Professional Development
Mentoring and Role Modelling in General Internal Medicine
Jean Gray, MD
About the Author
Jean Gray is professor emeritus at Dalhousie University (Medical Education, Medicine, Pharmacology) and currently serves as chair of the Nova Scotia Health Research Foundation and a member of the Human Drug Advisory Panel of the Patented Medicines Prices Review Board. She was educated at Alberta, Toronto, Stanford, and Dalhousie Universities but has spent her entire professional career surrounded by the warmth and kindness of colleagues in Atlantic Canada, where she was the founding head of the Division of General Internal Medicine.
Mentors are guides. They lead us along the journey of our lives. We trust them because they have been there before. They embody our hopes, cast light on the way ahead, interpret arcane signs, warn us of lurking dangers and point out unexpected delights along the way.
– L. A. Doloz, Effective Teaching and Mentoring: Realizing the Transformational Power of Adult Learning Experiences
In Greek mythology, Mentor was chosen by Odysseus to act as guardian and teacher for his son, Telemachus. His name lives on in describing the role of teacher, sponsor, guide, exemplar, and counsellor.
The business world recognized decades ago that mentorship plays a major role in fostering young individuals’ career development and satisfaction. A recent systematic review of mentoring in medicine1 suggested that fewer than 50% of medical students and, in some fields, fewer than 20% of faculty had a mentor. Additionally, there was also a perception that women had more difficulty finding mentors than their male colleagues did. This same review, however, provided evidence that mentorship can have an effect on personal development, career choice and satisfaction, and (in academia) research productivity. Thus, it is timely to think about mentoring in general internal medicine, both in the academic environment and in community practice.
Mentoring is different from role modelling. Mentoring is an active process, defined as “a dynamic, reciprocal relationship in a work environment between an advanced career incumbent (mentor) and a beginner (protégé), aimed at promoting the development of both.”2 Role modelling, on the other hand, is passive. Role models “teach by example and influence professional identity in multiple ways,” but the process is “less intentional and often unaware, more informal, and more episodic than mentoring.”3 Mentoring often includes role modelling.
To illustrate the role of mentoring in career development, this article focuses on four short case studies, drawn from my personal experience. Each illustrates the influence of a mentor at a critical phase of career choice, development, and enhancement. Although the actual relationships were brief in time, the impact of each was lifelong and the individuals who served as mentors remain trusted advisors, friends, and guides. Please use these examples to think back on your own mentoring relationships in which you may have served as a mentor or a protégé (the recipient of mentoring).
Case 1
At the end of first year medical school, I sought a summer job to provide much-needed financial support. After a series of dead ends, I was directed to the laboratory of a new faculty member in the Pharmacology Department. Dr. GM was a recent immigrant to Canada with a PhD in chemistry, followed by postdoctoral experience in a noted laboratory. His knowledge of pharmacology was almost as slight as mine, but he was determined to establish a research and teaching career in the discipline, and his enthusiasm was infectious! Through example (role modelling) and through active encouragement, he provided me with a passion for lifelong learning and a strong incentive to consider a career in pharmacology by marrying my clinical skills with my laboratory work. With his help, I continued to advance my clinical and research skills, both in his laboratory and subsequently in others.
This vignette illustrates the major role that mentors (regardless of their gender) can play in helping students to consider possible career options. Through discussion with Dr. GM, I was able to determine my strengths and weaknesses, my interests, and even my passions. He helped me through listening and feedback, through example and support. Surprisingly, given that he was just at the beginning of his own career, he recognized that he needed to play this role with all students who subsequently worked in his laboratory, and their success is a part of the legacy of his own success.
Case 2
After a period spent practising general internal medicine, I was invited to join the Department of Pharmacology at a Canadian university. A new head joined the department a short time later. Dr. PD was a large individual, both in stature and in personality, and he took a strong personal interest in each of the younger faculty. His attentions were sometimes forceful, his advice sometimes harsh – features that didn’t endear him to all those who were the focus of his help. But he was determined to identify and foster the best in each of us, assisting us with everything from developing our teaching skills to enhancing our grantsmanship. Probably most important of all, he was able to recognize skills and strengths that we didn’t know we possessed and push us to develop these further. And he was always there with a safety net should we stumble and fall. His encouragement enabled us to overcome the uncertainty faced by all new faculty members.
Dr. PD was, in some respects, not the ideal mentor. He was outspoken, critical, and bigger than life. But he was also concerned and determined that each of his faculty achieved their full potential. His ability to recognize abilities that we didn’t know we possessed and provide support (both tangible and intangible) for their development was critical to our career development. He recognized the need to foster clinical investigation long before that concept became popular and took steps to create bridges between his department and clinical departments.
Case 3
The chair of the Department of Medicine at the same time was Dr. RA, a wise and capable administrator. Dr. RA appreciated that a young woman attempting to combine a family with clinical and research careers would need extra support, and he provided it willingly. He approached every decision he took, whether clinical or administrative, with care and consideration, examining all possible options before selecting the appropriate one. He recognized the need to assist junior faculty to learn the impact of committee work, how to balance our time (and our lives), and the importance of treating everyone, regardless of position, with respect and encouragement. Through his tutelage, we learned how to delegate, how to get organized, how to maximize the potential of all those with whom we worked, and when to say “no,” all skills that were transferable to any arena in which we practised.
The skills that Dr. RA taught us, both by example and by tutelage, are some that can be formally taught (but rarely are) and need to be practised in an environment where there will be constructive feedback and correction – precisely the kind of environment provided by Dr. RA. His kind and careful listening when the load seemed altogether too heavy or the decision incorrect proved invaluable in sorting out whatever the crisis was and moving forward again along a new path.
Case 4
New knowledge and skills became necessary, and Dr. RA provided encouragement. A year at a major American university, working under the direction of Dr. TB, enhanced my knowledge and skill base but, most importantly, markedly expanded my network of contacts. Dr. TB went out of his way to introduce me to all the major players in our discipline and included me on major committees in the United States.
One of the important roles that a mentor can play is to provide networking opportunities for his or her trainees. Although Dr. TB is actually slightly younger than I am, he has a massive network of clinical and scientific contacts and he made sure that his network was my network by the end of that year. He invited me to social events with all visiting speakers, took me to meetings where he introduced me to colleagues at other American universities, allowed me to use his name when approaching others for scientific or clinical advice, and strongly encouraged presentations at meetings that would draw attention to the work being done in a Canadian university, virtually unknown to most Americans.
Discussion
These vignettes illustrate that no one mentor can provide all the guidance required by a young individual commencing his or her career. Over time, different mentors fulfill different needs. Some of the traits of a good mentor,4 as evidenced in these vignettes, include the following:
• Accessibility – an open door and an approachable attitude
• Empathy – personal insight into what the trainee is experiencing
• Open-mindedness – respect for each trainee’s individuality, and for working styles and career goals different from his or her own
• Consistency – acting on stated principles on a regular basis
• Patience – awareness that people make mistakes and that each person matures at his or her own rate
• Honesty – the ability to communicate the hard truths about the world “out there” and about the protégé’s chances of success
• Savvy – attention to the pragmatic aspects of career development
And these traits are accompanied by the following roles of the mentor4:
• Make everything a learning opportunity.
• Set specific goals and measures of accomplishment.
• Encourage strategic thinking and creativity.
• Uphold professional standards – that is, be a “good” role model.
• Impart skills.
• Provide networking opportunities.
• Give moral support.
• Make sure you get the mentoring you need even later in your career.
If you are seeking a mentor, here are some tips on being mentored well4:
• Foresight – Start thinking about your future at an early stage.
• Proactivity – Don’t expect to be taken care of. You could easily be overlooked.
• Probing – Ask tough questions. Find out about the experience of others with this potential mentor.
• Respect – Be polite. Make and keep appointments. Stay focused. Don’t overstay your welcome.
• Gratitude – Everyone likes to be thanked.
• Reciprocation – Repay your mentor indirectly by helping others.
• Humility – Be willing to accept critical feedback so that you are open to learning new ways of thinking about and practising medicine.
Not all of us will necessarily serve as mentors or protégés, but all of us will serve as role models. There is less literature about this important aspect of the formation of a physician, but a recommended article3 highlights some of the aspects of role modelling including the process of “moral enculturation,” that is, the taking of values, attitudes, character, and identity of the chosen profession as one’s own. Roles models are central to this process of enculturation because professional behaviour is learned in the experience of practice and is at the heart of professional character formation. Give thought to whether you are serving as a “good” role model or a “bad” role model for the next generation of medical students, residents, and practitioners in general internal medicine because if you are a good role model, you will attract others to the specialty. The future of general internal medicine depends on the availability of a plethora of good role models.
References
1. Sambunjak D, Straus SE, Marusic A. Mentoring in academic medicine: a systematic review. JAMA 2006;296:1103–15.
2. Healy CC, Welchert AJ. Mentoring relations: a definition to advance research and education. Educ Res 1990;19:17–21.
3. Kenny NP, Mann KV, MacLeod H. Role modeling in physicians’ professional formation: reconsidering an essential but untapped educational strategy. Acad Med 2003;78:1203–10.
4. Burroughs Wellcome Fund – Howard Hughes Medical Institute. Mentoring and being mentored. In: Making the Right Moves: A Practical Guide to Scientific Management for Postdocs and New Faculty, 2nd edition; http://www.hhmi.org/labmanagement. Accessed June 2, 2008.
Article Citation: Gray J, Mentoring and Role Modelling in General Internal Medicine. Can J Gen Intern Med 2008;3(4):170-172 |
