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How mentors can enhance your training and career

Residents say that mentors can improve confidence and lead to job opportunities they had not considered

From the November 1998 ACP-ASIM Observer, copyright © 1998 by the American College of Physicians-American Society of Internal Medicine.

By Christine Kuehn Kelly

It was early evening, and Oregon Health Sciences University resident Richard A. Mularski, ACP-ASIM Associate, was discussing pulmonary and critical care fellowships with one of his mentors. Dr. Mularski, who is interested in ethical issues and end-of-life care, was looking for advice on finding a fellowship program that matched his interests. At the same time, he was searching for a missing bath toy that had disappeared while his mentor's youngest son was taking a bath. A three-hour discussion about fellowships took place at the advisor's home, during which time both put the children to bed.

Mentors often function as colleagues, teachers and friends, but they are first and foremost guides who have put aside self-preoccupation to foster the growth of new professionals. "Mentors place the needs of protégés ahead of their own interests," said Gordon L. Noel, FACP, chief of medicine at Portland VA hospital and professor at Oregon Health Sciences University, who has served as a mentor.

Many residents say that the best mentors help develop the insight and self-awareness that help integrate professional life, personal concerns and core values. Equally important, mentors believe in their advisees, share their dreams and help those dreams come to fruition. For Dr. Mularski, his mentor is also a role model.

"Mentoring is one of the most important aspects of our education," Dr. Mularski said. "Medicine is more an art than a science, and it needs to be learned through observation and mentoring."

Opening doors

Physicians who have worked as mentors point out that advisors can often improve their protégé's confidence and open doors that would otherwise be closed to them by pointing out skills that residents may not realize they have. "A lot of people come out of residency with the ability to practice medicine and take care of patients," said Elizabeth S. Allen, ACP-ASIM Member, an assistant professor at Oregon Health Sciences University in Portland who has served as a mentor. "But they often have other skills that they haven't recognized."

Mentors are also familiar with a wider range of professional opportunities such as training programs, fellowships and specialties. Laura J. Zakowski, ACP-ASIM Member, director of the primary care residency program for internal medicine at the University of Wisconsin, said that her mentor helped steer her career in a new direction. "I was thinking about going into clinical practice, but my mentor pointed out my teaching abilities," she said. "He thought I would be a good teacher and should stay in an academic setting. He was right; I'm extremely happy now."

A good mentor will help residents find the resources they need to branch out in their careers. "I'm interested in getting an MBA and working in hospital administration," said Jonathan D. Darer, ACP-ASIM Associate, a resident at Oregon Health Sciences University. "My mentors helped me find new people to work with who have expertise in that area. Academic departments are often focused on clinical medicine, but my mentors were able to provide a broader perspective on what is available."

Even if you have already decided on a career, mentors can still offer help. Whether it's writing letters of recommendation or making a phone call to a colleague, a mentor's reputation and contacts can help open up new opportunities.

Mentors also can intervene in problems residents might encounter during training, and they often serve as a facilitator to resolve difficulties with attendings, problems with scheduling or obstacles getting into a fellowship.

Choosing a mentor

If you're thinking about choosing a mentor, experts suggest taking the initiative and approaching the individual who you think would make a good mentor. Don't be afraid to knock on the door and say, "I had a great time with you as my attending. Could we discuss something I'm especially concerned about?" Or use e-mail, which is appreciated by busy faculty members who use it to organize their time to help residents.

Residents may also be reluctant to get involved with mentoring because they find it difficult to choose the right person to serve as their mentor. Residents who have been through the process say that observation is key. "I found my mentors by observing professors to see whom I identified with. I wanted those who shared my values," said Chieko Misaki, MD, an internal medicine resident at Legacy Health System's Emanuel and Good Samaritan Hospitals in Portland.

When choosing a mentor, consider exactly what skills you can learn from an individual. According to Roger W. Bush, FACP, program director in internal medicine, Virginia Mason Medical Center in Seattle, the major teaching centers where residents have access to faculty may not necessarily be the best places for residents to find mentors who can help them obtain the skills they need in the changing medical environment. "The better training programs are working to cultivate community-based teaching," he said. "Look for mentors in areas that will be relevant to your career."

General internists, for instance, are often team leaders and tend to be the mortar between the bricks. "Seek out mentors who have good clinical skills but who can also manipulate the system for the patient's benefit," Dr. Bush said. "These skills are difficult to teach; a mentor has to model them."

Dr. Darer said that he looks for mentors who can provide a reality check. "It's important to find someone who has experience and is in touch with the real world," he said. "I needed someone to encourage me and help measure my progress as a resident. My mentor gave me a sense of how I was doing and where I should focus my energies."

Dr. Misaki said that she doesn't limit herself to a single mentor, a point emphasized by others in mentoring relationships. "Everybody has something to bring into your life," she said. "One person may have incredibly strong skills in interviewing patients, while others can guide you on personal issues or how to deal with difficult patients. It's healthy to have more than one mentor."

Making it work

Once you have chosen a mentor, expect to spend some time developing the relationship. Dr. Darer suggested not waiting until things aren't going well in your training to get in touch with a mentor. He said that residents should instead set up a specific time to meet with their mentor before a crisis develops.

Here are some additional tips to making the relationship work:

  • Don't assume faculty is too busy to be interested in you. Physicians who have been involved in mentoring uniformly agree it is one of the most satisfying aspects of their professional lives.
  • Be honest. Mentors and residents alike need to be able to expose their thoughts and feelings to make the relationship worthwhile. "Mentoring is a professional friendship based on mutual interest and respect in each other," said Dr. Noel. This includes the important element of understanding each other's professional values and lives.
  • Don't miss mentoring opportunities. "Mentoring doesn't have to be formal," said Dr. Misaki. "It can happen anywhere, in the elevator or in the hallway." She recalled the time she was dealing with a difficult patient and had to leave the room. By chance, one of her mentors was passing in the hallway. "She was able to give me some advice that helped me put things into perspective, and I was able to return to the patient and resume care," Dr. Misaki.

    However, Dr. Noel noted, some residents may find it easier to contact potential mentors by e-mail rather than calling them or catching them in the hall.

  • Try co-mentoring. "We formed a group of women peers who mentor each other," said Dr. Zakowski. "One of the women has children older than mine. Another woman is in clinical practice with me." The women aren't necessarily wiser than each other, she said, but they all have different skills and knowledge. Female residents could easily form a similar co-mentoring group, she said.
  • Set a limit on age differences. The typical age difference between mentors and protégés is eight to10 years, experts point out. This makes the mentor more of an older brother or sister than a parent figure. A wider age disparity may make it more difficult for residents to be junior colleagues.
  • Be aware of the pitfalls. "Some mentors can be needy," said Dr. Noel. "They may be getting things out of the relationship that are not in the best interests of the protégé. Their attitude is, 'Let me hold up a mirror to you so you can reflect what I'm saying.'" However, protégés usually outgrow this kind of dysfunctional relationship, Dr. Noel said
  • Evaluate the mentor. Once you're involved in a mentoring relationship, ask yourself these questions: Is your mentor encouraging and respectful of your goals? Do you receive regular feedback? Does your mentor facilitate your participation in committees, help you stretch your boundaries or try out new roles? Does your mentor make professional connections for you? Is your mentor easy to communicate with? Do you continue to respect your mentor and his or her accomplishments?
  • Expect the relationship to change. It can simply wind down as energy gets used up, original issues are dealt with or the faculty member or resident moves on. Or the relationship may develop into a peer relationship. When this happens, the relationship is likely to continue through more periodic visits, phone calls or even socializing together.

Christine Kuehn Kelly is a Philadelphia-based freelance writer specializing in health care.


Resources

  • "Faculty Mentoring Guide." Virginia Commonwealth School of Medicine, Medical College of Virginia Campus, P.O. Box 980565, Richmond, Va. 23298-0565. $2 includes postage.
  • "Mentorship in general internal medicine: investment in our future." Journal of General Internal Medicine. 1992;7:248-251.
  • "Examining what residents look for in their role models." Academic Medicine. 1996;71:290-292.
  • "Women physicians and their mentors." Journal of the American Medical Women's Association. 1989; 44:123-126.

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