Solving the Mentoring Mystery

By R. Kevin Grigsby, AAMC Senior Director, Leadership & Talent Development

When the question “What is mentoring?” is posed, I typically hear responses that are more mystical than scientific. It’s as if there’s more theology than evidence under-girding the mentoring knowledge base. In a sense, we have “faith” that mentoring will work, but we don’t know why.

In the January issue of Academic Medicine, Straus and colleagues asked about the nature of successful mentoring at two North American institutions. I was very impressed to read that they also asked about failed mentoring. This line of questioning is fruitful, yet there is a dearth of evidence-based information about it. The authors found that “poor communication, lack of commitment, personality differences, perceived (or real) competition, conflicts of interest, and the mentor’s lack of experience” characterized failed mentoring relationships. By improving our understanding of these factors, we can change the way we approach mentoring in academic medicine and science.

Also in January, Tillman and colleagues addressed the issue of mentoring in the context of organizations receiving Clinical and Translational Science Awards (CTSAs). Their approach is valuable as well. Examining the policies and activities of these organizations provides impetus for other organizations to compare their specific policies, structures, and activities with those at other CTSA institutions. Based upon these comparisons, they can make improvements to maximize the potential of mentoring relationships.

But, is maximizing mentorship potential in our organizations really enough to meet the challenges of the future? A recently published AAMC report revealed that, although women have made significant progress in academic medicine and science, they are still underrepresented as department chairs and deans. At a recent AAMC meeting, Elizabeth Travis, PhD, Director of Women Faculty Programs at MD Anderson Cancer Center, provocatively argued that women and members of underrepresented groups in academic medicine and science need substantially more than good mentors–they need organizational leaders to actively sponsor them as candidates for high level leadership positions. A sponsor is more than a role model or mentor. A sponsor uses her or his own reputation to vouch for someone else. If we, as a community, expect to reach parity in the proportion of women leading academic departments and colleges as chairs and deans, then all leaders must actively sponsor women for these leadership positions.

Accompanying these studies in the January issue is an article on physician shadowing. After a literature review, Kitsis and colleagues proposed that a set of guidelines and a code of conduct for premed students and faculty be developed and implemented to enhance shadowing experiences and to address both practical and ethical considerations. I agree. But are guidelines and a code of conduct enough?

I believe that all of these relationships will be improved with clearly stated guidelines and a set of expectations regarding role models (as in shadowing), mentors, and sponsors. Communicating clearly and openly, keeping commitments, declaring and eliminating conflicts of interest, and giving credit where credit is due should guide the conduct of those of us fortunate to serve in these roles.

Should we create guidelines and a code of conduct for faculty and staff that go beyond shadowing to include mentoring and sponsoring? If so, what, specifically, should we include in these guidelines?

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