Although formal mentoring programs in medical education were not launched in the United States until the late 1990s,1 today they are regarded as playing an essential role in the career development of medical trainees and have been associated with improvements in research, teaching, and patient care.2 Mentoring is defined as a personal developmental relationship in which a more experienced or more knowledgeable person (the mentor) provides guidance for a less experienced or less knowledgeable person (the mentee).3
Mentors can have a profound impact on the career direction of young trainees, said David H. Johnson, MD, MACP, FASCO. Dr. Johnson credits his own early mentor, Paul Webster, MD, who was Chairman of Medicine at the Medical College of Georgia when Dr. Johnson was Chief Resident there in the late 1970s, with steering him toward a career in academic medicine and a specialty in oncology, especially in the research and treatment of lung cancer.
During Dr. Johnson’s tenure at Vanderbilt University Medical School, where he served as Director of the Division of Hematology and Medical Oncology and Deputy Director of the Vanderbilt-Ingram Cancer Center, he helped develop bevacizumab (Avastin) and erlotinib, both now approved by the U.S. Food and Drug Administration (FDA) in the treatment of lung cancer. Dr. Johnson served as ASCO President from 2004–2005 and was instrumental in advancing ASCO’s Quality Oncology Practice Initiative (QOPI®), as well as the development of ASCO’s Cancer Survivorship Program. He has also served on the FDA Oncologic Drugs Advisory Committee, as well as on the Board of Directors of the National Comprehensive Cancer Network, the International Association for the Study of Lung Cancer, and the LIVESTRONG Foundation.
In addition to these career achievements, Dr. Johnson said that he is most proud of the successes of the young trainees and junior faculty he has mentored over his 35-year career in oncology. The ASCO Post talked with Dr. Johnson, the Donald W. Seldin Distinguished Chair in Internal Medicine and Chairman of the Department of Internal Medicine at the University of Texas Southwestern Medical Center in Dallas, about the value of mentorship and the qualities necessary to be an effective mentor.
Choosing the Right Mentor
Please talk about the benefits and value of mentorship.
One of the most important decisions a person preparing for a career in medicine can make is choosing the right mentor. Mentoring usually starts in medical school and can be instrumental in helping students choose a specialty and subspecialty to pursue and decide on a career in academics, community practice, government, or private industry.
The key component to career development is having the right mentor. Mentorship does not need to end once physicians are established in their career. It is a useful relationship to have throughout one’s career. I still have mentors and feel very fortunate to have people I can turn to for advice, insight, and guidance all the way through my career.
Necessary Qualities
What are the qualities of a good mentor?
A good mentor is someone who is well regarded in his or her field, possesses high standards, is objective, honest, direct, patient, approachable, and a good listener, observer, and problem solver. Most important, a good mentor tends to be selfless and interested in the successes of others; he or she does not use trainees or mentees for personal benefit. I know that sounds obvious, but it is an important point to make.
Personal Sacrifices
The Accreditation Council for Graduate Medical Education has identified six core competencies to evaluate residents in training. They include patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. How can mentors help mentees succeed in these areas?
The main way is through role modeling. If the mentor has the attributes I described earlier, he or she will have competency in these six areas of training. Mentors have to have medical knowledge, have to be good communicators, and have to understand how institutional systems work; this does not mean just how hospitals and clinics function but also the systems needed to make scientific laboratories work effectively and efficiently.
Mentoring is more like a parent/child relationship than a teacher/student relationship. There are some elements of teacher and student in mentoring, but a good mentor, like a good parent, is going to make personal sacrifices for the benefit of the trainee/mentee. Although many good teachers do make personal sacrifices for their students, it is not necessarily an inherent part of their role.
Role of the Mentee
What are the key responsibilities of a mentee?
Mentees cannot outsource their career development. They must be full participants in their advancement. They have to take charge of their program of study, have to read, do their course work, and hone their technical skills. Mentees should continuously apprise their mentor of their progress and any problems they are experiencing and work proactively with their mentor to solve potential difficulties.
Mentees also have the responsibility to recognize when the relationship with their mentor is no longer working and make a change if necessary. And, because mentors have different strengths and qualities, it is important for mentees to establish relationships with multiple advisors to become exposed to a variety of professional experiences and perspectives.
Role of the Mentor
What are some of the key responsibilities of a mentor?
Mentors have many roles in the career development of their mentees. They are teachers, role models, networkers, and counselors. They schedule regular, structured meetings for advising their mentees on developing a career plan that includes professional milestones to be met. Mentors help mentees develop better writing, speaking, and strategic thinking skills. They also teach trainees how to assess journal articles critically, write technical papers and grants, and revise manuscripts.
Career Goals and Expectations
How often should mentors and mentees meet, and what should be discussed at these meetings?
There is not a hard and fast rule on the optimal number of times to meet. It depends on the needs of the mentee and the schedules of the mentor and mentee. Some mentees need structured, directed guidance and require regularly scheduled meetings, whereas other mentees may be more advanced, preferring less structured supervision.
Regardless, at the initial meeting, the mentee’s professional goals, knowledge, and skill gaps should be assessed. Understanding these items can help guide the frequency of meetings. Common mentee needs include help with establishing career goals, choosing fellowships, developing communication and time management skills, and networking.
Creating specific written career development goals to be accomplished over a set period (1 month, 6 months, 5 years) is a good idea. The mentor and mentee should also establish the best way of communicating, such as in person, by phone, via e-mail, or all three. During each meeting, the mentee should describe progress he or she has made since the last meeting and ask what is expected in terms of accomplishments before the next meeting.
Transitioning to Independence
How can mentors help mentees transition to independence?
We use the term progression-free survival, or PFS, to describe how well a cancer treatment works. I use PFS as an abbreviation for “prolonged fellow syndrome” to describe the danger of trainees becoming long-term extensions of their mentors—always a “risk” if the mentee remains at the institution where he or she trained. A good mentor will develop a separation plan early in the relationship, as the mentee progresses in his or her career development and after the mentee has achieved his or her goals.
That said, a satisfying, successful mentorship relationship never really ends. Those who helped me during my early training are people I still turn to for guidance today. It is a different kind of relationship, more like a strong friendship between two colleagues than a parent/child relationship, but it still provides me with the tools I need for continued professional growth. ■
Disclosure: Dr. Johnson reported no potential conflicts of interest.
References
1. Buddeberg-Fischer B, Herta KD: Formal mentoring programmes for medical students and doctors—A review of the Medline literature. Med Teach 28:248-257, 2006.
2. Illes J, Glover GH, Wexler L, et al: A model for faculty mentoring in academic radiology. Acad Radiol 7:717-726, 2000.
3. Detsky AS, Baerlocher MO: Academic mentoring—How to give it and how to get it. JAMA 297:2134-2136, 2007.
GUEST EDITOR
Education in Oncology focuses on faculty development, medical education curricula, fellowship training, and communication skills. The column is guest edited by Leora Horn, MD, MSc, Associate Professor of Medicine, Assistant Director of the Educator Development Program, and Clinical Director of the Thoracic Oncology Program at Vanderbilt University School of Medicine, Nashville.
