Mentorship

As the head of a department you are bringing on several new members of staff. These young staff are asking for mentorship. While staff have been paired in the past, they almost never met and seldom did the mentee or mentor find the relationship effective. What are the expectations of a mentorship programme and how do you ensure that the program actively achieves its aims?

Mentorship is an important mechanism to foster a successful start to a clinical career or develop leadership. For the mentee, it offers practical training and guidance to support their ongoing professional development. It can help develop confidence by allowing the practice of new skills under the guidance of a more experienced clinician. It can also help by providing a framework for managing challenges encountered in the role effectively. However, there are also benefits to the mentorship arrangement for mentors themselves. The process offers opportunity to reflect on their own practice and can help enhance communication skills.

Mentorship comes in multiple forms, and can be both formal and informal. Mentorship should focus on all aspects of career development, including clinical care and (if appropriate), academic. Informal mentorship in many ways reflects the culture of the institution and ideally is characterized by open and supportive conversations about how to enhance performance. For example, clinical conversations or case presentations must focus on evidence and doing what is best for patients, with open and frank conversation considering the multiple ways complex problems may be managed. Rather than shame and blame, morbidity and mortality rounds should focus on system issues and solutions. Pre- and post-operative, or complex case, conferences need to discuss care plans with openness to different approaches. The key is for all these conversations to reflect the ideal mentor/mentee relationship – candid but respectful.

In addition to informal mentorship, as noted above, formal mentoring programs should also be developed for each sphere of professional activity, including clinical, academic, leadership and career advice. The intent of mentoring is to guide and maximize success. A formal program is more likely to lead to successful outcomes, but also provide a better experience for the mentor. Such a program should have formal explicit expectations of the mentor/mentee. Metrics for success should be agreed upon by the mentor and mentee. It is useful if both parties have orientation and training germane to their roles. In addition, scheduled meetings between mentor and mentee should be weekly or bi-weekly. Quality mentorship is central to effective clinical training, so it is important that the mentor/mentee relationship is not only fostered and prioritised, but that it is a good fit. Mechanisms for mentor change if the relationship isn’t working should be available.

For clinical mentoring, in addition to face-to-face meetings, the mentoring process should include complex case discussion between mentor and mentee, opportunities to shadow and observe (where the mentor periodically observes the mentee in clinical situations), on-call backup, and assistance with technical procedures or complex patients.

In addition to regular meetings between mentor and mentee, meeting between the mentee, their mentor and the mentee’s leader should occur at least every 6-12 months to review progress for the first 3-5 years. These meetings should discuss institutional support for the individual, activities and productivity of the mentee, and future plans. Progress should be measured against institutional expectations articulated in the initial appointment letter of offer (more information can be found in my post Hiring and Negotiating with New Staff by clicking here). While the early meetings among mentor, mentee and appropriate leader should be exclusively focused on ensuring institutional support and early success, subsequent meetings may need to shift the focus to institutional expectations for the individual in teachings, research and clinical care. These discussions should yield written documentation of successes, future expectations and any remedial steps, if needed. These meetings should be supportive and not seen as punitive. However, if despite sufficient remediation expectations are not met, the focus in subsequent years will need to shift to Accountability for performance and requires a different type of meeting (see Accountability for more details and also my post on Performance Management).

In summary, mentorship is crucial in developing successful clinical careers. It should encompass all spheres of activity, but to be successful, must be formalized and explicit.

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