Academic Mentoring—How to Give It and How to Get It

Academic Mentoring—How to Give It and How to Get It
Allan S. Detsky; Mark Otto Baerlocher
Online article and related content
current as of May 12, 2009.
JAMA. 2007;297(19):2134-2136 (doi:10.1001/jama.297.19.2134)
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Ann J. Brown et al. JAMA. 2007;298(7):739.
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COMMENTARIES
Academic Mentoring—How to Give It
and How to Get It
Allan S. Detsky, MD, PhD, FRCPC
Mark Otto Baerlocher, MD
S
TUDENTS, TRAINEES, RESEARCH FELLOWS, AND JUNIOR
faculty all benefit from the direction provided by academic mentors and research supervisors. The literature contains numerous reports on the importance
of mentorship in helping facilitate the future success of trainees, documenting benefits such as more productive research careers, greater career satisfaction, better preparation in making career decisions, networking within a
profession, and aiding in stress management.1-10 This Commentary describes several key points of advice both for individuals who mentor and those who receive mentoring
(mentees). In some places, a mentor is an individual who
is not the student’s direct clinical, academic, or research supervisor. This advice applies to those kinds of mentors as
well as the more traditional direct supervisors.
Determine How the Mentee
Likes to Spend Time
Several years ago a faculty member who had worked in his
profession for 10 years visited the corresponding author
(A.S.D.) to announce plans for a career change. Until that
time, this particular faculty member was a basic science researcher in the division of endocrinology who also provided clinical care to patients with diabetes 1 day per week.
He was moving to a full-time clinical position in a nonteaching hospital and he described experiencing moderate
career success and enjoyment from research activities performed during the first 5 years, but thereafter realized a dislike for the work. His clue about his career became evident
when he noticed feeling excited about how the day would
unfold seeing follow-up patients with diabetes and determining their clinical progress on the 1 clinical day per week
vs the other 4 days of the week when he awoke, pulled the
sheets over his head in the morning, and dreaded going to
work in his laboratory. This realization led to an understanding that he was in the wrong job.
One of a mentor’s most important jobs is to help mentees
determine what kind of career they wish to pursue.3,11 Those
who train in medicine can pursue at least 4 types: clinical
care, education, research, or administration. Good mentors should present all 4 options without communicating
2134 JAMA, May 16, 2007—Vol 297, No. 19 (Reprinted)
value judgments. In particular, because the primary purpose of attending medical school is to learn how to provide
direct patient care, it is inappropriate to cause mentees to
feel this activity is less worthy than the others. The best way
to help mentees choose a career path is to help them understand what day-to-day activities instill excitement. One
suggested approach to determine this is for mentors to express the following: “Don’t tell me what you want to be (ie,
an academic physician). Tell me how you want to spend your
time. What gets you out of bed in the morning? What really
interests you? What jobs are fun for you? Design your position around those activities.”
Be Honest
Mentors need to understand that mentees frequently are
afraid to tell their supervisors what they want if they feel
they will disappoint their mentors. It is important that
mentors not promote their own agenda over that of
mentees with aspirations of producing academic clones.11
The following has been stated (A.S.D.) to help the mentee
become more honest: “I am a general internist, health
economist, and I perform health care research. I am happy
being me. I do not need you to be me to reaffirm that I
made the right choice.” Once said, the body language of the
mentee is often observed to become much more comfortable. It is important that mentees not simply tell mentors
what they think mentors wish to hear, but rather what they
really think, without wasting time by pursuing unwanted
directions.
At the same time, mentors need to understand that mentees
may choose not to follow their advice. Mentors should not
be disappointed when this happens. The nature of the relationship is that mentors and mentees should feel free to
give honest expressions and advice without insistence from
either side that mentees accept it.12
On a more formal note, some have suggested that mentoring relationships should undergo regular evaluations
for process (clear objectives and regular, purposeful
meetings), communication (feedback, mentees being able
Author Affiliations: Departments of Health Policy, Management, and Evaluation
and Medicine, University of Toronto, Departments of Medicine, Mount Sinai Hospital and University Health Network (Dr Detsky); Department of Medical Imaging,
University of Toronto (Dr Baerlocher), Toronto, Ontario.
Corresponding Author: Allan S. Detsky, MD, PhD, FRCPC, Mount Sinai Hospital,
600 University Ave, Room 427, Toronto, Ontario, Canada M5G 1X5 (allan.detsky
@uhn.on.ca).
©2007 American Medical Association. All rights reserved.
Downloaded from www.jama.com at Univ Of Southern California on May 12, 2009
COMMENTARIES
to challenge mentors), and outcomes (sense of progress
and development, improved networks).13 Such periodic
evaluations are valuable tools to help ensure ongoing
honesty.
There are circumstances in which mentors should perhaps not be completely forthcoming. For instance, when
the mentee tells of making a particular career choice (as
opposed to asking for advice about the choice), the mentor should not show disapproval or state the choice is a
mistake. In these circumstances, mentors must distinguish between the mentee’s requests for advice and
announcements of firm decisions (often not easy to do).
Once mentees have decided, expressing disappointment
can be a very bad way to end the communication. Mentors can make it clear that the door is open to reverse the
decision, but should not say “You are making a mistake,”
because that phrase may be counterproductive and will
not be forgotten.
Follow Through
It is important for mentors to be supportive. This can take
the form of making the right introductions, dealing with individuals whose cooperation is required, or providing financial support.9,12,14 In other cases, providing support simply involves responding to the mentee’s questions, reading
manuscripts, providing advice, and following through on
promises. Prolonged delays on either side are harmful to the
success of mentees. Students should, therefore, carefully investigate the experiences of previous individuals who received mentoring from someone they are considering approaching. They should review a proposed mentor’s
curriculum vitae and determine how many students were
overseen who now have successful careers. If the answer is
many, it bodes well for the future. If a faculty member has
been in a mentorship role for more than 20 years but has
almost no successful disciples, the mentee might do well to
avoid that person.12,14
Do Not Become Friends
In this relationship mentors have power. The individuals
can never be equal and therefore should not establish a relationship as friends during the mentorship period. Doing
so may result in complications, hurt feelings, and can be destructive. This is not to say that the mentoring relationship
cannot be cordial, personal, enjoyable, or fun. This simply
means that the appropriate professional distance must be
maintained to protect both parties.15,16
Do Not Be Afraid to Terminate
a Mismatched Relationship
Personality conflicts in the mentor/mentee relationship may
occur. If these conflicts are irreconcilable, to the point that
a positive mentor/mentee relationship is unlikely, the relationship should be terminated. This advice applies for both
mentors and mentees.
©2007 American Medical Association. All rights reserved.
Be Explicit About Credit for Work
At the beginning of the mentoring relationship, the roles
are usually very clear: mentors often provide the initial
ideas, infrastructure, financial support, and supervision
for a project and mentees often perform the day-to-day
work. Over time, roles change. For example, original
ideas or questions will ultimately be generated by
mentees and mentors may increasingly play a more
peripheral role. This may lead to difficulties in determining who gets credit for the work. The principal objective
way of assigning credit is the designation of an individual’s role on a grant application (principal investigator or
coinvestigator) and the position of the names on the
author list.
Early in the corresponding author’s career (A.S.D.), an
unfortunate interaction occurred between a mentor and
mentee that best illustrates the problem. The mentee, who
was then a junior faculty member, had an idea to use an
existing medication to treat a genetic disorder and this
intervention had a very positive result in 1 patient. Because
there had been no similar descriptions in the literature, the
mentee prepared a manuscript describing this case report,
and the paper was subsequently accepted by a high-profile
medical journal. The mentee did not include his mentor as
a coauthor primarily because the mentee felt that the mentor, who was an internationally recognized expert in the
field, would have received credit for the idea. The mentee
claimed that the idea and work were entirely his and that
the mentor had no role in the paper; moreover, the mentor
certainly did not meet the current authorship criteria established by the International Committee of Medical Journal
Editors (this episode preceded the development of those
criteria by several years).17 The mentor learned about the
paper and objected strenuously to being excluded from the
author list. The disagreement ascended the chain of command at the university. Ultimately the paper was published
in the high-profile journal without the mentor’s name as an
author. This episode led to the mentee leaving the institution because many of his colleagues reportedly ostracized
him for this behavior.
The best way to avoid similar episodes is to be explicit
from the beginning of a project about who is going to receive what credit, to acknowledge that the mentor/mentee
relationship will change over time, and to follow the International Committee of Medical Journal Editors’ established criteria for authorship, although this may require some
subjective judgment. Mentors should not expect their
mentees to include them as honorary authors.
Similarly, it may be common practice for some mentors
to include their students as authors specifically to advance
their careers even without proper contribution to warrant
authorship. This is equally inappropriate. If mentors wish
to include students as authors on manuscripts, an appropriate set of tasks that constitute grounds for authorship
should be assigned and conducted by students.
(Reprinted) JAMA, May 16, 2007—Vol 297, No. 19
Downloaded from www.jama.com at Univ Of Southern California on May 12, 2009
2135
COMMENTARIES
Separate at the End
At some point, supervisors have to end the mentoring relationship with students. It does a junior faculty member
no good to continue to put the supervisor’s name on grants
or papers. Doing so stunts the growth and reputation of
mentees and is problematic when they are considered for
career awards or promotions. The responsibility for separation lies primarily with mentors and at some point mentors have to state directly, “We will no longer write together.” This does not mean that mentors stop providing
advice. It just means that the names can no longer be attached on grants and articles.16 Although the exact publication record and length of time for mentor/mentee relationships is not well established, data from a preliminary
survey suggest that the break point seems to be 6 to 10 papers and 3 to 5 years before separation typically occurs (unpublished data, A.S.D.).
What Mentees Should Do If Mentors
Do Not Wish to Separate
In these situations, mentees should ascend the chain of command in the organization and solicit help of the division head,
department chief, chair, or dean. These individuals will clearly
understand the issue and broker the separation. After separation, mentors and mentees can become friends, assuming they actually (still) like each other, because at this point
they will be equals. One of the wise mentors of A.S.D. taught
the following: “I was always careful to be nice to the people
I met on the way up. They were the same people I met on
the way down.”
The mentor/mentee relationship is an essential aspect of
career development. These suggestions provide advice and
helpful behaviors for this worthwhile and integral activity
in academic medicine.
2136 JAMA, May 16, 2007—Vol 297, No. 19 (Reprinted)
Financial Disclosures: None reported.
Disclaimer: The second author (M.O.B.) is a second-year radiology resident and
the corresponding author (A.S.D.) is a senior faculty member who has mentored
more than 500 students and junior faculty during the past 27 years.
Acknowledgment: We thank Richard Sztramko, MD for his help with the
literature review. He did not receive compensation for work relative to this
article.
REFERENCES
1. Roch GR. Much ado about mentors. Harv Bus Rev. 1979;57:14-20.
2. Palepu A, Friedman RH, Barnett RC, et al. Junior faculty members’ mentoring
relationships and their professional development in US medical schools. Acad Med.
1998;73:318-323.
3. Pololi LH, Knight S, Dennis K, Frankel RM. Helping medical school faculty realize their dreams. Acad Med. 2002;77:377-384.
4. Allen TD, Eby LT, Poteet ML, Lentz E. Career benefits associated with mentoring for proteges: a meta-analysis. J Appl Psychol. 2004;89:127-136.
5. Cameron SW, Blackburn RT. Sponsorship and academic career success. J Higher
Educ. 1981;52:369-377. doi:10.2307/1981284.
6. Schapira MM, Kalet A, Schwartz MD, Gerrity MS. Mentorship in general internal medicine: investment in our future. J Gen Intern Med. 1992;7:248-251.
7. Ramanan RA, Taylor WC, Davis RB, Phillips RS. Mentoring matters: mentoring
and career preparation in internal medicine residency training. J Gen Intern Med.
2006;21:340-345.
8. Kirsling RA, Kochar MS. Mentors in graduate medical education at the Medical College of Wisconsin. Acad Med. 1990;65:272-274.
9. Jackson VA, Palepu A, Szalacha L, Caswell C, Carr PL, Inui T. ”Having the right
chemistry“: a qualitative study of mentoring in academic medicine. Acad Med.
2003;78:328-334.
10. Sambunjak D, Straus SE, Marusic A. Mentoring in academic medicine. JAMA.
2006;296:1103-1115.
11. Rose GL, Rukstalis MR, Schuckit MA. Informal mentoring between faculty and
medical students. Acad Med. 2005;80:344-348.
12. Lee JM, Anzai Y, Langlotz CP. Mentoring the mentors: aligning mentor and
mentee expectations. Acad Radiol. 2006;13:556-561.
13. Grainger C. Mentoring—supporting doctors at work and play. BMJ Career
Focus. 2002;324:S203. doi:10.1136/bmj.324.7353.S203.
14. Tobin MJ. Mentoring: seven roles and some specifics. Am J Respir Crit Care
Med. 2004;170:114-117.
15. Ramani S, Gruppen L, Kachur EK. Twelve tips for developing effective mentors.
Med Teach. 2006;28:404-408.
16. Hunt DM, Michael C. Mentorship: a career training and development tool.
Acad Manage Rev. 1983;8:475-485. doi:10.2307/257836.
17. International Committee of Medical Journal Editors. Uniform requirements for
manuscripts submitted to biomedical journals: writing and editing for biomedical
publication, updated February 2006. http://www.icmje.org/. Accessed January
3, 2007.
©2007 American Medical Association. All rights reserved.
Downloaded from www.jama.com at Univ Of Southern California on May 12, 2009
VOLUME
31
䡠
NUMBER
6
䡠
FEBRUARY
20
2013
JOURNAL OF CLINICAL ONCOLOGY
A R T
O F
O N C O L O G Y
Tips for Success As an Academic Clinical Investigator
Stephanie J. Lee
From the Fred Hutchinson Cancer
Research Center, Seattle, WA.
Published online ahead of print at
www.jco.org on January 7, 2013.
Author’s disclosures of potential conflicts of interest are found at the end of
this article.
Corresponding author: Stephanie J.
Lee, MD, MPH, Fred Hutchinson
Cancer Research Center, 1100 Fairview
Ave N, D5-290, Seattle, WA 98109;
e-mail: [email protected].
© 2013 by American Society of Clinical
Oncology
0732-183X/13/3106-811/$20.00
DOI: 10.1200/JCO.2012.46.8751
When confronted with a new and challenging task,
the first thing I have always done is to see how others
have succeeded before me. Hearing and reading others’ reflections on their tips, tricks, and pearls has
often given me helpful strategies, whether the topic
is parenting, traveling, or having a successful career.
In hearing the reflections of those who went before,
I can benefit from their experiences without any
commitment to follow their paths. The advice is free,
and I can take what I want and leave the rest behind.
So it is in this spirit that I decided to share what
I tell aspiring young investigators if they seek my
advice about how to achieve success as an academic
clinical investigator. After writing down my initial
thoughts, I shared the list with my colleagues, who
provided many helpful additions and edits. I then
circulated it to junior investigators, and the list continued to evolve. Clearly the generalizability of the
strategies varies, and the list reflects the lens of my
experience. I have been told by some young investigators that the list looks scary, but I wanted to be
concrete about how discipline and hard work can
enhance your chances for success in academic medicine. My hope is that people reading the list might
find some new tactics that resonate with them or, at
least, that it will provide a nidus for more discussion
about what success as an academic clinical investigator means and how best to achieve it.
This article is not about what someone else can
do for you—that is mentorship.1 This article is
about what you can do for yourself—the behaviors
and skills that you can cultivate to increase your
likelihood of success in academic medicine. Although everyone has a unique path that reflects his
or her interests, skills, talents, and environment, effective habits can help you achieve your goals and be
more successful in whatever career you choose. For
fellows and junior faculty who spend less time engaged in research, protected time may be more limited, making focus and efficiency consequently even
more critical.
A number of benchmarks have been used to
quantify success in academic medicine, including
number of publications, grants, lectures, research
collaborations, and leadership positions.2,3 These
closely mirror the physician-scientist criteria for
promotion, the academic track with which I am
most familiar. For the purposes of this article, academic success is defined as a personal sense of accomplishment and external recognition by others in
the areas noted. It does not cover many other
sources of job satisfaction, including the physicianpatient relationship.
Clinician-scholars are also judged on their clinical productivity, clinical reputation, and teaching
skills. I have not seen any tips for success published
for this academic track but hope to see this gap in the
literature filled by someone else.
The following tips are organized according to the
major challenges for academic clinical investigators:
Choosing and Completing Projects
1. Choose important and feasible research projects. Consider all aspects of a project in addition to
its intrinsic scientific quality. Will you gain new skills
or work with someone established and successful? If
you have a negative study, is it still interesting and
publishable? Choosing good projects takes time,
thought, and discussion with many people. It is a
research project in itself.
2. Seek out a niche rather than a crowded area.
The project should not be easily scooped or done
better or quicker by someone else.
3. Make sure you are passionate about your research topic. It is hard to sustain the necessary enthusiasm unless you are vitally interested in your
research question.
4. Stagger your projects. Try to have at least one
short-, medium-, and long-term project going simultaneously so that the time crunches for each are
spread out, and the payoffs are layered.
5. It is more efficient if your projects intersect. A
simple test is whether you can adapt some of the
previously written background material for use in
your new project.
6. Take personal responsibility for your success.
Attack problems and barriers with creativity and
vigor. Do menial tasks yourself to move a project
forward. The surest way to get something done is
almost always to do it yourself.
7. Have productivity goals and timelines. A general benchmark of productivity for a young investigator is three projects in planning, two projects in
process, and one manuscript under review or in
© 2013 by American Society of Clinical Oncology
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Copyright © 2013 American Society
of Clinical Oncology. All rights reserved.
137.53.241.27
811
Stephanie J. Lee
press at any one time. Approximately double this target is appropriate
for a midcareer investigator. Set research goals for the month, and
make sure you achieve them.
Interacting With People
8. Surround yourself with people of high standards, skills, work
habits, and compatibility. Ensure your efforts are enhanced rather
than sabotaged.
9. Avoid chronophages who ask you to perform extraneous tasks that
eat your time without reward.4 Ask yourself: “Where could this new
responsibility be listed on my CV?” If you cannot find an appropriate
heading to put it under, you should strongly consider saying no.
10. Fully commit to whatever you agree to do. If you are part of a
committee, then strive to be part of the 30% of members who actually
contribute to the functioning of the group.5 Prepare for meetings, and
speak up.
11. If you cannot commit, be able to say no. If you have a hard time
saying no to requests, then a strategy of “yes, no, yes” can be helpful.
Starting with a positive statement such as “thank you so much for
thinking of me” is an easy first sentence. Then deliver the no clearly:
“But I’m sorry I won’t be able to write a chapter… join that committee… write a review… I am unable to meet your deadline.” Then end
on a positive note: “Please think of me in the future” or just simply end
with a thank you. You can offer to suggest someone else who will do a
good job (if it is actually a good opportunity).
12. Understand and participate in others’ work, and include
them in yours. Give insightful comments on others’ papers, protocols, and grants. Be a sought-after collaborator who can deliver
what is promised.
13. Help your colleagues, and celebrate the success of others. Give
credit where credit is due. Academic medicine is a small world.
Giving Talks
14. Know your audience. Aim your content at them, and prepare meticulously.
15. Be clear in your slides, logic, and speech. Practice until you are
completely comfortable with your talk. If you are a beginner, memorize your abstract presentations.
16. Make sure you stay within your allotted time, and allow adequate time for questions. Practice answering questions about your
work. Know the work of others.
Writing Papers
17. Write often and well. Understand that if nothing is published,
then nothing is gained on your CV. During the promotion process,
you will be asked to provide your three to five most important papers.
18. Take pride in what you write. Make sure grammar, spelling,
and formatting are correct. People are getting an impression of you
through your writing, even the drafts and e-mails. Read your writing
out loud to see how it sounds and flows. Start early enough that you
can put it aside for a while to get some perspective.
19. If you have writer’s block, break the paper apart on your to-do
list. Methods, results, conclusion, and introduction are not as daunting as “write paper.”
20. If all else fails, just start typing some text. Worry about editing
in the next phase. It is usually easier to edit than write.
812
© 2013 by American Society of Clinical Oncology
Securing Funding
21. If research grants will be your primary source of support, then it
is critical that you become adept at writing grants. These should convince others that your research question is important, and you and
your team are capable of successfully answering the question. Read
about how to write grants and look at other people’s successful grants.
Ask more experienced grant writers for help, and give them enough
time to help you.
22. Pace yourself with interim deadlines. Ensure you have adequate time to submit the best grant you can.
23. Do not waste your time writing a grant for a funding source that
is not appropriate for you. Invest the time to talk to your colleagues
and granting agency officials to find this out.
Clinical Work
24. The earlier and more precisely you specialize, the easier it is to
maintain your expertise with less clinical time.
25. Whenever possible, clinical work should synergize with research endeavors.
Time Management
26. Set priorities. It is helpful to consider the profile of the various
tasks in your day. Is a task important or trivial, difficult or easy? The
basic idea is to do the hard and important tasks first, then fill in the
remaining time with the easier and less important stuff (Fig 1).
27. Meet deadlines. Reliability is noticed, and reliable people are
usually given more responsibilities, which can lead to great opportunities. Make it a priority to meet all external deadlines, such as paper
reviews and return of comments to coinvestigators. Set your own
deadlines for your research tasks, and make sure you achieve them.
28. Work many hours. The number of hours needed to work
during the week is controversial and personal, but many academic
physician-scientists I know log at least 60 hours, often gaining extra
and precious hours of deep focus on the weekends, early mornings,
late nights, or during travel.
29. Work efficiently. Make whatever hours are devoted to work
count. Aim to work smarter, not harder. Know when you work most
Important
Grants
Papers
Protocols
Prepare talks
Enroll patients
Plan new projects
Review the literature
Attend meetings
Sign clinical notes
Read journals
Review papers
E-mail
Trivial
Difficult
Easy
Entirely in my control
Partially reliant on others
Fig 1. An example of prioritizing research tasks based on balancing importance,
ease of completion, and reliance on others. Set aside focused time for tasks in
the upper right. Complete tasks in the lower left during downtime or at the end
of the day.
JOURNAL OF CLINICAL ONCOLOGY
Information downloaded from jco.ascopubs.org and provided by at Oregon Health Sciences Univ on August 21, 2013 from
Copyright © 2013 American Society
of Clinical Oncology. All rights reserved.
137.53.241.27
Art of Oncology
effectively during the day and week. Protect your research time from
small distractions.
30. Do not confuse being busy with being productive. They are not
the same thing.
31. Keep a realistic and prioritized to-do list. Find the format that
works best for you.
Self-Awareness
32. Think deeply and clearly. Force yourself to ask why and
how, and be able to communicate this information to others. Aim to
be authoritative.
33. Try to see yourself through others’ eyes. Critically evaluate
yourself after completing something. Did I do a good job? Why or why
not? Know your own strengths and weaknesses.
34. Study others you admire. Dissect which specific qualities you
want to emulate.
35. Get feedback from different people. Self-reflect, reprioritize,
and learn from these comments.
36. Understand why you want to be an academic clinical investigator. Keep sight of the noble goals of your work while you are down in
the trenches.
about your relationship or your children, it is impossible to focus on
anything else. Make time for your partner and your children.
41. Consider getting involved in professional societies. Let organizations know you want to be involved. If invited to participate, make
sure you do an outstanding job.
42. Keep your CV updated. Include dates of invited talks and
committee participation. Know what format is required by your institution. Include a summary of your research program.
43. Have fun. Not always, not only. But academic medicine can
be grueling, and you need to enjoy the many hours spent at your job.
The personal sacrifices of achieving success in academic clinical
investigation can be burdensome, in terms of the long work hours, job
insecurity, lower salary, and delayed gratification. If after reading this,
you find yourself saying, “I don’t want to do this, be like this, work like
this,” then ask yourself whether this is the best career for you. There are
many other definitions of a successful career. Academic clinical investigation is only one approach to improving the care of people with
cancer.
Recommended additional reading: Johns,6 Goldman,7 Sackett,8
and Lewis.9
AUTHOR’S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST
The author(s) indicated no potential conflicts of interest.
Keep Evolving
37. Be a continuous learner. Embrace challenges. Learn new
skills, and take some chances to keep things fresh.
38. Practice leadership when you get a chance. Notice the skills
and behaviors required to be a good leader.
39. It is helpful to interact with others from different disciplines and
different institutions whenever you get a chance. This exposure helps
encourage creativity and makes sure you are known outside your
institution. Your local, national, and even international reputation
will be evaluated in the promotion process.
Final Bits of Advice
40. For those with significant others or children, do not underestimate the challenge of work-life balance. Choosing a supportive significant other and, if applicable, reliable child care about which you feel
good is absolutely essential to a productive career. If you are worried
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career trajectories of male and female career development award recipients.
Acad Med 86:1415-1421, 2011
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115:795-797, 2005
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Clin Cancer Res 5:2281-2285, 1999
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9. Lewis JD: The pathway to academic success starts during fellowship.
Gastrointest Endosc 61:587-588, 2005
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813
Faculty Mentoring
Making the Most of Mentors: A Guide for
Mentees
Judy T. Zerzan, MD, MPH, Rachel Hess, MD, Ellen Schur, MD, Russell S. Phillips, MD,
and Nancy Rigotti, MD
Abstract
Effective mentorship is likely one of the
most important determinants of success
in academic medicine and research.
Many papers focus on mentoring from
the mentor’s perspective, but few give
guidance to mentees forging these
critically important relationships. The
authors apply “managing up,” a
corporate concept, to academic medical
Mentoring, a lifelong process
particularly important for career
development in academic medicine, is
essential for a mentee to develop
confidence in his or her work. It
facilitates career selection, career
advancement, publication productivity,
and achievement of grant funding.1–3
Mentoring is a symbiotic relationship
aimed at advancing careers and career
satisfaction for both the mentor and the
mentee.4,5 Ideally, it is a dynamic,
collaborative, reciprocal relationship
focused on a mentee’s personal and
professional development.6 Mentoring
can develop either spontaneously, based
Dr. Zerzan is assistant professor, Division of
General Internal Medicine, Department of Medicine,
University of Colorado Denver School of Medicine,
Denver, Colorado.
Dr. Hess is assistant professor, Division of General
Internal Medicine, Department of Medicine and
Epidemiology, University of Pittsburgh School of
Medicine, Pittsburgh, Pennsylvania.
Dr. Schur is acting instructor, Division of General
Internal Medicine, University of Washington,
Harborview Medical Center, Seattle, Washington.
Dr. Phillips is chief, Division of General Medicine
and Primary Care, and professor of medicine, Beth
Israel Deaconess Medical Center, Department of
Medicine, Harvard Medical School, Boston,
Massachusetts.
Dr. Rigotti is professor of medicine, Massachusetts
General Hospital, Harvard Medical School, Boston,
Massachusetts.
Correspondence should be addressed to Dr. Zerzan,
University of Colorado Denver, Division of General
Internal Medicine, 12631 E 17th Ave., B180, PO Box
6511, Denver, CO 80045; telephone: (303)
724-2244; fax: (303) 724-2270; e-mail:
([email protected]).
140
settings both to promote effective,
successful mentoring and to make a
mentor’s job easier. Managing up
requires the mentee to take responsibility
for his or her part in the collaborative
alliance and to be the leader of the
relationship by guiding and facilitating
the mentor’s efforts to create a satisfying
and productive relationship for both
on mutual interests, or be set up
institutionally.7,8 Mentees benefit from
multiple mentors to gain exposure to a
variety of styles, opinions, and experiences.
Previous research has focused primarily on
the importance of mentoring and mentors’
activities.1,2,9 We focus on the active role a
mentee (at any level: student, resident,
fellow, or junior faculty) might take to
promote success in a mentoring
relationship. In addition, we discuss
common pitfalls and how to avoid them.
One classic definition of mentor is
someone of advanced rank or experience
who guides, teaches, and develops a
novice.9 Mentors in academic medicine
can help with day-to-day tasks, such as
manuscript editing, or they can help
guide more substantial decisions, such
as career planning. Some mentors are
on-site; others are at a distance.9 Mentors
are peers, near their mentee’s level of
training; sounding boards who listen to
their mentees process a decision; or role
models who provide inspiration. They
provide emotional and career support,
facilitate insight and change, and/or help
mentees avoid burnout. Good mentors
value mentoring as part of their
professional role and avoid focusing on
their own professional needs and
agendas, instead helping mentees develop
theirs.10 –12 Good mentors take an interest
in the mentee, provide both professional
and personal support, prompt a mentee
to take risks, and help open doors to
opportunities.5,10 Because all mentors
have different strengths and may not
perform all these roles and embody all
parties. The authors review the initiation
and cultivation of a mentoring
relationship from the perspective of a
mentee at any stage (student through
junior faculty), and they propose specific
strategies for mentee success.
Acad Med. 2009; 84:140–144.
these qualities, establishing a
complement of multiple mentors capable
of making diverse contributions is useful
for mentees. Whereas mentees benefit
through their personal and professional
development, mentors benefit by gaining
professional stimulation, personal
enrichment, satisfaction, and a sense of
giving back to their profession.8,13
The mentee is not an empty vessel receiving
the mentor’s advice and wisdom but,
rather, an active participant, shaping the
relationship. The ideal mentee aspires to
self-assessment, receptivity, initiative,
responsibility, honesty, and appreciation
for his or her mentor.4,14 One particularly
effective way for mentees to get the most
out of a mentoring relationship is
“managing up.” Managing up is a common
corporate concept for an
employee/supervisor relationship that we
believe to be highly applicable to mentoring
relationships in academic medicine. The
principal concept is that the mentee takes
ownership of and directs the relationship,
letting the mentor know what he or she
needs and communicating the way his or
her mentor prefers. Ideally, a motivated
mentee manages the work of the
relationship by planning and setting the
meeting agenda, asking questions, listening,
completing assigned tasks, and requesting
feedback.4,5 Managing up makes it easier
for a mentor to help a mentee, which
makes the relationship more satisfying and
more successful for both.
We focus on initiating and cultivating a
mentoring relationship, assigned or chosen,
from the mentee’s perspective. We propose
Academic Medicine, Vol. 84, No. 1 / January 2009
Faculty Mentoring
using the strategy of managing up to guide
the mentee’s actions during these stages
(List 1).6
List 1
Initiation
Getting ready
Preparing self
Before a mentee seeks a mentor, a few
introspective steps are necessary.4,15 First,
a mentee must clarify his or her own
values: What motivates him? What values
and attributes does she respect in
relationships? Are there personal
preferences such as gender or race
congruence, personality, emotional
needs, or work habits important to the
mentee? Next, a mentee should consider
his or her personal work style and how it
fits with mentoring approaches.
Remembering their work styles in past
academic environments, mentees might
ask the following questions: “How do I
learn best— by reading or listening?”15
“Do I need structured, directive
guidance, or do I prefer gentle
supervision?” Finally, mentees must
clarify their needs. What are their
knowledge and skill gaps? Specifically,
what domains do they want to gain or
cultivate from the relationship: personal
(creating work–life balance, building
confidence), professional development
(networking, establishing goals, choosing
fellowships or jobs), skill development
(communicating, managing time,
increasing clinical skills), academic
guidance (learning administrative skills,
understanding department values,
developing collegial relationships), or
research (collaborating, developing
methodology, drafting manuscripts, and
writing grants)?5,7,16
Once a mentee has thought about his or her
values, work style, and needs, the mentee
should develop a clear vision of career goals
using these values and needs. Creating
specific, written goals for three months, one
year, and five years is helpful.17 If a mentee
does not know what he or she wants to be
doing in a year, establishing a possible
direction provides a starting point. Goals
should relate to the knowledge and skill
gaps identified, but otherwise they can be
specific (e.g., publish a paper) or broad
(e.g., improve clinical exam skills),
medically related, work related, or
personal.11 Setting goals helps a mentee
present his or her needs to potential
mentors. A mentee who clearly assesses skill
and knowledge deficits and sets goals can
effectively seek mentoring and become
Academic Medicine, Vol. 84, No. 1 / January 2009
Checklist for Mentees to “Manage Up” to Create Successful Mentoring
Relationships
▫ Clarify your values
▫ Identify your work style and habits
▫ Identify knowledge and skill gaps
䡩 Personal
䡩 Professional development
䡩 Skill development
䡩 Academic guidance
䡩 Research
▫ List specific opportunities sought — e.g. grant writing, presentation
▫ Write down goals: 3 months, 1 year, 5 year
Finding a mentor . . . or two
▫ Meet with people you know
▫ Get recommendations
▫ Ask people you meet with who else they recommend
▫ Be persistent
▫ Find multiple mentors, both junior and senior people
Things to look for in a mentor
▫ Is available and accessible
▫ Provides opportunities and encourages mentee to take risks
▫ Helps mentee develop own agenda
▫ Has prior mentoring experience
The first meeting
▫ Tell your mentor how he or she has already helped you
▫ Share your background, values, and needs
▫ Send a thank-you note after the meeting
Cultivating the mentor–mentee relationship
▫ Agree on structure and objectives of relationship
▫ Plan and set the meeting agendas
▫ Ask questions
▫ Actively listen
▫ Follow through on assigned tasks
▫ Ask for feedback
▫ Manage up
䡩 Set goals and expectations
䡩 Be responsive and flexible
䡩 Direct the flow of information
䡩 Follow a regular meeting schedule with agenda
Separation
▫ Talk about when the relationship should end
▫ Talk with your mentor about next steps
▫ Talk about future mentors
responsible for his or her own growth.9 It is
important to refine and rewrite goals
periodically.17
Finding a mentor . . . or two . . .
Finding a mentor may be the most
difficult step in establishing a mentoring
relationship. Institutions may assign
mentors, but often multiple mentors are
helpful for specific needs, so a mentee
may need to look for other mentors
beyond those officially assigned. There
are several ways to approach the process.
Mentees may start by meeting with
141
Faculty Mentoring
faculty they already know both inside
and outside their department, school,
and/or hospital in order to talk about
what guidance and support they seek and
to get recommendations of potential
mentors who might be a “good fit.”10 In
these meetings, a mentee should ask
about potential mentors’ reputations and
experiences mentoring successful
mentees. Another strategy for identifying
mentors suggests the mentee consider
people who have positively impacted him
or her. The official mentoring
relationship can start positively if it is
based on previously established
admiration, trust, and compatible
background and interests. Once the
mentee has a list of recommendations, he
or she should meet with the selected
faculty and conduct informational
interviews seeking compatible interests
and work styles. Finally, during these
meetings, mentees should ask who else
the mentor might recommend to advise
them, and in this way the initial list grows
into a network of contacts.
connecting a mentee to other prominent
scholars, providing research datasets, and
giving long-term career planning advice.
Multiple mentors are necessary to get
needed guidance across the spectrum of
work and personal goals.5,10 Also,
identifying and cultivating multiple
mentors is advantageous for the mentors
because providing mentorship becomes
less demanding and time consuming, and
the mentor can keep focused on what he
or she knows and does best. Strategies for
making multiple mentors successful
include clear roles and expectations
for each mentor, a good relationship
among mentors, and mentors with
complementary experience.18 Potential
problems arise when there are unclear
expectations, disagreement, or
competition among mentors. A risk of
multiple mentors is erosion of a close
mentoring relationship because the dyad
spends less time together. Cultivating the
relationship and managing up, discussed
in the next section, will help address these
problems.
One common difficulty during the
initiation stage is a perception by the
mentee that people are too busy or
unavailable to be mentors. Knowing that
mentoring is time- and energy-intensive
and that a potential mentor may say no, a
mentee may be uncomfortable requesting
mentorship and fear rejection. One
remedy for these difficulties is persistence
in approaching potential mentors.
Additionally, a mentee should be clear in
expressing needs, thus providing
potential mentors a sense of the
commitment sought. When people are
too busy or overcommitted, they can
gracefully decline and suggest others for
the mentee to approach. Another
impediment to approaching mentors,
even after considering needs and listing
potential mentors, is that a mentee may
be indecisive regarding his or her career
and, therefore, have difficulty knowing
whom to approach.16 If a mentee does
not yet have a clear career direction, he or
she can seek out mentors who are good at
guiding exploration of career options.
Meeting for the first time
Mentees should begin seeking mentoring
early and in multiple places. A mentee
benefits from cultivating mentors at both
junior and senior levels. Junior-level
mentors complement senior faculty
mentors because they may have more
time and are closer to the mentee’s career
stage. Senior mentors are helpful in
142
When a mentee first meets with a
prospective mentor, whether chosen or
assigned, the mentee must have a plan.19
Mentees should consider how to market
themselves; with busy and
overcommitted mentors, it helps if a
mentee can recruit a mentor. In fact, it
may be best to schedule a brief meeting
when considering a potential mentor,
and only after the mentee has engaged
the potential mentor and demonstrated
organization and ability should he or she
formally ask whether a person will
mentor. The meeting may start with both
individuals sharing their backgrounds,
followed by the mentee clearly
articulating his or her needs and values.20
A mentee demonstrates early success to
prospective mentors by having predefined
goals and needs. Other tips for the initial
meeting include telling the mentor how he
or she has already been helpful, asking for
feedback about a research idea, or
specifically discussing how the mentor may
be helpful. A mentee should ask the
mentor’s permission to contact him or her
for future guidance and explicitly state the
likely purpose. Finally, a mentee must be
accountable to his or her prospective
mentor and should follow up with a thankyou note or e-mail summarizing the
discussion and the mentee’s plans to
proceed, thereby keeping the mentor
engaged.
At the next meeting, the mentee can ask
for more advice. Finding a suitable
mentor requires effort and persistence,
allowing brief interactions to grow into
learning partnerships and long-term
alliances.9,10
Cultivation
Once a mentee has engaged a mentor, the
relationship needs cultivation. At this stage,
the mentoring dyad agrees on both
objectives and a relationship structure such
as meeting frequency (e.g., often an hour
every two to four weeks), key
responsibilities and needs of each party
(such as the mentor’s availability outside of
meetings, and networking opportunities for
the mentee), mutual expectations and goals
(e.g., the mentor will review writing; the
mentee will ask for feedback), and concrete
measures of progress and success (e.g., the
mentee will eventually present an abstract
at a meeting). It is important for each
individual to make the relationship a
priority, set aside time for the relationship,
and agree on confidentiality.4
Managing up
Managing up is one way of cultivating the
mentoring relationship.15 Managing up
means the mentee takes ownership of the
relationship, letting the mentor know
what he or she needs and organizing
information in the form the mentor
prefers. A mentee must express his or her
needs in a direct manner and take
responsibility for setting and sticking to a
goal schedule. Managing up makes it
easier for mentors to help a mentee, and
it makes the relationship more satisfying
and more successful for both parties
because the mentor can target help and
the mentee gets exactly what he or she
needs most. A mentee must ask directly
how the mentor will judge success and be
responsive to the mentor’s suggestions
and tasks. A mentee should be available
and flexible if a mentor’s time or
schedule changes. A mentee must
communicate in a straightforward way by
addressing issues of potential conflict
(e.g., authorship on a paper) as they arise
and asking when he or she does not
understand something.
A mentee’s understanding of him- or
herself and the mentor is key to making
the relationship successful. The mentee
must know the work styles and personal
styles, strengths and weaknesses, blind
spots, and trigger points of both
Academic Medicine, Vol. 84, No. 1 / January 2009
Faculty Mentoring
participants.4,21 A mentee will observe
these over time, but he or she may also
ask about them, either directly or
through other peers and supervisors. A
mentee can use the information gleaned
from his or her own self-assessment to
develop and manage a healthy working
relationship compatible with each
person’s work style and expectations and,
most importantly, in a way that meets his
or her critical needs.21
Managing up requires the mentee to take
responsibility for managing information
flow.15 A mentee should ask directly
about the mentor’s preferred
communication style—Does the mentor
like to know the detailed facts and
figures, or is a broad overview with
specific problems better? Does the
mentor like to communicate by e-mail,
phone, or both? Is the mentor a “listener”
or a “reader”?21 If the mentor is a listener,
the mentee should provide a verbal brief
first and follow up with a short written
summary of the details. If the mentor is a
reader, than the mentee should provide
written material in advance and follow up
by talking about the issues in person at
the arranged meeting. It is essential to
communicate frequently and effectively
according to the mentor’s preferred
format and frequency of information
exchange.4
A mentee needs to ask questions to get new
insight, verify or clarify ideas, show interest,
and listen actively. Although a mentee
should put forth his or her own ideas, it is
critical that he or she not get defensive
or argumentative when the mentor
disagrees or provides constructive feedback.
The relationship’s ultimate goal is to help
the mentee succeed, and the mentor has the
mentee’s best interests in mind. If a mentee
disagrees with a mentor, he or she should
try to understand the mentor’s perspective
but discuss both opinions because,
although the mentor has more experience
than the mentee, the mentee brings a new
and potentially valuable view to a
situation.4,12 If a mentee must disagree, he
or she should do so respectfully and start by
asking clarifying questions to find out more
about the basis for the mentor’s
suggestions. When mentees learn from
disagreements, they grow.
Mentees should take responsibility for
managing the meetings. They should start
by agreeing with their mentors on a
regular schedule that is both feasible,
Academic Medicine, Vol. 84, No. 1 / January 2009
considering time commitments, and
adequate, allowing them to reach their
intended goals. One suggested structure
for each mentoring meeting begins with a
social opening, followed by agenda
negotiation, goal setting, discussion of
two to three topics, and a closing,
including a summary and plans for the
next two to four weeks.22 A mentee
should write an agenda for each meeting,
even if it is simply for his or her own
personal organization, to keep track of
goals and progress. Some mentors may
like to receive a written agenda and
questions ahead of time; others just like
to arrive and talk. At each meeting, a
mentee should inform the mentor of his
or her progress since the last meeting and
ask what is expected in terms of tasks
before the next meeting.4 A mentee
should use a mentor’s time wisely by
keeping meetings as short as possible or
cancelling an appointment in advance if
there is neither anything new to report
nor new issues to discuss. Mentees should
keep in mind, however, that nothing new
to report can represent a road block they
have encountered, and mentors may be
able to help navigate this problem.
Challenges
Dissatisfaction and problems are common
to every relationship, including
mentorships. Finding a successful
mentoring relationship is like dating: one
cannot expect a perfect fit every time,
and a good relationship takes work.
Dissatisfaction may occur from a mismatch
of goals, commitment, or expectations;
from a reluctance of the mentee to own and
pursue his or her own development; or
from a mentee’s reluctance to ask for
personal help.5,13 There can be power issues
(over ownership of authorship or
resources), generational tensions (over
differences in work schedule expectations),
or personality clashes (over differences in
communication or work style).
Occasionally, a mentor enters a mentorship
in search of a clone, encouraging mentees
to be dependent rather than to cultivate
their own ideas.8 When problems occur,
either the mentee or mentor can suggest a
change, and the approach to the problem
depends on the mentee’s and mentor’s
styles. Often, another person outside the
mentoring relationship can offer advice
about disagreements or concerns.
Common mentor complaints are that the
mentee did not follow through, the mentee
did not use the mentor’s time effectively, or
there was a poor fit with work style and/or
personality.19 If a mentee is aware of
potential difficulties early, knows his or her
values and needs, and manages up, then
many of these problems can be avoided.12
Long-distance mentoring relationships,
becoming more common as both mentees
and mentors move institutions or as a
mentee seeks specific expertise, inspire their
own unique set of potential problems,
including ineffectiveness because there is no
direct observation or accountability, and
misunderstandings due to phone and
e-mail communications.18,23 Some ways
to make long-distance mentoring more
successful include establishing the
relationship in a face-to-face meeting and
then continuing it at a distance, having
occasional face-time at conferences, and
having clear expectations set up about roles
and goals.18
Separation
All relationships naturally change and
evolve, and this is true of mentoring.9
Ideally, there will be a planned separation
as mentees advance their careers, attain
their goals, and become more collegial
with their mentors. Mentorship needs
evolve over time, and managing up helps
smooth the transition of ending the
mentoring relationship and moving
toward more equal standing. Often, both
the mentor and mentee recognize that
their mentoring relationship has fulfilled
its purpose, and both are ready for a
change. Occasionally an insurmountable
problem may occur such as differences in
communication, respect, or resource
use that leads to the sudden end of a
mentoring relationship. Ideally, to
promote productive future interactions,
the mentor or mentee should directly
address the transition, rather than letting
the relationship dwindle away or
avoiding talking about a problem. Part of
the mentoring relationship is to
communicate about any issues so that, as
one mentoring relationship evolves, a
mentee begins thinking about next steps
and potential future mentors, if needed.
In Sum
Mentoring is an evolving relationship
that requires time and attention to
develop and includes successes and
challenges. We outline the strategy,
managing up, which may be helpful to
improve mentoring relationships but that
has not yet been empirically tested in
143
Faculty Mentoring
academic medicine. Nevertheless,
following these tips is likely to improve
communication and the experience of
both mentor and mentee. Next steps for
research in this area include testing the
success of this strategy in groups of
mentees, so we are planning a phased,
randomized study at a single institution.
When a mentee knows him- or herself,
knows his or her values and needs,
manages up, makes the relationship a
high priority, and shows appreciation, he
or she will most likely become successful.
By implementing these specific tasks,
mentees can nurture and improve a
relationship that may ultimately become
a productive and enjoyable force in the
careers of both the mentor and the
mentee.
Acknowledgments
This work was presented in part as a workshop at
the National Meeting of the Society for General
Internal Medicine, Los Angeles, California, April
2006, and in Toronto, Canada, April 2007.
This work was supported by the Office of
Research and Development, Department of
Veterans Affairs, and the Robert Wood Johnson
Clinical Scholars Program at the University of
Washington.
Disclaimer
The views expressed are those of the authors and do
not necessarily reflect the views or opinions of the
supporting programs.
144
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