- Email: [email protected]
Factors affecting fellowship satisfaction, thesis completion, and career direction among maternal-fetal medicine fellows
Factors affecting fellowship satisfaction, thesis completion, and career direction among maternalfetal medicine fellows Anthony C. Sciscione, DO, Garrett H. C. Colmorgen, MD, and Mary E. D’Alton, MD Objective: To determine fellowship satisfaction through a survey of maternal-fetal medicine fellows. Methods: We constructed a survey using multiple choice, Likert scale, ordinal, and categorical scale questions. The questions focused on faculty involvement, mentorship, research time and productivity, education, fellowship selection, ultimate goals of fellows, and satisfaction. We sent the survey in two mailings to all maternal-fetal medicine fellows during April and May 1996. Results: One hundred thirty-eight surveys were mailed, and 136 were returned (98.5% return rate). Twenty-seven percent of fellows did not believe they would complete their thesis by the end of their fellowship. No statistically significant relationship was noted between the fellows’ predicted thesis completion and the availability of funding, support for statistical analysis, the presence of animal research facilities, age, number of dependents, or year of fellowship. The presence of a mentor on the maternal-fetal medicine faculty increased the likelihood of thesis completion from 52.3% to 83.5% (P < .001). Similarly, the presence of a faculty advisor increased the likelihood of thesis completion from 58.9% to 83.5% (P 5 .001). Thirty-two percent of the respondents did not have a mentor on the faculty, and 41% did not have a faculty advisor. Forty percent indicated that they were too involved in clinical pursuits to perform research. This group was significantly more likely to believe that their theses would not be completed (63% versus 80%, P 5 .029). Overall, 22% of the fellows would not recommend their fellowships. Fellows with a mentor (88.2% versus 55.8%; P < .001) or faculty advisor (87.3% versus 64.9%; P 5 .002) were more likely than those without to recommend their fellowship. Conclusion: A mentor or faculty advisor plays a significant role in the training of maternal-fetal medicine fellows and is associated with a higher incidence of satisfaction with the fellowship program, thesis completion, and entrance into academic practice. (Obstet Gynecol 1998;91:1023– 6. From the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Medical Center of Delaware, Newark, Delaware, and the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, New England Medical Center, Boston, Massachusetts.
VOL. 91, NO. 6, JUNE 1998
© 1998 by The American College of Obstetricians and Gynecologists.)
In 1994, the Society of Perinatal Obstetricians held its first fellows’ retreat in San Antonio, TX. The society had feared that because of its rapid growth, fellows did not have the opportunity to meet and exchange ideas with senior members of the society who could act as mentors. The purpose of the meeting was to foster these relationships, as well as to encourage entrance into academic medicine. Mentorship is an important part of training in medicine. Most physicians agree that mentorship should take place at all levels of training, but its importance has been underplayed in the medical literature. In an effort to ascertain the role of mentorship in maternal-fetal medicine fellowships, we performed an anonymous survey. This method was chosen because evaluations that lack anonymity may not result in a true reflection of fellow satisfaction, nor may they reveal the practical structure of the program. We believed an anonymous survey was the only means of accurately assessing fellows’ overall satisfaction with their program. In addition, we took this opportunity to determine the division of time between clinical and research activity and to identify specific problems perceived by those in training.
Methods We developed a survey that used multiple choice, Likert scale, ordinal, and categorical scale questions. The survey was administered to ten residents in an obstetrics and gynecology training program to identify confusing and unclear questions. After the questions were reviewed with each resident and reworded or eliminated as necessary, the survey was administered during the second maternal-fetal medicine fellows’ retreat in February 1996. Unfortunately, not all fellowship programs were represented at the retreat, and the response rate from those fellows who attended was low (52%). Because of the poor response, the results of the survey were disregarded, and the same survey was mailed to all maternal-fetal medicine fellows registered with the Society of Perinatal Obstetricians. We requested a response from all fellows, regardless of whether they had responded to the survey at the time of the retreat. In conjunction with the survey, we sent a letter to each of the program directors requesting that they encourage their fellows to respond to the survey. Envelopes containing returned questionnaires were opened and discarded by someone unrelated to this study so that postmarks were unknown and anonymity
0029-7844/98/$19.00 PII S0029-7844(98)00076-3
1023
was preserved. The response rate was 69% (95 of 138). A second mailing was sent immediately after the end of the first response period, and only those fellows who had not completed the previous survey were asked to return this survey. This improved the overall response rate to 98.5%. The results of the survey were analyzed using a x2 test of independence, the Wilcoxon rank sum test, and Goodman’s gamma.
Results One hundred thirty-six of the 138 fellows who were mailed a survey ultimately responded, yielding a 98.5% return rate. Thirty-nine percent were first-year fellows, 60% were second-year fellows, and 1% were third-year fellows. The majority of fellows (63%) were 31–35 years old. Fifteen percent were 36 –39 years old. Five percent were 40 years old or older. Fifty-one percent of the fellows were men, and 49% were women. Most fellows were married (63%) and did not have dependents (54%). Neither year of fellowship, age group, gender, or marital status were associated significantly with predicted thesis completion. Most fellows planned to enter academic practice (72%), but none planned a career devoted only to research. Those fellows who planned to enter academic practice were significantly more likely to predict thesis completion (79.2% versus 59.5%, P 5 .021). The majority (83%) said they were prepared to enter academic practice. Fellows estimated that a median (range) of 30% (0 – 80%) of their time was devoted to research. Thirtyfour percent reported they had inadequate research time, and 40% reported that clinical responsibilities hampered their attempts to develop a research project. Respondents in the latter group were significantly less likely than others to believe their theses would be completed by the end of their fellowships (63% versus 80%, P 5 .029). Nonetheless, 74% stated they were undertaking a research project. Only 20% of fellows believed they had adequate training in securing research grants. This group was significantly more likely to believe their theses would be completed during their fellowships (88.9% versus 69.4%, P 5 .041). Sixty-seven percent of fellows reported adequate funding for their research. Eighty-six percent reported having adequate statistical support, and 69% reported access to animal research facilities. The availability of money, statistical assistance, or animal experimentation facilities were not significant predictors of thesis completion. Seventy-one percent of fellows had the opportunity to attend the annual meeting of the Society of Perinatal Obstetricians in 1996, whereas 12% did not have the
1024 Sciscione et al
Factors Affecting Fellowship
opportunity to attend a continuing medical education course in the last year. Thirty percent had not given a presentation of their research outside their institution, but 93% had the opportunity to present at national meetings. The frequency with which fellows presented their research was correlated positively with the belief that their theses would be completed during their fellowships (P 5 .004). Fellows reported that they spent a median (range) of 10% (0 –100%) of their time in educational pursuits with faculty. As contact with their faculty increased, so did the fellows’ perception that their theses would be completed (P 5 .036). Seventy-one percent believed that having an opportunity to evaluate their faculty would have a positive impact on their training. Forty-one percent of fellows reported not having a faculty advisor, and 32% reported not having a mentor. Of the fellows who were able to cite a mentor, only 3% ranked that mentorship as weak. The presence of a mentor on the maternal-fetal medicine faculty increased the likelihood of thesis completion significantly from 52.3% to 83.5% (P , .001). Similarly, the presence of a faculty advisor increased the likelihood of predicted thesis completion from 58.9% to 83.5% (P 5 .001). Furthermore, a fellow’s desire to enter academic practice was associated significantly with the presence of a faculty advisor (37.5% versus 21.3%, P 5 .038) or mentor (41.8% versus 21.5%, P 5 .014). Fellows who presented their research outside the training institution were significantly more likely to predict thesis completion (81.9% versus 53.7%, P 5 .001). Twenty-two percent of the fellows surveyed would not recommend their fellowships to others. Those fellows who were satisfied with their fellowship were significantly more likely to have a mentor (88.2% versus 55.8%, P , .001) and a faculty advisor (87.3% versus 64.9%, P 5 .002). Those fellows who did not believe their theses would be completed during their fellowships were significantly less likely to recommend their fellowships (85.9% versus 55.9%, P , .001). Age, gender, year in fellowship, number of dependents, or marital status did not affect the recommendation of a fellowship or change the perception of fellows with regard to the likelihood of completing their theses. Fellows were asked to rank the three most important reasons for selecting their fellowships. By far, location was their most important reason (Figure 1), with 26% of fellows ranking location as the most important reason for selecting their fellowships, and 62% ranking it as an important reason for fellowship selection (Figure 2). Fellows who chose their fellowship primarily on the basis of location were no more likely to be dissatisfied with their program or predict thesis completion. Other factors were, in decreasing order of importance, re-
Obstetrics & Gynecology
search opportunities, faculty quality, and academic reputation. Again, none of these affected program satisfaction or thesis completion.
Discussion Mentorship has been correlated with academic success,1 increased research production, and publication.2– 4 A mentor offers students a role model after which they can pattern their approach to their profession. Our colleagues in the nursing profession have written extensively about the role of mentors in their educational process5 and their profession.6 Although most physicians acknowledge its importance,7,8 the role of mentors has not been studied adequately in the medical profession. The results of this survey underscore the importance of mentorship in maternal-fetal medicine training programs. The strong association of mentoring with fellows’ satisfaction with their training programs, with fellows’ prediction of thesis completion, and with their desire to enter academic practice speaks to the significance of this component of their education. Because mentorship was not always being provided, we hoped a more formal relationship with one of the faculty may be occuring. We found that many programs did not provide a formal faculty advisor for their fellows. The significant positive correlation with the presence of a faculty advisor and fellows’ satisfaction with their program and thesis completion is compelling evidence that each fellow should have a faculty advisor. Interestingly, of those fellows who did not have a mentor or faculty advisor, almost 90% reported that a faculty member in their program could provide that function. Exposure to faculty in general is important. On average, fellows reported only 21% of their time, on average, in contact with faculty, with increasing exposure related to an increased likelihood of thesis comple-
Figure 1. Most important reason for selecting fellowship (location, research opportunities, faculty quality, academic reputation [rep.] and patient diversity).
VOL. 91, NO. 6, JUNE 1998
Figure 2. Percentage of fellows who ranked item as one of the top three reasons for selecting fellowship (location, faculty quality, academic reputation [Rep.], research opportunities, patient diversity, patient volume, and interview quality).
tion. Finally, 71% of fellows believed that a system that allowed for the evaluation of the faculty would result in an improvement in their fellowship program. The American Board of Obstetrics and Gynecology requires each fellow to complete a thesis to meet the requirement for board certification in maternal-fetal medicine. This requirement implies that fellows should be taught the principles of research and be provided adequate time and supervision to complete an appropriate thesis successfully. On average, the fellows surveyed reported that one third of the time during their fellowships was spent in research, but the time varied greatly from fellowship to fellowship. A full one third of fellows reported inadequate time to complete a meaningful research project. In all likelihood, this is not due to the fact that the fellowships do not plan adequate research time, but rather to the fact that other responsibilities interfered with the research time allocated. As fellowships expand from 2 to 3 years, there is now an American Board of Obstetrics and Gynecology requirement for 18 months of protected research time. Also, the board requires a potential thesis title and mentor. This survey should serve as a baseline against which the success of the changes implemented by the board can be compared. In these times of changing health care reimbursement, we expect that adequate funding for research might not be available. We were surprised to find that most fellows reported that they did have funding for their research. Even more encouraging was that most fellows reported adequate statistical assistance and animal experimentation facilities. However, few fellows received training in the securing of grants and other funding for research. Those who did receive such training were more likely to expect to complete their theses during their fellowships. We believe that this indicates that training in obtaining support for research
Sciscione et al
Factors Affecting Fellowship
1025
endeavors must be included in the curriculum of fellowship programs. We were not surprised to find a statistically significant relationship between the number of presentations made by fellows and their predictions that their theses would be completed during their fellowships. The expectation that research will be presented to those outside the training department is a strong impetus for performing and completing research. A fellow in this position must evaluate and organize data in such a manner that they can be easily understood by an audience that is not familiar with the work. Feedback from an outside audience also can provide valuable insights to the fellow. Having completed this process, it is not difficult to take the next step and prepare the manuscript for submission for publication. Thirty percent of first- and second-year fellows reported they had not given a presentation outside their institution. Again, the presence of a mentor seemed to play a significant role because the presence of a mentor was correlated positively with the number of presentations reported by the fellows. With one in five fellows not willing to recommend their fellowship, it is time to reevaluate the manner in which we train our fellows. We found that fellows were significantly more satisfied with their fellowship if they had a mentor or faculty advisor on the maternal-fetal medicine faculty. The current climate of academic medicine has made it more difficult to fulfill the obligations of mentorship. The increasing demands for economic, as well as academic, production place significant restraints on the time faculty members have available for mentoring. Department chairpersons and division chiefs will need to recognize the importance of mentorship and create time for their faculty to be mentors. Although forcing faculty to be mentors is impossible, assigning a capable person to be a faculty advisor should be feasible. The important question raised by this study is not who should be a mentor, but how can I become a mentor? Clearly the answer is different for
1026 Sciscione et al
Factors Affecting Fellowship
each mentor and student. The logical place to begin the relationship is with the desire to be a mentor or to be mentored. The successful relationship requires a committed effort from the student and mentor. This relationship should be pursued by all who train.
References 1. Applegate WB. Career development in academic medicine. Am J Med 1990;88:263–7. 2. Dudley DJ. Optimism for perilous times: A survey of American Association of Obstetricians and Gynecologists Foundation and Reproductive Scientist Development Program postdoctoral research fellows. Am J Obstet Gynecol 1997;176:814 – 8. 3. Rogers JC, Holloway RL, Miller SM. Academic mentoring and family medicine’s research productivity. Fam Med 1990;22:186 –90. 4. Mills OF, Zyzanksi SJ, Flocke S. Factors associated with research productivity in family practice residencies. Fam Med 1995;27:188 – 93. 5. Crim BJ, Hood AW. Learning partners: Preceptor, mentor, facilitator, learner. Semin Perioper Nurs 1995;4:67–72. 6. Lanio-Curran D. Choosing your mentor. Nursing 1995;25:78 –9. 7. Addison WA. Paying debts that cannot be repaid. Am J Obstet Gynecol 1995;173:1661–3. 8. Gerbie MV. A knee in the back and a little balsam of Peru. Am J Obstet Gynecol 1996;174:1815–9.
Address reprint requests to:
Anthony C. Sciscione, DO Division of Maternal-Fetal Medicine Department of Obstetrics and Gynecology Christiana Care Health Services 4755 Stanton-Ogletown Road Newark, DE 19713 E-mail: [email protected]
Received November 4, 1997. Received in revised form January 29, 1998. Accepted February 5, 1998. Copyright © 1998 by The American College of Obstetricians and Gynecologists. Published by Elsevier Science Inc.
Obstetrics & Gynecology
VOL. 91, NO. 6, JUNE 1998
© 1998 by The American College of Obstetricians and Gynecologists.)
In 1994, the Society of Perinatal Obstetricians held its first fellows’ retreat in San Antonio, TX. The society had feared that because of its rapid growth, fellows did not have the opportunity to meet and exchange ideas with senior members of the society who could act as mentors. The purpose of the meeting was to foster these relationships, as well as to encourage entrance into academic medicine. Mentorship is an important part of training in medicine. Most physicians agree that mentorship should take place at all levels of training, but its importance has been underplayed in the medical literature. In an effort to ascertain the role of mentorship in maternal-fetal medicine fellowships, we performed an anonymous survey. This method was chosen because evaluations that lack anonymity may not result in a true reflection of fellow satisfaction, nor may they reveal the practical structure of the program. We believed an anonymous survey was the only means of accurately assessing fellows’ overall satisfaction with their program. In addition, we took this opportunity to determine the division of time between clinical and research activity and to identify specific problems perceived by those in training.
Methods We developed a survey that used multiple choice, Likert scale, ordinal, and categorical scale questions. The survey was administered to ten residents in an obstetrics and gynecology training program to identify confusing and unclear questions. After the questions were reviewed with each resident and reworded or eliminated as necessary, the survey was administered during the second maternal-fetal medicine fellows’ retreat in February 1996. Unfortunately, not all fellowship programs were represented at the retreat, and the response rate from those fellows who attended was low (52%). Because of the poor response, the results of the survey were disregarded, and the same survey was mailed to all maternal-fetal medicine fellows registered with the Society of Perinatal Obstetricians. We requested a response from all fellows, regardless of whether they had responded to the survey at the time of the retreat. In conjunction with the survey, we sent a letter to each of the program directors requesting that they encourage their fellows to respond to the survey. Envelopes containing returned questionnaires were opened and discarded by someone unrelated to this study so that postmarks were unknown and anonymity
0029-7844/98/$19.00 PII S0029-7844(98)00076-3
1023
was preserved. The response rate was 69% (95 of 138). A second mailing was sent immediately after the end of the first response period, and only those fellows who had not completed the previous survey were asked to return this survey. This improved the overall response rate to 98.5%. The results of the survey were analyzed using a x2 test of independence, the Wilcoxon rank sum test, and Goodman’s gamma.
Results One hundred thirty-six of the 138 fellows who were mailed a survey ultimately responded, yielding a 98.5% return rate. Thirty-nine percent were first-year fellows, 60% were second-year fellows, and 1% were third-year fellows. The majority of fellows (63%) were 31–35 years old. Fifteen percent were 36 –39 years old. Five percent were 40 years old or older. Fifty-one percent of the fellows were men, and 49% were women. Most fellows were married (63%) and did not have dependents (54%). Neither year of fellowship, age group, gender, or marital status were associated significantly with predicted thesis completion. Most fellows planned to enter academic practice (72%), but none planned a career devoted only to research. Those fellows who planned to enter academic practice were significantly more likely to predict thesis completion (79.2% versus 59.5%, P 5 .021). The majority (83%) said they were prepared to enter academic practice. Fellows estimated that a median (range) of 30% (0 – 80%) of their time was devoted to research. Thirtyfour percent reported they had inadequate research time, and 40% reported that clinical responsibilities hampered their attempts to develop a research project. Respondents in the latter group were significantly less likely than others to believe their theses would be completed by the end of their fellowships (63% versus 80%, P 5 .029). Nonetheless, 74% stated they were undertaking a research project. Only 20% of fellows believed they had adequate training in securing research grants. This group was significantly more likely to believe their theses would be completed during their fellowships (88.9% versus 69.4%, P 5 .041). Sixty-seven percent of fellows reported adequate funding for their research. Eighty-six percent reported having adequate statistical support, and 69% reported access to animal research facilities. The availability of money, statistical assistance, or animal experimentation facilities were not significant predictors of thesis completion. Seventy-one percent of fellows had the opportunity to attend the annual meeting of the Society of Perinatal Obstetricians in 1996, whereas 12% did not have the
1024 Sciscione et al
Factors Affecting Fellowship
opportunity to attend a continuing medical education course in the last year. Thirty percent had not given a presentation of their research outside their institution, but 93% had the opportunity to present at national meetings. The frequency with which fellows presented their research was correlated positively with the belief that their theses would be completed during their fellowships (P 5 .004). Fellows reported that they spent a median (range) of 10% (0 –100%) of their time in educational pursuits with faculty. As contact with their faculty increased, so did the fellows’ perception that their theses would be completed (P 5 .036). Seventy-one percent believed that having an opportunity to evaluate their faculty would have a positive impact on their training. Forty-one percent of fellows reported not having a faculty advisor, and 32% reported not having a mentor. Of the fellows who were able to cite a mentor, only 3% ranked that mentorship as weak. The presence of a mentor on the maternal-fetal medicine faculty increased the likelihood of thesis completion significantly from 52.3% to 83.5% (P , .001). Similarly, the presence of a faculty advisor increased the likelihood of predicted thesis completion from 58.9% to 83.5% (P 5 .001). Furthermore, a fellow’s desire to enter academic practice was associated significantly with the presence of a faculty advisor (37.5% versus 21.3%, P 5 .038) or mentor (41.8% versus 21.5%, P 5 .014). Fellows who presented their research outside the training institution were significantly more likely to predict thesis completion (81.9% versus 53.7%, P 5 .001). Twenty-two percent of the fellows surveyed would not recommend their fellowships to others. Those fellows who were satisfied with their fellowship were significantly more likely to have a mentor (88.2% versus 55.8%, P , .001) and a faculty advisor (87.3% versus 64.9%, P 5 .002). Those fellows who did not believe their theses would be completed during their fellowships were significantly less likely to recommend their fellowships (85.9% versus 55.9%, P , .001). Age, gender, year in fellowship, number of dependents, or marital status did not affect the recommendation of a fellowship or change the perception of fellows with regard to the likelihood of completing their theses. Fellows were asked to rank the three most important reasons for selecting their fellowships. By far, location was their most important reason (Figure 1), with 26% of fellows ranking location as the most important reason for selecting their fellowships, and 62% ranking it as an important reason for fellowship selection (Figure 2). Fellows who chose their fellowship primarily on the basis of location were no more likely to be dissatisfied with their program or predict thesis completion. Other factors were, in decreasing order of importance, re-
Obstetrics & Gynecology
search opportunities, faculty quality, and academic reputation. Again, none of these affected program satisfaction or thesis completion.
Discussion Mentorship has been correlated with academic success,1 increased research production, and publication.2– 4 A mentor offers students a role model after which they can pattern their approach to their profession. Our colleagues in the nursing profession have written extensively about the role of mentors in their educational process5 and their profession.6 Although most physicians acknowledge its importance,7,8 the role of mentors has not been studied adequately in the medical profession. The results of this survey underscore the importance of mentorship in maternal-fetal medicine training programs. The strong association of mentoring with fellows’ satisfaction with their training programs, with fellows’ prediction of thesis completion, and with their desire to enter academic practice speaks to the significance of this component of their education. Because mentorship was not always being provided, we hoped a more formal relationship with one of the faculty may be occuring. We found that many programs did not provide a formal faculty advisor for their fellows. The significant positive correlation with the presence of a faculty advisor and fellows’ satisfaction with their program and thesis completion is compelling evidence that each fellow should have a faculty advisor. Interestingly, of those fellows who did not have a mentor or faculty advisor, almost 90% reported that a faculty member in their program could provide that function. Exposure to faculty in general is important. On average, fellows reported only 21% of their time, on average, in contact with faculty, with increasing exposure related to an increased likelihood of thesis comple-
Figure 1. Most important reason for selecting fellowship (location, research opportunities, faculty quality, academic reputation [rep.] and patient diversity).
VOL. 91, NO. 6, JUNE 1998
Figure 2. Percentage of fellows who ranked item as one of the top three reasons for selecting fellowship (location, faculty quality, academic reputation [Rep.], research opportunities, patient diversity, patient volume, and interview quality).
tion. Finally, 71% of fellows believed that a system that allowed for the evaluation of the faculty would result in an improvement in their fellowship program. The American Board of Obstetrics and Gynecology requires each fellow to complete a thesis to meet the requirement for board certification in maternal-fetal medicine. This requirement implies that fellows should be taught the principles of research and be provided adequate time and supervision to complete an appropriate thesis successfully. On average, the fellows surveyed reported that one third of the time during their fellowships was spent in research, but the time varied greatly from fellowship to fellowship. A full one third of fellows reported inadequate time to complete a meaningful research project. In all likelihood, this is not due to the fact that the fellowships do not plan adequate research time, but rather to the fact that other responsibilities interfered with the research time allocated. As fellowships expand from 2 to 3 years, there is now an American Board of Obstetrics and Gynecology requirement for 18 months of protected research time. Also, the board requires a potential thesis title and mentor. This survey should serve as a baseline against which the success of the changes implemented by the board can be compared. In these times of changing health care reimbursement, we expect that adequate funding for research might not be available. We were surprised to find that most fellows reported that they did have funding for their research. Even more encouraging was that most fellows reported adequate statistical assistance and animal experimentation facilities. However, few fellows received training in the securing of grants and other funding for research. Those who did receive such training were more likely to expect to complete their theses during their fellowships. We believe that this indicates that training in obtaining support for research
Sciscione et al
Factors Affecting Fellowship
1025
endeavors must be included in the curriculum of fellowship programs. We were not surprised to find a statistically significant relationship between the number of presentations made by fellows and their predictions that their theses would be completed during their fellowships. The expectation that research will be presented to those outside the training department is a strong impetus for performing and completing research. A fellow in this position must evaluate and organize data in such a manner that they can be easily understood by an audience that is not familiar with the work. Feedback from an outside audience also can provide valuable insights to the fellow. Having completed this process, it is not difficult to take the next step and prepare the manuscript for submission for publication. Thirty percent of first- and second-year fellows reported they had not given a presentation outside their institution. Again, the presence of a mentor seemed to play a significant role because the presence of a mentor was correlated positively with the number of presentations reported by the fellows. With one in five fellows not willing to recommend their fellowship, it is time to reevaluate the manner in which we train our fellows. We found that fellows were significantly more satisfied with their fellowship if they had a mentor or faculty advisor on the maternal-fetal medicine faculty. The current climate of academic medicine has made it more difficult to fulfill the obligations of mentorship. The increasing demands for economic, as well as academic, production place significant restraints on the time faculty members have available for mentoring. Department chairpersons and division chiefs will need to recognize the importance of mentorship and create time for their faculty to be mentors. Although forcing faculty to be mentors is impossible, assigning a capable person to be a faculty advisor should be feasible. The important question raised by this study is not who should be a mentor, but how can I become a mentor? Clearly the answer is different for
1026 Sciscione et al
Factors Affecting Fellowship
each mentor and student. The logical place to begin the relationship is with the desire to be a mentor or to be mentored. The successful relationship requires a committed effort from the student and mentor. This relationship should be pursued by all who train.
References 1. Applegate WB. Career development in academic medicine. Am J Med 1990;88:263–7. 2. Dudley DJ. Optimism for perilous times: A survey of American Association of Obstetricians and Gynecologists Foundation and Reproductive Scientist Development Program postdoctoral research fellows. Am J Obstet Gynecol 1997;176:814 – 8. 3. Rogers JC, Holloway RL, Miller SM. Academic mentoring and family medicine’s research productivity. Fam Med 1990;22:186 –90. 4. Mills OF, Zyzanksi SJ, Flocke S. Factors associated with research productivity in family practice residencies. Fam Med 1995;27:188 – 93. 5. Crim BJ, Hood AW. Learning partners: Preceptor, mentor, facilitator, learner. Semin Perioper Nurs 1995;4:67–72. 6. Lanio-Curran D. Choosing your mentor. Nursing 1995;25:78 –9. 7. Addison WA. Paying debts that cannot be repaid. Am J Obstet Gynecol 1995;173:1661–3. 8. Gerbie MV. A knee in the back and a little balsam of Peru. Am J Obstet Gynecol 1996;174:1815–9.
Address reprint requests to:
Anthony C. Sciscione, DO Division of Maternal-Fetal Medicine Department of Obstetrics and Gynecology Christiana Care Health Services 4755 Stanton-Ogletown Road Newark, DE 19713 E-mail: [email protected]
Received November 4, 1997. Received in revised form January 29, 1998. Accepted February 5, 1998. Copyright © 1998 by The American College of Obstetricians and Gynecologists. Published by Elsevier Science Inc.
Obstetrics & Gynecology