The Challenges And Responsibilities Of An Effective Mentoring Relationship

Mentorship Challenges And Responsibilities


The mentoring relationship is one of collaboration that should ultimately benefit both parties. Therefore mentees should demonstrate eagerness to learn, flexibility and an understanding of the mentor’s demanding schedule.30 Mentees should be prompt for all appointments, and respect the time and effort the mentor is investing on their behalf. They should attend meetings prepared with lists of topics for discussion including timelines for projects. Open and honest communication is essential and the mentee should be open to feedback and critique. The mentee should become an active participant in their own future by developing a professional support network within and outside their institution.27 They should participate in the activities of professional organizations both locally and nationally. Furthermore, mentees should request visible leadership roles and learn how to promote themselves without alienating others. Finally mentees should ensure that they deliver, and deliver well, the tasks entrusted to them.30

A mentor is a unique individual who is a combination of friend, colleague and more. As such a mentee may witness private moments when the mentor lets her or his guard down and the mentee should show loyalty and maintain confidentiality. Although some mentor mentee relationships develop into long-lasting friendships, the relationship is, foremost, a professional one.


Mentoring is like parenting in many ways: just as good parenting skills are essential for the upbringing of future generations of children so skills in mentoring are essential for developing future surgical leaders, educators and role models. Similar to parenting mentoring requires an investment of time, energy, and emotional resources. Mentors serve the dual function of guiding professional and personal development. They are essential in assisting individuals to make successful transitions such as from student to resident or resident to junior faculty.

Mentors support the professional development of mentees in multiple ways. They ensure that mentees achieve academic milestones. Mentors also contribute to the personal development of mentees by promoting their integration into the social environment of the workplace and assisting them in forming professional relationships that may lead to future collaboration. Mentors can also protect a mentee from excessive institutional demands, provide guidance in navigating institutional politics and give advice on which requests are “career-enhancing” or “career-killing.” A good mentor will encourage and demonstrate confidence in a mentee, ensure a supportive environment, and provide frequent feedback.

Effective mentors balance support with challenge by providing opportunities and setting positive expectations.31 A student may require active prompting and occasionally even pushing to encourage success while more senior mentees may need less direction to achieve their goals. Deciding which mentorship style is appropriate can be extrapolated from the Hersey Blanchard work on Situational Leadership whereby leadership styles are divided into categories depending on the ability and motivation of the mentee.32 The amount of direction necessary for the mentor to provide will depend on the development level of the mentee and the task at hand.

A mentor makes a long-term commitment to further the professional and personal development of the mentee. Over time the perceptions of both members of the relationship will change as the mentee’s performance evolves to new levels of competence under the mentor’s guidance and support. In all cases the mentor must respect the mentee and act responsibly as the wrong advice could destroy a mentee’s academic career. In this regard it is important to make sure that advice is current and appropriate. Mentors must also maintain cultural and gender sensitivity towards the mentee and respect confidentiality. Finally, mentors should be generous with credit and never see their mentee as a threat. It is worth emphasizing that imaginative, creative ideas often come from more junior colleagues. As with others we teach, we want to see our students reach beyond us and our mentee’s success is ultimately our success.19


Contemporary mentoring presents challenges not faced previously by academic medicine’s current leaders, most of whom were “groomed” by someone who looked, thought and acted just like them. The homogeneity of senior faculty contrasts sharply with the heterogeneity of young faculty, many of whom present priorities and values unfamiliar to their potential mentors. Given the rapidly changing complexities of medicine and career pathways, advice applicable even five years ago may no longer be helpful.24 Since child bearing is often a priority in early years after residency for women they may have a different career trajectory and a later professional peak.33 Similarly, men may desire paternity leave and a more flexible schedule when starting a family. Mentors may need to assist mentees in the development of novel career pathways. Challenges may also arise because of the intensity of mentoring relationships and the potential for misunderstandings; one example might be cross-race and/or cross-gender relationships where a mentor may have trouble identifying with the mentee or vice versa. Finally, generational differences can significantly alter the mentoring relationship. Effective mentoring for generation X (born from the early 1960’s to the early 1980’s) and millennials or Generation Y (born early 1980’s to early 2000’s) present additional challenges.

A mentee may not successfully meet agreed-upon goals because of personal difficulties or external problems. The most common problems are time constraints, lack of research funds, or infrastructure. With assistance and guidance the mentee should learn to readjust priorities and say “no” to those distracting tasks that are not helpful towards advancement. A mentor can help a mentee explore the option of outside grants from professional specialty organizations and industry or make an introduction to a colleague to improve the strength of a proposal. It may be possible to “borrow” a colleague’s resources in exchange for the mentee’s expertise. Unhelpful or obstructive colleagues can be the most challenging problem. Occasionally it may be necessary for the mentor to facilitate negotiation on behalf of a mentee to resolve a conflict. There are instances when a mentee will need to follow different paths to seek advice and/or resolution depending on their institution and position. For example, medical students may seek advice from a representative of the Dean of Student Affairs, residents likely have an ombudsman through the GME office, and faculty would seek the counsel of their institution’s Human Resources department for advice on relevant institutional grievance policies.

Some mentee problems may overstep the boundaries of the usual mentor-mentee relationships. Mentees may develop clinical depression; have personality disorders, substance abuse or academic issues. Mentors should recognize when they are unable to resolve such problems and should refer challenged mentees to their primary care physician or suggest consultation with specialists such as study counselors or psychologists. Mentors are not expected to take on roles in which they do not have expert skills.

Mentoring relationships mature toward an end in a number of ways: mentees graduate, change jobs and/or need someone with different expertise. Both mentor and mentee should appreciate that as the relationship evolves, and the mentee progresses along his or her career path, his or her needs may change in a direction that leads them away from the mentor. This can be perceived as an awkward time for both but it should be regarded positively as evidence of the success of the mentoring relationship.

A more difficult situation is when a mentee encounters a bad mentor and needs to unilaterally terminate the relationship. The bad mentor may misinterpret the mentee’s potential, fail to define appropriate professional and personal limits, or even take credit for the mentee’s work. Competition between mentors and mentees can be a major contributor to a failed relationship. Other qualities of the bad mentor include inappropriate praise or criticism, disregard for the mentee’s opinions, and unethical and, rarely, immoral behavior. Major negative qualities include exploitation, secrecy, and dishonesty. The mentee will very carefully need to seek the advice of a more senior colleague, possibly at a different institution, and may need the advice of multiple colleagues to effectively manage ending an ineffective mentoring relationship. Care should be taken to gain the trust of the colleague the mentee seeks advice from while maintaining professionalism with regards to the issues of concern.

Mentoring is essential to the complex professional and personal development of the contemporary surgeon. While the process can be challenging, and expectations as outlined are significant on both sides, both mentor and mentee may derive great benefit from the relationship. A mentor has the opportunity to leave a part of themselves in everyone they mentor. Long after they have retired from the world of grants, publications, students and patients, their work will still be going on in those they have guided.


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

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.

Ariel Jacoby
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