Expert Consult

By Karen Sokal-Gutierrez, MD, MPH, FAAP

Published November 1, 2017


Many years ago, when I was a medical student and resident, I envisioned my future career as a mountain that I needed to climb. I saw myself at the base of the mountain, with no clear path forward and upward. At the top of the mountain, I saw successful clinicians, researchers, and medical educators who had clearly found the path, or a path, to the top. I wondered, “How will I ever get there?” I knew that I could benefit from guidance, but I was reluctant to bother a very important and busy professional, and I feared that they would not be interested in helping me. However, several years out of my residency program, a distinguished pediatrician, Dr. Susan Aronson, took interest in me, reached out to me with a lifeline, and helped me begin to find my own path to scale the mountain.And after that, I was able to reach out more confidently to other mentors. I’ll forever be indebted to all of my mentors. In turn, I committed to “pay it forward” by mentoring those coming up behind me — and, this experience has become the most rewarding part of my career. What is Mentorship?

Mentorship is a relationship in which a more experienced/knowledgeable person helps guide a less experienced/knowledgeable person. It can involve career advice, role modeling, and emotional support. Although mentorship in medicine tends to focus on career guidance, a successful relationship involves you and your mentor as whole people and considers your career in the context of your life, including family, friendships, and personal wellness activities.

A successful mentoring relationship involves the same principles as all healthy relationships, including mutual respect, openness, responsibility, trust, appreciation, and mutual benefit. A good mentor does not dictate the specific career path that you must follow, but instead listens to you regarding your goals and interests; offers feedback, perspective and helpful ideas for you to consider; and provides encouragement and support as you discover and navigate your own career and life path.

Establishing a New Mentor-Mentee Relationship

In September 2017, NEJM Resident 360, hosted a discussion on mentorship (Standing on the Shoulders of Giants: Establishing and Fostering Successful Mentorship). The introduction to the discussion stated, “Behind every successful clinician stands a host of mentors and advocates. Finding the right mentor can be challenging at times. Like any great relationship, there needs to be the right balance of shared interests, common goals, and mutual understanding.” Medical experts, residents, and students discussed establishing a new mentor-mentee relationship, including the following pearls:

How to Find the Right Mentor

  • Be honest about your goals, concerns, and areas of need.

  • Identify what matters to you most (e.g., research advice, clinical mentorship, or guidance on work-life balance) and look for a mentor with that strength.

  • Take the time to find a mentor who is a good fit, including a comfortable chemistry in the relationship.

  • Make sure that your potential mentor has time for you, is responsive in a prompt manner to your emails/calls/texts, and makes you feel that you’re not bothering him/her.

  • It’s okay to have multiple mentors. You may not be able to get everything you need from one person.

The mentor should bolster the mentee's confidence by pointing out their strengths and abilities andencourage the mentee to think out of the box and think big! A good mentor will listen with patience, inspire and challenge, support and cheerlead, help resolve conflict, and serve a role model. They will be available to guide and help the mentee find their own way to success.

-- Oscar Salvatierra, MD, Professor of Surgery and Pediatrics, Emeritus, and former Advising Dean at Stanford University School of Medicine

How to Build a Relationship with a Mentor

  • Mentorship relationships take an investment of time. Even with a busy schedule, try to stay in touch by email every month, and be proactive about setting up a call and/or meeting at least every few months.

  • Discuss expectations up-front for what each of you will be contributing to the mentor-mentee relationship. Clarify how often to meet, how to prepare before meetings, how to structure meetings, and how to follow-up after meetings.

  • Be clear that you value the mentor’s time, expertise, and support and that you will hold up your end of the relationship.

  • Have a general objective or agenda for each meeting.

  • Leave time at the beginning or end of each meeting to get to know each other personally (e.g., relationships, family, and wellness activities).

The better the mentor understands the mentee's goals, motivations, and life in general, the more personalized the guidance provided will be. The more the mentee understands about the mentor, the better they can place any advice received in context.

-- Jason Napolitano, MD, Assistant Dean for Student Affairs at David Geffen School of Medicine at UCLA

Tips for Mentors

  • Be a good listener. Use active listening and ask clarifying questions.

  • Help mentees identify a realistic goal and develop a path to achieve the goal.

  • Help the mentee make connections with other helpful people.

In the role of the mentor, it is important for us to give without the expectation of receiving something in return. That being said, I find the mentor-mentee relationship to be mutually beneficial. It is my goal when I am working with mentees to do what I can to help them be their best possible self and that often means putting aside of my areas of interest to cultivate the mentee's interests.

-- Fatima Cody Stanford, MD, Obesity Medicine Physician at Massachusetts General Hospital and Harvard Medical School

Examples of Helpful Advice from Mentors

  • Engage in meaningful reflection on your professional and personal goals.

  • Try to stay focused on one or two goals at a time, and avoid trying do too much at one time.

  • Avoid needless worrying: It can impede focus, impair concentration, disrupt sleep, and beget more worry. Much of what we may worry about we cannot do anything about, and it self-corrects with time.

My mentor has always tried to guide me towards developing an understanding of the bigger picture when it comes to approaches to health and healthcare systems. I have found this top-down approach of reflection a very useful method of identifying the direction I wish to head. It also gives me a more balanced and humble outlook when I realize that there is so much more that is important than reflecting on oneself alone.

-- Ilhaam Ashraf, 4thyear medical student, Bangalore Medical College

One of my dearest mentors told me to remember that your first job out of residency will most likely not be your last. It seems obvious, but given that many residents are so accustomed to having their work schedules, locations, types of shifts, call requirements, etc. prescribed to them so concretely (starting with the Match!), this idea of having some agency and flexibility post-training can seem like a revolutionary perspective.

-- Iljie Fitzgerald, MD, MS, Assistant Dean for Student Affairs at the David Geffen School of Medicine at UCLA

How to Show Appreciation for Your Mentor

  • Send simple written thank you notes with specific things that you appreciate.

  • Consider nominating your mentor for a mentorship award through your academic institution or professional association.

  • Stay in touch over time and update your mentor on how you’re doing, in work and life.

  • Pay it forward by mentoring those coming up behind you.

Be real, be yourself, be sincere, be honest, have integrity, give it your best, and you will havegreat relationship with your mentor.

-- Ronit Katz, MD, Clinical Associate Professor at Stanford University Medical Center

A Final Thought

You may continue to reap the benefits of a mentor's guidance and wisdom for years to come. Be patient, alert to, and appreciative of the multitude of small and large gifts that arise from mentorship throughout your career and lifetime.

Karen Sokal-Gutierrez, MD, MPH, is a NEJM Editorial Fellow and Clinical Professor UCB-UCSF Joint Medical Program.