- Email: [email protected]
Mentorship in academic medicine: a critical component for all faculty and academic advancement
ORIGINAL REPORTS
Mentorship in Academic Medicine: A Critical Component for All Faculty and Academic Advancement Rosemary B. Duda, MD Center for Faculty Development, Carl J. Shapiro Institute for Education and Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts INTRODUCTION Mentorship for faculty in academic medicine is a partnership whereby a senior faculty member provides support and guidance on a professional or personal level to a more junior individual. This partnership can be intense and of variable duration, frequently existing until the junior person achieves the established goals. It can, however, be a long-term relationship that continues throughout the career of the junior faculty member. KEY WORDS: academic medicine, leadership, mentorship
State of Affairs Dr. Chris Holbrook has just joined the academic faculty a few months ago after completing a residency in general surgery and a residency in thoracic surgery. Dr. Holbrook is new to the institution and the metropolitan area in general. He is also a single surgeon from a minority background with no family and few friends in the area. His career goals are to build a busy academic practice, to teach medical students and residents, and to perform both laboratory and clinical research. He hopes to become a division chief within the next 6 years and ultimately a department chair. He is a brilliant clinician and scholar, with extensive research training. He is industrious and willing to make the commitment to achieve his goals. His goals are realistic relative to his talents. He has found that he is feeling rudderless in this academic environment and wants to know how he can make the correct contacts to fulfill his dreams. He is also feeling out of touch with the outside world.
Response It is not uncommon for young or new faculty to become or at least feel lost in a new environment or system. The best training Correspondence: Inquiries to Rosemary B. Duda, MD, Center for Faculty Development, Carl J. Shapiro Institute for Education and Research, Beth Israel Deaconess Medical Center, RW817/Surgical Oncology, 330 Brookline Avenue, Boston, MA 02215; fax: (617) 667-2978; e-mail: [email protected]
in the world cannot take the place of a good mentor. Many department chairs or division chiefs pride themselves in this role. When there are significant time constraints on the chief or chair, they may not be able to serve in this capacity for all members of the division or department. Dr. Holbrook would benefit by having a senior member of the department, and in his research field meet with him routinely to assess his progress and review his performance. He would benefit by having someone help steer him along his academic course, providing important information and direction to help him achieve his goals as well as balance in his life. He may also benefit from a mentor of a similar ethnic background to help him with both the academic and social issues that are specific to his situation. He may also benefit by having a mentor outside the institution to be certain that he is recognized for his accomplishments and help establish relationships with others that are critical to any advancement. One mentor alone may not be sufficient to meet all of the career and academic needs of faculty. Most faculty, like Dr. Holbrook, may benefit from different mentors with different skills and backgrounds. The mentor serves as a teacher, role model, coach, sponsor, exemplar, or confidant to the prote´ge´ or mentee on a one-onone relationship.1 The mentor assumes an active role and facilitates the career development of the mentee by providing an understanding of the culture of the institution and academic profession in general.2 Both parties benefit from the partnership as well as the academic institution. Mentoring can invigorate the senior faculty and foster their own growth and development. The mentee gains an understanding of the distinct structural features of the institution, role relations, the informal system dynamics, complexities, and stresses. An understanding of the institutional culture can provide overall stability for the mentee’s career, can improve performance, and can promote the progression of their academic career. Formal and informal mentoring advances the concept of individual and institutional empowerment by supporting the growth and development of junior faculty.2 Mentoring pro-
CURRENT SURGERY • © 2004 by the Association of Program Directors in Surgery Published by Elsevier Inc.
0149-7944/04/$30.00 doi:10.1016/j.cursur.2003.12.004
325
motes faculty productivity, advocates collegiality, and provides access to informal and formal networks of communication, which facilitates productivity. Mentoring relationships have been shown to be important in obtaining funding for research and recognition for work-related achievements; ultimately, the lack of mentors may halt the advancement of individuals and prevent them from obtaining leadership positions.3 Of particular benefit to an institution, mentoring encourages a broader academic goal of attracting, retaining, and promoting faculty members. Mentoring contributes to the stability of the academic environment. Two principles are of paramount importance to the success of any mentoring relationship or program: institutional commitment and institutional rewards and recognition to the mentors.3 Mentorship benefits all faculty members, men and women alike. All faculty members, at one time or another, face challenges in career advancement and benefit from senior-level guidance. Mentoring may be particularly important to advance the academic career development of women and underrepresented minority faculty, both groups seriously underrepresented in the senior ranks and in leadership positions in academic medicine. A survey of 34 department chairs and 2 division chiefs was performed in 1998-1999 to assess the reason for the scarcity of women in leadership positions in academic medicine.4 Women are seriously underrepresented at the senior level of academic institutions and in leadership positions. Cohort studies comparing men and women medical school faculty reveal that women remain substantially less likely to be promoted than men to senior-level ranks, even after adjusting for variables such as hours worked, number of publications, and grant support.4-6 This scarcity of senior women in academics and leadership positions raises the question about women’s access to effective mentorship, career opportunities, and a gender bias-free work area. In this survey, the chairs and chiefs universally acknowledged the existence of barriers to the advancement of women. Prospects for the academic advancement of men and women faculty are enhanced significantly by the guardianship of an effective mentor. The survey respondents indicated that mentors can play a key role in addressing several of the barriers to advancement. Interestingly, the respondents felt that senior women would serve as the best mentors for junior women, but again acknowledged the scarcity of senior women. However, if most senior faculty are men and men faculty are in the greatest number, are the most aware of the institutional culture and politics, have developed the networks of communication, and have been promoted academically, why can they not serve as mentors for women and guide them along the academic pathway? Both senior men and senior women faculty should rise to the occasion to mentor the junior women faculty. One intervention that was suggested from this survey and appears to make the most sense is that junior women faculty should use multiple mentors to meet the needs of balancing a successful academic career with life and distinctive gender-related needs. 326
Both men and women could benefit from mentoring for such purposes. But women are not the only group of academic faculty members to lag behind their male colleagues in terms of academic advancement to senior ranks and leadership positions. Minority physicians often do not have mentors, and the problem is the greatest for minority groups underrepresented in medicine.7 There are even fewer senior-level, underrepresented minority faculty than women faculty. Faculty mentors and networking with peers are critical ingredients for a successful academic career, but minority physicians are frequently unable to find mentors essential to their academic career advancement.8 In the business executive world, minorities who advance the furthest all share one characteristic—a strong network of mentors who nurture their professional development.9 The importance of an awareness of the challenges that race may present to the faculty member cannot be overemphasized. As suggested for junior women faculty, more than one mentor may be critical to address the needs of the underrepresented minority faculty. On an academic institutional level, it is necessary to integrate the principles of opportunity, development, and diversity into the fabric of the philosophy of the institution. The Center for Faculty Development (CFD) at the Carl J. Shapiro Institute for Education and Research at Beth Israel Deaconess Medical Center instituted a formal mentorship program in January 2003, at the request of the Women’s Subcommittee and the Underrepresented Minority (URM) Subcommittee. A single announcement was sent via e-mail to all men and women faculty (n ⫽ 1573) and all underrepresented minority trainees (n ⫽ 48) requesting volunteers to serve as a mentor, a mentee, or to participate at both levels. There were a total of 97 affirmative responses, including 12 URM trainees. From a faculty pool that comprises 30% women and 5% URM, and a trainee pool that is also 5% URM, 53% of the respondents were women and 27% were URM. Our target group was successfully reached. Of those who requested to serve as a mentor and a mentee, 62% were women and 31% were URM faculty or trainees. Of those who requested to serve as mentors only, 68% were men and 22% were URM faculty or trainees. Of those who requested to serve as a mentee only, 72% were women and 33% were URM faculty or trainees. In this program, the senior men faculty as well as the URM faculty have demonstrated a strong willingness to serve as mentors to the junior women faculty and the URM faculty and trainees. A formal match was performed by hand based on the requirements of the prospective mentee and the qualifications of the mentor. Guidelines were sent to all participants and formal follow-up on the matches is done routinely. Special seminars for the mentorship program and a mentoring skills program are included in the CFD Mentorship Program. All faculty members in academic medicine benefit from mentorship, whether it be a formal program or informal. It is to the benefit of the academic institution to support and reward the participants who foster the growth and development of their junior colleagues as these efforts add stability to the institutions. CURRENT SURGERY • Volume 61/Number 3 • May/June 2004
REFERENCES 1. Sachdeva AK. Preceptorship, mentorship and the adult
learner in medical and health science education. J Cancer Educ. 1996;11:131-136. 2. Luna G, Cullen DL. Empowering the Faculty: Mentoring
redirected and renewed. ASHE-ERIC Higher Education Report 3, 1995. The George Washington University Graduate School of Education and Human Development, Washington, D.C.; 1995. 3. Mark S, Link H, Morahan PS, Pololi L, Reznik V, Tropez-
Sims S. Innovative mentoring programs to promote gender equity in academic medicine. Acad Med. 2001;76(1):39-42. 4. Yedidia MJ, Bickel J. Research Report: Why aren’t there
more women leaders in academic medicine? The views of the clinical department chairs. Acad Med. 2001;76:453-465.
CURRENT SURGERY • Volume 61/Number 3 • May/June 2004
5. Bickel J, Clark V, Marshall Lawson R. Women in U.S. Aca-
demic Medicine Statistics, 1998-1999. Washington, DC: Association of American Medical Colleges; 1999. 6. Tesch B, Wood HM, Helwig AL, Nattinger AB. Promotion
of women in academic medicine: glass ceiling or stick floor? JAMA. 1995;273:1022-1025. 7. Johnson JC, Williams B, Jayadevappa R. Mentoring pro-
gram for minority faculty at the University of Pennsylvania School of Medicine. Acad Med. 1999;74:376-379. 8. Gregler LL, Clark LT, Jackson EB Jr. Careers in academic
medicine and clinical practice for minorities: opportunities and barriers. J Assoc Acad Minority Phys. 1994;5:68-76. 9. Thomas DA. The truth about mentoring minorities: race
matters. Harvard Business Rev. 2001;April:99-107.
327
Mentorship in Academic Medicine: A Critical Component for All Faculty and Academic Advancement Rosemary B. Duda, MD Center for Faculty Development, Carl J. Shapiro Institute for Education and Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts INTRODUCTION Mentorship for faculty in academic medicine is a partnership whereby a senior faculty member provides support and guidance on a professional or personal level to a more junior individual. This partnership can be intense and of variable duration, frequently existing until the junior person achieves the established goals. It can, however, be a long-term relationship that continues throughout the career of the junior faculty member. KEY WORDS: academic medicine, leadership, mentorship
State of Affairs Dr. Chris Holbrook has just joined the academic faculty a few months ago after completing a residency in general surgery and a residency in thoracic surgery. Dr. Holbrook is new to the institution and the metropolitan area in general. He is also a single surgeon from a minority background with no family and few friends in the area. His career goals are to build a busy academic practice, to teach medical students and residents, and to perform both laboratory and clinical research. He hopes to become a division chief within the next 6 years and ultimately a department chair. He is a brilliant clinician and scholar, with extensive research training. He is industrious and willing to make the commitment to achieve his goals. His goals are realistic relative to his talents. He has found that he is feeling rudderless in this academic environment and wants to know how he can make the correct contacts to fulfill his dreams. He is also feeling out of touch with the outside world.
Response It is not uncommon for young or new faculty to become or at least feel lost in a new environment or system. The best training Correspondence: Inquiries to Rosemary B. Duda, MD, Center for Faculty Development, Carl J. Shapiro Institute for Education and Research, Beth Israel Deaconess Medical Center, RW817/Surgical Oncology, 330 Brookline Avenue, Boston, MA 02215; fax: (617) 667-2978; e-mail: [email protected]
in the world cannot take the place of a good mentor. Many department chairs or division chiefs pride themselves in this role. When there are significant time constraints on the chief or chair, they may not be able to serve in this capacity for all members of the division or department. Dr. Holbrook would benefit by having a senior member of the department, and in his research field meet with him routinely to assess his progress and review his performance. He would benefit by having someone help steer him along his academic course, providing important information and direction to help him achieve his goals as well as balance in his life. He may also benefit from a mentor of a similar ethnic background to help him with both the academic and social issues that are specific to his situation. He may also benefit by having a mentor outside the institution to be certain that he is recognized for his accomplishments and help establish relationships with others that are critical to any advancement. One mentor alone may not be sufficient to meet all of the career and academic needs of faculty. Most faculty, like Dr. Holbrook, may benefit from different mentors with different skills and backgrounds. The mentor serves as a teacher, role model, coach, sponsor, exemplar, or confidant to the prote´ge´ or mentee on a one-onone relationship.1 The mentor assumes an active role and facilitates the career development of the mentee by providing an understanding of the culture of the institution and academic profession in general.2 Both parties benefit from the partnership as well as the academic institution. Mentoring can invigorate the senior faculty and foster their own growth and development. The mentee gains an understanding of the distinct structural features of the institution, role relations, the informal system dynamics, complexities, and stresses. An understanding of the institutional culture can provide overall stability for the mentee’s career, can improve performance, and can promote the progression of their academic career. Formal and informal mentoring advances the concept of individual and institutional empowerment by supporting the growth and development of junior faculty.2 Mentoring pro-
CURRENT SURGERY • © 2004 by the Association of Program Directors in Surgery Published by Elsevier Inc.
0149-7944/04/$30.00 doi:10.1016/j.cursur.2003.12.004
325
motes faculty productivity, advocates collegiality, and provides access to informal and formal networks of communication, which facilitates productivity. Mentoring relationships have been shown to be important in obtaining funding for research and recognition for work-related achievements; ultimately, the lack of mentors may halt the advancement of individuals and prevent them from obtaining leadership positions.3 Of particular benefit to an institution, mentoring encourages a broader academic goal of attracting, retaining, and promoting faculty members. Mentoring contributes to the stability of the academic environment. Two principles are of paramount importance to the success of any mentoring relationship or program: institutional commitment and institutional rewards and recognition to the mentors.3 Mentorship benefits all faculty members, men and women alike. All faculty members, at one time or another, face challenges in career advancement and benefit from senior-level guidance. Mentoring may be particularly important to advance the academic career development of women and underrepresented minority faculty, both groups seriously underrepresented in the senior ranks and in leadership positions in academic medicine. A survey of 34 department chairs and 2 division chiefs was performed in 1998-1999 to assess the reason for the scarcity of women in leadership positions in academic medicine.4 Women are seriously underrepresented at the senior level of academic institutions and in leadership positions. Cohort studies comparing men and women medical school faculty reveal that women remain substantially less likely to be promoted than men to senior-level ranks, even after adjusting for variables such as hours worked, number of publications, and grant support.4-6 This scarcity of senior women in academics and leadership positions raises the question about women’s access to effective mentorship, career opportunities, and a gender bias-free work area. In this survey, the chairs and chiefs universally acknowledged the existence of barriers to the advancement of women. Prospects for the academic advancement of men and women faculty are enhanced significantly by the guardianship of an effective mentor. The survey respondents indicated that mentors can play a key role in addressing several of the barriers to advancement. Interestingly, the respondents felt that senior women would serve as the best mentors for junior women, but again acknowledged the scarcity of senior women. However, if most senior faculty are men and men faculty are in the greatest number, are the most aware of the institutional culture and politics, have developed the networks of communication, and have been promoted academically, why can they not serve as mentors for women and guide them along the academic pathway? Both senior men and senior women faculty should rise to the occasion to mentor the junior women faculty. One intervention that was suggested from this survey and appears to make the most sense is that junior women faculty should use multiple mentors to meet the needs of balancing a successful academic career with life and distinctive gender-related needs. 326
Both men and women could benefit from mentoring for such purposes. But women are not the only group of academic faculty members to lag behind their male colleagues in terms of academic advancement to senior ranks and leadership positions. Minority physicians often do not have mentors, and the problem is the greatest for minority groups underrepresented in medicine.7 There are even fewer senior-level, underrepresented minority faculty than women faculty. Faculty mentors and networking with peers are critical ingredients for a successful academic career, but minority physicians are frequently unable to find mentors essential to their academic career advancement.8 In the business executive world, minorities who advance the furthest all share one characteristic—a strong network of mentors who nurture their professional development.9 The importance of an awareness of the challenges that race may present to the faculty member cannot be overemphasized. As suggested for junior women faculty, more than one mentor may be critical to address the needs of the underrepresented minority faculty. On an academic institutional level, it is necessary to integrate the principles of opportunity, development, and diversity into the fabric of the philosophy of the institution. The Center for Faculty Development (CFD) at the Carl J. Shapiro Institute for Education and Research at Beth Israel Deaconess Medical Center instituted a formal mentorship program in January 2003, at the request of the Women’s Subcommittee and the Underrepresented Minority (URM) Subcommittee. A single announcement was sent via e-mail to all men and women faculty (n ⫽ 1573) and all underrepresented minority trainees (n ⫽ 48) requesting volunteers to serve as a mentor, a mentee, or to participate at both levels. There were a total of 97 affirmative responses, including 12 URM trainees. From a faculty pool that comprises 30% women and 5% URM, and a trainee pool that is also 5% URM, 53% of the respondents were women and 27% were URM. Our target group was successfully reached. Of those who requested to serve as a mentor and a mentee, 62% were women and 31% were URM faculty or trainees. Of those who requested to serve as mentors only, 68% were men and 22% were URM faculty or trainees. Of those who requested to serve as a mentee only, 72% were women and 33% were URM faculty or trainees. In this program, the senior men faculty as well as the URM faculty have demonstrated a strong willingness to serve as mentors to the junior women faculty and the URM faculty and trainees. A formal match was performed by hand based on the requirements of the prospective mentee and the qualifications of the mentor. Guidelines were sent to all participants and formal follow-up on the matches is done routinely. Special seminars for the mentorship program and a mentoring skills program are included in the CFD Mentorship Program. All faculty members in academic medicine benefit from mentorship, whether it be a formal program or informal. It is to the benefit of the academic institution to support and reward the participants who foster the growth and development of their junior colleagues as these efforts add stability to the institutions. CURRENT SURGERY • Volume 61/Number 3 • May/June 2004
REFERENCES 1. Sachdeva AK. Preceptorship, mentorship and the adult
learner in medical and health science education. J Cancer Educ. 1996;11:131-136. 2. Luna G, Cullen DL. Empowering the Faculty: Mentoring
redirected and renewed. ASHE-ERIC Higher Education Report 3, 1995. The George Washington University Graduate School of Education and Human Development, Washington, D.C.; 1995. 3. Mark S, Link H, Morahan PS, Pololi L, Reznik V, Tropez-
Sims S. Innovative mentoring programs to promote gender equity in academic medicine. Acad Med. 2001;76(1):39-42. 4. Yedidia MJ, Bickel J. Research Report: Why aren’t there
more women leaders in academic medicine? The views of the clinical department chairs. Acad Med. 2001;76:453-465.
CURRENT SURGERY • Volume 61/Number 3 • May/June 2004
5. Bickel J, Clark V, Marshall Lawson R. Women in U.S. Aca-
demic Medicine Statistics, 1998-1999. Washington, DC: Association of American Medical Colleges; 1999. 6. Tesch B, Wood HM, Helwig AL, Nattinger AB. Promotion
of women in academic medicine: glass ceiling or stick floor? JAMA. 1995;273:1022-1025. 7. Johnson JC, Williams B, Jayadevappa R. Mentoring pro-
gram for minority faculty at the University of Pennsylvania School of Medicine. Acad Med. 1999;74:376-379. 8. Gregler LL, Clark LT, Jackson EB Jr. Careers in academic
medicine and clinical practice for minorities: opportunities and barriers. J Assoc Acad Minority Phys. 1994;5:68-76. 9. Thomas DA. The truth about mentoring minorities: race
matters. Harvard Business Rev. 2001;April:99-107.
327