Bringing mentors back into medicine: Promoting career guidance for medical residents

doctors discussing mentoring mentorship
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A supportive mentor can make a huge impact on a novice physician’s confidence and career trajectory. Proven benefits range from a higher promotion rate to improved job satisfaction. One study from Harvard Medical School found that residents with mentors were twice as likely to report “excellent career preparation,” and 93 percent said it’s important to have a mentor during residency.

Unfortunately, only half of the residents who took part in that study could actually name a current or past mentor.

“You used to see senior physicians, mid-career doctors, residents and fellows all eating together in the cafeteria,” says Theodore Sectish, MD, Director of Education for the Boston Combined Residency Program (BCRP), a joint training effort of Boston Children’s Hospital and Boston Medical Center. “Now it’s more likely that people eat at their desks. You just don’t see those kinds of organic interactions.”

Even the BCRP has fallen into the trap. In a June 2013 survey of BCRP residents, roughly one-third disagreed with the statement: “I have identified resources and strategies to aid in the achievement of my career goals.”

The problem is particularly acute for residents aiming to enter an academic track after completing their training.

“The overwhelming majority of our residents go into academic medicine,” says BCRP associate program director Ariel Winn, MD. “But there is very little in the formal curriculum that addresses the scholarly components of their future careers. Our residents want mentors in their field who can help them think about their career trajectories and assist them with producing scholarship.”

I’d like to thank the Academy

Winn and her colleagues decided to address the lack of mentorship opportunities with an innovative program that would supplement the BCRP curriculum and encourage residents to both find mentors and pursue their specific passions within medicine.

The result is actually four programs in one. Each new BCRP resident must now enroll in one of four “Academies,” which function as pseudo-schools or departments within the larger “university” of the BCRP:

  • the Innovation Academy, for problem solvers and quality-improvement enthusiasts
  • the Investigation Academy, for basic science research buffs
  • the Medical Education Academy, for residents interested in teaching
  • the Community and Global Societies Academy, for those with a passion for public and/or global health

Each Academy hosts six afternoon workshops throughout the year in addition to multiple evening networking events. Senior BCRP faculty are encouraged to participate as leaders in the Academy that most closely aligns with their specialty or field of interest.

Holly Hodges, MD, a newly appointed BCRP chief resident, enrolled in the Investigation Academy. “One of my favorite events was a ‘data blitz’,” she recalls. “Each faculty member had five minutes to present a condensed description of his or her research to the group. It was a great way to get a broad view of the work being done in a variety of disciplines.”

To foster strong mentor-mentee relationships, a residency program must promote opportunities for residents to reach out as well as incentives for elder physicians to offer assistance.

Another common activity for all of the Academies is “mentor speed dating.” Resident pairs spend ten minutes at a time with various faculty in their Academy, learning about each other’s personalities as well as research interests and current projects.

After the end of the program’s first year, 71 percent of interns identified a mentor (compared with a benchmark of 54 percent the previous year); 33 percent directly attributed this to the Academy structure.

A win-win

The severity and complexity of hospital cases has been steadily increasing for decades, and both professional and administrative demands are at an all-time high. Senior level physicians may be reluctant to engage in mentoring for fear of another huge time commitment. To foster strong mentor-mentee relationships, a residency program must promote opportunities for residents to reach out as well as incentives for elder physicians to offer assistance.

Seemingly small measures such as recognizing mentors with awards, incorporating mentoring activities into yearly self-evaluations and reimbursing physicians for mentoring-related activities (such as treating residents to coffee) have proven effective at increasing senior-level engagement.

Winn points out that having a mentee can actually be beneficial to a senior doctor with a lot on his or her plate. Residents can and do help their mentors with ongoing research projects, she says. “Everyone is busy, but the entire idea of mentoring is that it is a bidirectional relationship.”

Nikolay Vasiliyev mentorship

Innovative strategies

Boston Children’s is not alone in recognizing the lasting impact of medical mentors.

At neighboring Brigham and Women’s Hospital, the Faculty Mentoring Leadership Program, or FMLP, teaches current mentors how to hone their skills and improve the effectiveness of their influence. The selective program, now in its seventh year, hosts a series of monthly lectures and discussions on topics such as Professionalism and Feedback, Mentoring Across Differences (gender, ethnicity, age) and Structuring the Mentoring Relationship: Expectations and Boundaries.

Stanford University School of Medicine launched their Scholarly Concentration requirement for pediatric residents in 2009. The program is similar in form to the BCRP Academies: interns choose one of six “concentrations,” each with its own curriculum, that they complete along with universal rotations on broader topics such as legislative advocacy and quality improvement. Residents are assigned a career advisor for twice yearly meetings and a coach for more frequent advice and feedback. In addition, they self-select a Scholarly Concentration leader and research mentor as they embark on their chosen tracks.

Balancing structure and freedom

Anyone who has ever been assigned an academic advisor at random knows this is not a great way to match students with mentors. Relationships develop organically, and providing opportunities for instructors and residents to meet and get to know one another is one of the foundational purposes of the Academies. As Winn explains, “Interns meet with their academy leader approximately twice per year and spend time brainstorming potential mentors for them to work with. Sometimes the Academy Leader actually becomes the mentor, but more often than not, he or she points the intern in the right direction. Interns can also meet mentors at Academy workshops or evening networking events.”

Carolyn Marcus, MD, another BCRP chief resident who was in the Medical Education Academy, says she gained an expanded professional network from the program. “Thanks to those meetings and conversations, I know who the experts are on a variety of topics,” she says. “I made connections and know who to reach out to if I have specific questions.”

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