspired to, such as community service or fund-raising.

Gender is often a consideration when mentoring relationships are being developed, especially since there is a shortage of female surgical mentors.¹³ The literature has produced conflicting results with some research suggesting that men are overall less effective career sponsors for women than female mentors.¹⁴ Other evidence suggests that mentors of either gender are equally effective in counseling women about career advancement.^7,15 Same-gender role models may be more effective at providing advice and encouragement in issues relating to work-life balance. While the literature does not provide clear evidence on specific gender advantages, it does show that in general women are more likely to perceive the lack of mentors as a barrier.⁷

With more people seeking out mentors at the beginning of their careers, some medical institutions are stepping up efforts to enhance faculty development opportunities by targeting professionals often marginalized from the traditional tenure-track environment. These are predominately junior (and often female) faculty with heavy clinical loads, moderate to heavy teaching responsibilities and little time for scholarly activities.¹⁶ Some institutions follow a business model of formal mentor assignment. Others adopt a more random informal approach or combine the two by identifying pools of potential mentors and mentees allowing each to select their own mentoring partners.

The formal or institutionally assigned roles customarily assume the relationship to be a strictly professional one: the senior person ensures that the junior person completes institutional requirements and is progressing appropriately in his or her field of study.¹⁷ Formal national programs include the Drexel Executive Leadership in Academic Medicine program,¹⁸ Junior Faculty Empowerment Program at Hershey¹⁹ and the American College of Surgeons and Association of Women Surgeons mentoring program for Early Career Women Faculty.²⁰

Informal mentoring relationships are more likely to involve a personal element since informal mentors are often role models for integrating professional and personal responsibilities.²¹ It has been demonstrated that mentees with informal mentors demonstrated superior career development, higher incomes and more promotions than those with only formal mentors. ^9,22

Other forms of mentoring, such as co-mentoring²³, “mosaic mentoring”²⁴, a “collaborative” framework of mentoring (also called peer-group mentoring)²⁴ and long-distance mentoring can be successful when clear roles and goals are established for each mentor relationship. The differences between the initiation, structure, duration and process of the mentoring relationship can impact its outcome. If nurtured, however, all models can be successful.

THE MENTORSHIP PROCESS

Mentors should set aside an hour for the first meeting with a mentee. Prior to the first meeting, the mentor should obtain a copy of the mentee’s curriculum vitae, grades and evaluations, where appropriate. Generally medical students who ask a surgeon to serve as their mentor are interested in pursuing a career in surgery. In order to give appropriate guidance the mentor must be familiar with the medical school class curriculum, know which courses are mandatory or optional and appreciate the policy on fourth year and “away” electives. The National Residency Match Program Website²⁵ has a number of resources that are useful in advising medical students about their specialty choices.

Prior to meeting with a resident mentee for the first time, the mentor should familiarize themselves with the institutional or departmental policies on parental leave, moonlighting and grievances in addition to the Accreditation Council for Graduate Medical Education requirements for their specialty.²⁶

If the mentee is a member of the faculty, the mentor should review the mentee’s official job description to ensure that the expectations of the mentor, mentee and chair are aligned. If possible, information should be gathered on clinical productivity to identify problem areas that might require intervention. Finally, the mentor should review the institution’s promotion and tenure guidelines.

The purpose of the first meeting is to get to know each other and set some ground rules including a commitment to confidentiality and to a regular meeting time. Expectations should be established about what each expects to gain and contribute to the relationship. Goals and priorities should be identified, with an appropriate timeline. Goals could be categorized as personal, clinical, education, research, and financial but will need to be flexible as priorities and opportunities will change with time.²⁷ There are many ways in which a mentor can guide the mentee. The mentor should ensure that a mentee is on committees, a member of relevant professional organizations and acquires additional skills that will aid career development. In addition it may be beneficial if the mentor can facilitate invitations to social functions and assist in forming professional relationships in the institution and at a national level. A mentor can also provide guidance in identifying research opportunities to fund medical student or resident attendance at national meetings such as the American College of Surgeons Resident and Medical Student Programs²⁸ and identify awards for outstanding residents or medical students that will advance their careers.^28,29 Faculty should be encouraged to start a promotion portfolio and to ensure that they will meet the appropriate criteria for their academic track and rank.

AUTHORS

Hilary Sanfey, MB. BCh. MHPE. FACS – Southern Illinois University Springfield, IL
Celeste Hollands, MD, FACS, FAAP – St. John’s Hospital, Springfield, IL
Nancy L. Gantt, MD, FACS – Northeast Ohio Medical University, Youngstown, OH

CORRESPONDING AUTHOR
Nancy L. Gantt, MD FACS

This paper was originally published submitted as part of the Career Development Resource prepared by the Association of Women Surgeons. For full list of references, see original article.