Leadership in Medicine: The Importance of Mentorship

Mentorship is important in every personal and professional discipline. This need for mentorship extends from the parents–child relationship to the teacher–student relationship and crosses all human interactions and disciplines. This article focuses on mentorship in academic medicine. Mentorship is advantageous in the successful navigation of careers in academic medicine, notably for the development of emotional and social intelligence, and for individuals in need of specialized knowledge, skills, and psychological growth.

The interdisciplinary nature of biomedicine requires the use of multiple mentors to provide diverse perspectives for mentees and junior faculty. Multi-mentorship programs require institutional commitment, with clear delineation of institutional goals and values with financial and political support. These important programs identify and train future leaders throughout an organization’s hierarchy, support innovation and flexibility within the academic medical center, increase work satisfaction, and, as a result, enhance workplace harmony. Given the constantly changing medical landscape, mentorship takes on discrete, but paired, functions for the mentee, mentor, and the academic medical center. There are benefits for all members of the triad.

The Importance of Mentorship Programs

Academic medical centers provide state-of-the-art, complex medical care, teach and train young aspiring professionals, and perform clinical and basic research. Yet medical centers are still subject to increased public and governmental scrutiny for the cost of medical care and research activities, and the quality and safety of medical care. Increased regulatory oversight, mandated use of electronic medical records, and economic constraints on health goods and services and research confront academic medical institutions, while the core requirements for clinical care, research, teaching and excellence and equity in quality care remain an expectation. The specialized clinical and technological skills required in academic medicine must be balanced by expertise in information technology, managerial and leadership skills, and political adroitness. The mentor is critical to the academic medical center in meeting these exponentially growing expectations across the core requirements of clinical care, basic research, teaching, and excellence and equity across the academic medical center campus.

Given the changing and demanding medical landscape, mentorship takes on discrete, but paired, functions for the mentee, mentor, and the academic medical center.

• Benefits received by mentees are improved assessment of personal and professional goals, an improved understanding of time management, counsel on work-life balance, increased socialization, and improved setting and resetting of priorities. The mentee can grasp essentialist attributes in this mentorship environment to enhance professional and personal development.

• For the mentor, the ability to share specialized knowledge and survival skills with a receptive mentee may provide a renewed sense of purpose and the pleasure of helping mentees’ achieve personal and professional growth.

• For the institution, well-crafted and formalized mentorship programs increase professional satisfaction of the medical staff, improve clinical medical care and research activities, foster development of human talent, and propagate dissemination of organizational values and mission.

• The academic medical center is successful when there is:

• Leadership throughout the organization;

• Employee alignment with institutional values and goals;

• Increased innovation and productivity across the campus;

• A milieu of constant learning and improvement;

• Achievement of diversity;

• Seeking of criticism attempting to identify and overcome failures; and

• Empowerment of employees across all programs of the institution.

Mentorship

Mentorship is a collaborative relationship between individuals in training across diverse groups who share the responsibility for the achievement of individual trainee development. Success in these relationships is based on the personal compatibility and commitment of the mentor and mentee, and is measured by the realization of personal and professional goals. Such goals must be well defined and agreed upon by the mentor and mentee and frequently evolve over time.

Mentorship, although closely aligned with coaching, is different: coaching directs learning by refining specific skills needed for performance improvement, whereas mentorship places greater emphasis on the process of individual development. Mentorship and coaching of mentees overlap. Both are essential for the mentee to achieve his or her maximum potential. The distinguishing features between mentorship and coaching are understood. The overlap is often identified in clinical settings where mentorship and coaching often coexist.

To be successful, mentoring programs must be part of the institutional fabric, valuing and supporting learning, innovation, and the development of mentees.

It is important for academic medical centers to formalize mentorship programs between mentors and mentees. This institutional formalization has the advantage of relaying institutional knowledge and professional experiences to the mentee, thus building a culture of mentoring. To be successful, mentoring programs must be part of the institutional fabric, valuing and supporting learning, innovation, and the development of mentees.

Mentors must receive clear guidance from institutional leaders regarding the values, skills, and behaviors expected of them. These structured programs must retain an emphasis on the specific needs of mentees, rather than those of the institution. Although organizations differ in their technical and cultural environments, and may require different skill sets for success, all organizations must provide opportunities for continuous learning, personal and professional development, and potential for future leadership roles both within and outside the organization.(1)

Strategies to attain the hoped-for benefits of mentorship include a supportive environment; formal programs with defined metrics for success; training programs for mentors and mentees; programs for continuous learning; and clearly articulated institutional values, missions, and goals. Mentees must be receptive, reflective, proactive, accepting of critique, and deeply appreciative of the mentors’ teaching and guidance. Mentors must have the capacity to lead; have the experience to provide relevant advice; be honest, approachable, and supportive; and provide comprehensive feedback to mentees. They also must have the ability to identify and teach relevant skills.

Mentors are admired when their mentees succeed. However, small subsets of mentees are resistant to mentorship, and some mentors lack the requisite skills to mentor. Such failed relationships must be evaluated, because the failure may occur on both sides of the mentor–mentee relationship. Mentees often are selected for their intelligence, work ethic, work performance, and teamwork, but they may lack the emotional and social intelligence necessary to survive in the training program. The mentor must recognize these deficiencies and determine whether they have the skills to enhance the emotional skills of the mentee, or whether other resources are needed to assist in the individual’s development. Mentorship programs must have the bandwidth to disentangle the challenges faced by mentee/mentor relationships. The breadth of the mentorship program must be able to assess psychological needs; systemic prejudices, including those related to gender, race or demographics; power relationships; and distinctions between coaching and mentoring.

Mentees and Mentorship in the Real World

The best path for all mentees cannot be identified by all would-be mentors. Mentors are limited by their own education and personal and professional experience, and not all mentees can navigate career paths for which they are unsuited by temperament or talent. Mentees in academic medicine may lack the capacity, or interest, to become clinical scientists, clinical teachers, administrators, or future leaders. The mentee who has limitations in interest or talent in these areas is set up for personal dissatisfaction and/or personal or professional failure. Therefore, mentors have the challenging responsibility to provide realistic assessment of an individual’s ability for a chosen path based upon their critical assessment and assessments by other mentors. A disconnect between an individual’s capacity to pursue a chosen path and the realistic assessment by mentors requires the presentation of alternative viewpoints and also introspection, by both the mentee and the mentor. These discussions can be challenging and may be filled with emotional resentment. Resolving this may require input from multiple mentors in the formalized mentorship program. The best path forward often is to build upon known strengths and to expand those strengths through additional knowledge and skill building. The formalized mentorship program must have the tools to handle these often-difficult issues and to identify where mentees can flourish.

Mentorship and the Institution

The academic medical center relies on the development of committed leaders and innovators who are aligned with its articulated institutional values and goals. Mentors require a clear and concise set of institutional values, skills, and behaviors.(2) Depth in institutional mentorship and leadership is a valuable asset. The importance of enunciating and communicating institutional goals increases as institutional priories change in relation to the changing healthcare environment.

The architecture of a mentorship program is critical to its success. The bandwidth of an academic medical center’s mentorship program in today’s world must be all encompassing. Physician trainees must be exposed to a broad range of disciplines to be prepared to survive in the new and diverse world of medicine that is impacted by business, the law, and the evolving role of the Internet and cyberspace in the practice of medicine. A strong mentorship program must provide in-depth teaching and training in medicine, business, law, technology, and ethics. Young trainees are faced with the rules and regulations of the “real space” physical environment defined by our constitution, statutes and other legal codes, and the rules and regulations defined by cyberspace where “code” is defined by software and hardware rules and regulations. The distinction between “code” in cyberspace and law in real space is important, because it has an impact on how we traverse the new and evolving medical learning environment.(3)

The introduction of the EMR and HIPAA, as well as federal regulatory policies and laws, has directly affected how physicians practice medicine. Transgressions against these laws and codes can lead to loss of license, exclusion from CMS payments, fines, and civil and criminal penalties. Contravention of federal statues and employment laws also can result in similar devastating penalties. This intersection of real space and cyberspace makes for a more difficult terrain in which to practice effective medical care, research, and leadership.

A strong, comprehensive mentoring program will prepare the trainee for a world of real space and cyberspace and help support institutional values and goals by endorsing the value of mentees and junior faculty in their goals and mission. The mentees will then support and champion organizational change. A formal mentorship program identifies leaders for succession planning and organizational growth. Mentees have different needs to meet their personal and professional goals. . Programs that understand and address these differences and needs with a commitment to inclusion and diversity develop a successful and harmonious working environment.(4) To achieve these desired goals requires a huge institutional commitment.

Multiple Mentor Mentorship

Personal and professional development of mentees is best nurtured with connections to multiple mentors. A hierarchy of mentors at various levels within the institution may better respond than a single mentor to the requirements posed by an individual in the training program. A system of multiple mentors also provides access to diverse areas of expertise as well as senior faculty; may provide a valuable female influence if that is unavailable elsewhere in the program; and also may allow the guidance and influence of esteemed underrepresented minority advisors. Multiple relationships may allow mentees to identify individual mentors whom they relate to and from whom they are better able to accept feedback and criticism.(5)

Mentors should be motivated to teach and mentor and must believe in the institution’s values and goals.

The educational institution can select mentors from faculty who are willing and desire to work in interdisciplinary groups. These mentors should be motivated to teach and mentor and must believe in the institution’s values and goals. Physician trainees must be exposed to a broad range of disciplines to be prepared to survive in the new and diverse world of medicine that is impacted by business, law, and the evolving role of the Internet in the practice and medicine. The expanding number of disciplines necessary for trainees to conquer mandates a multiple mentorship program. The complexity of the interdependent relationship between mentees and mentors cannot be created by edict. Mentorship program assessment requires ongoing feedback from mentees and mentors, with that feedback then used to alter approaches to training in an attempt to maximize the training of the mentee and the satisfaction of the mentors.(6)

Final Thoughts

Mentorship, which is important across all personal and professional relationships and disciplines, has increased importance today in academic medicine. Increased regulatory oversight, the mandated use of EMRs, and economic constraints on health goods and services and research confront academic medical institutions, all while the core requirements for clinical care, research, teaching and excellence and equity in quality care remain an absolute expectation of academic medical centers.

Formal mentorship programs for all staff members enhance the development of leadership, innovation, flexibility, and alignment with institutional values and goals.

Formal mentorship programs are necessary to meet these expectations. Mentorship programs allow mentees to develop both professionally and personally. Mentors gain increased purpose and career satisfaction knowing they are creating a better future for trainees and the future of medicine.

Formal mentorship programs for all staff members enhance the development of leadership, innovation, flexibility, and alignment with institutional values and goals. Well-developed, formalized mentorship programs are the critical piece for academic medical community to meet the growing demand for excellence across all departments on the campus. As I have shown, the bandwidth of a mentorship program in today’s world must be all encompassing. From childhood through adulthood, mentorship is crucial to optimal personal and professional growth.

References

1. Zachary IJ. Creating a Mentoring Culture. San Francisco: John Wiley & Sons; 2005.

2. Ready D, Conger J. Why leadership-development efforts fail. MIT Sloan Management Review. 2003;44(3):83-88.

3. Brenner S. The privacy privilege: law enforcement, technology, and the Constitution. Journal of Technology Law and Policy. 2002;7:123, 160.

4. Bhagia J, Tinsley JA. The mentoring partnership. Mayo Clinic Proc. 2000;75:535-537.

5. Sambunjak D, Straus SE, Murusic A. A systemic review of qualitative research on the meaning and characteristics of mentoring in academic medicine. J Gen Intern Med. 2010;25(1):72-78.

6. DeCastro R, Sambuco D, Ubel PA, Stewart A, Jagsi R. Mentor networks in academic medicine: moving beyond a dyadic conception of mentoring for junior faculty researchers. Acad Med. 2013;88:488-496.