Exploring the Mentorship Relationship from both the Mentor and Mentee

So welcome everyone to today's teach health professions educator series session um today we have exploring the mentorship relationship from both the mentor and mentee with dr charles padgett he is associate professor of surgery at virginia tech carillion school of medicine vice chair for education in the department of surgery and program director for the general surgery residency at krillin throughout the session you'll see sandy dehart putting a link to receive cme and faculty development related teaching credit in the chat box so if you need either of those make sure to complete that brief evaluation and without further ado i'm going to pass things over to dr patrick thank you well good afternoon uh thank you for the opportunity to talk about something that i'm fairly passionate about um i would say for the majority of my um career i was more about being a clinician and a surgeon but i think the last decade my interest is switched to that being of an educator and i think mentoring is is one aspect that my generation really didn't experience in a positive or even a proactive way but that the learners of uh now very much for seeking this out and i think in some ways as faculty my observation is we don't always know what mentor mentoring or the mentorship relation really entails i i was part of a panel a couple of years ago on uh one of the national meetings about this and and interesting i got about a question some um about a year and a half ago from one of my faculty who had been asked to be a mentor by one of the residents and in in this person a lot of people are not as honest but they this person said to me what does that really entail do i need to help them if they're struggling or do i need to work on their you know the areas that they're weak on in terms of educating and it really kind of spurred me to write this talk and and discuss mentoring as one aspect of education and and like a lot of other things that we do that seems to be more on the soft science side how do you do how what makes a good teacher what makes a good instructor i thought it would be a lot of what was my opinion about what makes a good mentor but surprisingly there is literature about uh mentoring the mentoring relationship and some of it uh not even somewhat prospectively as much as you can with this so i'm going to try to use that to guide a discussion and and i hope to uh engage maybe the the audience in this discussion please feel free to interrupt me i i never give the same lecture twice so no matter how practice it is it really doesn't throw my flow off that much and as you see i've got my first slide showing that really i think mentoring and the mentorship relationship kind of comes in the center of the relationship and the teaching experience so i'll get this off the bat i have no financial disclosures and um my target audience i've kind of bolded faculty and i really think this i wrote this more for faculty i kind of secondarily included residents and fellows with the idea that mentorship is a relationship and just like anything that's a partnership or requires one or more people it requires sort of the involvement of both sides and either side not participating really diminishes this relationship and how successful it is so my my interest is in talking towards residents and fellows is how to utilize these ones how to pick a mentor who is uh more what they need rather than the more generic and we'll even go into some studies that show that residents actually don't know very well how to pick the appropriate mentor and finally i kind of put down their clinicians early in practice and this is getting more and more uh pressed that maybe maybe we're not a finished product and i would say say it probably took me until i don't know my early 50s to think that i was some sort of a finished product and the idea that we can um create a mentorship that actually allows sort of people earlier practice to thrive i i would suggest that that is sometimes the least supported and the most difficult part of many people's uh career is probably after medical school probably after residency and fellowship and it probably extends into our first couple years because we have the least guidance in that so goals um we need goals otherwise we can't have cme uh define the need and the value which are two different things of a mentorship relationship describe ways faculty can feel confident this was like i say the the genesis of mine am i providing what the mentee needs am i am i a good am i a good uh mentor and and find strategies that try to encourage this two-way relationship and you'll see i'll continuously stress that this is very much a two-way relationship so um start off with a study showing that mentorship and surgical training this was about six years ago and and really they this one calls out the fact that the business world has been uh way ahead of us in this understanding that a mentorship relationship is instrumental to having people uh succeed as professionals and and this i will apologize most of my literature that i'm gonna draw from are from the surgery world you'll see though i think that there is really no difference though in most of the things that they're measuring and looking at between surgery and any other profession medical profession in terms of the need for mentorship but my my literature is coming from what uh and honestly this came from a grand rounds per um talk i did for the department of surgery and the study also is trying to say what how are we doing and how well are we doing it and as you might imagine the answer is not that well remember this is less than a decade ago so outline for my talk i'll try to define what mentorship is try to wrap my hands around that try to explain the why and and i would say this is probably more intended for my generation because a lot of us did it without quote a formal mentor and why does this generation need it when we didn't and i think the answer is truly that we probably could have used it we just didn't know that talk about the things that really make a good mentor and the tools the talents you can utilize to do that i'm going to move on what's called the mosaic model this acknowledges really that the idea of a single mentor as a solution to every mentee's problems probably is not realistic and probably uh isn't what we need to strive for more things to how to select the right mentor and then some of the things that they we talk about special problems in mentoring um and this often has to do with do we have the right mentor in terms of gender uh maturity um uh clinical interest in that match our mentee's interest if we have time i'll talk about a few case studies in terms of the people that i've interacted with and to kind of illustrate that i probably won't get to that so we have to start out with history where did the word mentor come from um for those people or not um uh greek uh mythology uh geeks uh remember the iliad the odyssey were two of the most important uh literature for the greeks iliad basically the trojan war and the odyssey was ulysses or odysseus uh same person greek as opposed to roman trying to get back to his home island which took him 10 years so as odysseus was going to leave he had a young son odysseus was a king and he was going to entrust the raising of his son to somebody and that person was his name was mentor how we get the word mentor or mentorship interesting enough just because that's what greeks did you could have a god or a goddess essentially manifests as a human form and it's interesting that the person that he chose was the goddess of wisdom the goddess athena so mentor was supposed to be someone that brought wisdom and understand that the greeks measured intelligence and wisdom is different so i think that was one of the things i took from this little story um so i'll start out with two quotes more because it's easier sometimes to describe a quality than to actually define it this one from a surgical article it talks about a tool if we think about education as utilizing tools be that that the reverse classroom small group discussions these are all tools curriculum this is outline of the knowledge base mentorship is really one of the tools that we are going to utilize to help them develop skills they need and i think the big word in that first choir is the success and it includes i highlight aspects of both their professional and personal life once again why my generation is still trying to figure it out is we really didn't understand that our professional life it was often determined by how successful we were in our personal life and we we probably over emphasize the the ability to succeed the ability to take care of patients and and and why we have the issue with wellness so mentorship speaks to both of those a second quote is a lot more um from a more philosophical standpoint what by this buddhist writer it talks about um staying true to your vision uh or path and i think that many of us have been doing this for more than a couple of decades understand that the path we took and the path we thought we were going to take really two different things and i think one of the things is to convey to these these young physicians is that what they think their path is and what it may be are two different things and it also talks about um to for a given mentee to perceive their own weaknesses and and we aren't taught to process our weaknesses or confront them and allow that person to succeed essentially on their own terms in terms of what they want to get out of that and so i come back to a mentor he is very different than an educator and very different than um some of the other roles we take in medic in medicine in the teaching roles mentorship has a specific place within that so why mentorship once again maybe not so much for the younger people because they all seem to crave and want that in the same way they crave in one feedback well there's been number of studies showing that it's fairly integral to number one well-being not surprisingly uh productivity and job satisfaction and those seem to be sometimes things that pull in opposite direction in other words the most the person the physician who's the most productive often sometimes doesn't know how to say no and their own well-being and job satisfaction uh is at risk and one of the ways is mentorship how you define what you see as a job satisfaction will allow you to do both of those i reference an article there that shows that it has been shown to decrease stress and burn out and and they even have qualified the areas of um word out that they think that the mentorship role specifically addresses uh emotional exhaustion depersonalization and and really at the end of the day a big thing is i think personal accomplishment and if we can get over that um wellness becomes a much um easier not to crack and finally uh preventing attrition so we'll go into this a little bit more there's two studies that i've gotten about this uh actually the one from dr freischlag dr freischad is a vascular surgeon who's now the ceo of the wake forest medical center and she's written a fair amount about uh mentorship and and its role in attrition and she's been actually our guest in in the past a charming woman who has accomplished pretty much everything in medicine and now looking back sees the mentorship role as vitally important and what i'm going to i have some numbers about this now we're going to dive into not chuck padgett's opinion but hopefully some of the other things how does it really change attrition and this is the paper it's i i think it's about four or five years old um here's the the take though that they look back three decades um and i can tell you there's probably little mentorship two decades ago in surgery that was effective or universal an attrition rate imagine that at 18 that's one out of five people coming into your program leaves for some reason or another doesn't mean they need leave medicine doesn't mean they uh they don't even necessarily succeed in surgery but they left a program to me that's pretty horrible and it showed that's maybe a little downtrend in the last decade but it didn't even reach significance not surprisingly there was a great variation and that would be a program to program variation i am sure um a couple other things that surprise is nobody who's been doing this for a while most attrition is in the first two years more in the first year it disproportionately affects female surgeons and which was significant and essentially they listed the reasons as an uncontrolled lifestyle and they were looking for a change in specialty why most of them left to me this is a uh a missing opportunity to educate people and train them and establish them in a career that they may be outstanding at but we just weren't flexible enough to accommodate them i threw in a couple of sides which i found this interesting article mentorship of our surgical interns are we failing to meet their needs the other thing i found about interested about this is it not only shows that we we may be failing their needs but they may be making the wrong decisions and as medical school uh educators we may be emphasizing the wrong people that they should be seeking as mentors so let's dive into this a little bit more um so in this study the the interns were allowed to pick faculty member for um their mentor they didn't have to know they weren't assigned them and we'll talk about our system in a little bit but they were out they were allowed complete current launch and who they would seek out was the senior faculty for their career planning that they would seek out junior faculty to describe work life integration and and very few of them did they feel like the relationship was ever assessed as was it positive negative of other words um only one in ten which seems like horrible disgust work like balance even though that's the thing that clearly drove more people out of the specialty in the other study 30 percent said they wouldn't admit if the red relationship was failed um that's also not surprising to me given my experience i've had to separate pairs before in the past that i didn't think was working but neither one wanted to give up and a fair significant amount we're not given the option for a new mentor if the person didn't work out also from this study they asked interns what do they think the most important challenge they would face in their uh in their transition from medical student to intern and and the first one balancing work with life is probably a very valid one managing pre-existing relationships figures heavily into that adjusting to the rigors of the surgical trainee and then you see the other things kind of fall off and surprisingly to me they didn't work at worry that much about picking the right mentor which will show that they probably should have okay now here is how they pick their mentors the gender uh was often emphasized and there's probably some pretty good reasons for that we'll talk about that a little bit ethnicity really didn't come into it very much the one that bothers me as someone objectively reading that is the one that says their current career status or prestige meaning they chose it based on how well known their mentor was the more prestige to a more senior surgeon who had more of a regional or national reputation often drives their selection and age probably meaning they look for the older faculty rather than the younger though it doesn't say that exactly now look over there at the far right just before surgical specialty reliability the least important they thought and i will argue as we go on that an unreliable mentor is virtually useless and despite this this is what one of the things that guided how they did it as long as the person had a big name and was prestigious the reliability didn't seem to matter to them so this is to me something we can teach our students that if you're picking a mentor their ability to engage their willingness to engage reliably is probably much more important than their prestige factor okay moving on to qualities of a mentor i love this quote confidence confidence commitment i would suggest like the other ones the three a's of practice the last one is probably the most important uh murray brennan is a well-known uh cancer surgeon out of new york uh probably i think at md anderson or who is he talks about a mentor being as truly colorblind politically so and i i think to maybe expand that um the idea that as a mentor what your mentees drive and focus it has to be what yours is rather the other way around um hillary santhi talked about a mentor is ideally a step or often two ahead and and i think this is i like the inference the step is a little bit hard does that mean a fourth year resident is a step ahead of the third year resident uh probably not is a faculty member the first three years a step ahead from a resident probably yes um but we the what we'll talk about is perspective and the the farther ahead you are the more perspective that you can lend the downside of it is maybe the less you can identify hillary also talked about the uh dr stampy also talked about successful relationships you can see them there but i would describe those as a somebody with a high emotional intelligence um and somebody willing to engage and give of themselves and and there's no doubt about it that a mentorship is not necessarily a if you're really going to truly engage in this it requires some commitment other things um other people that have weighed in on this the empathetic traits are more important than the role model i think that part of being a mentor is to be able to exemplify the things that you talk about if you're somebody who does not really live the life you talk about i think that's a little bit of problematic but this one would suggest that the empath the empathy was probably more important than the role model um i would emphasize the next one more than a teacher or counselor or certainly more than a preceptor coach i actually like the best but i think of a coach as something very different than maybe i think that coaches is if you're talking about coaching a world-class athlete there's a number of different things that you're trying to work with them for in terms of their their goals their attitude things around them so maybe that's the closest one um uh two other people emphasized the two-way relationship and carlos pellegrini talked about being both the guardian and the promoter and and i think that's um especially at a young faculty member that you you talk about that but that also becomes for residents and fellows also um and one this is another paper um without reading all these they start to you start to get the idea um you talk about being compassionate kind but also to be an evaluator assessor and a critic a fair critic and the last one i would disagree with a leader in the field and challenges the mentee i have no problem with the challenges the mentee i think that's an important aspect of being a mentor [Music] but to be a leader in the field i think that's where we get into the idea that to be a mentor you need to be some sort of nationally known figure rather than being able to put in the work so i would disagree with part of that [Music] i think that the things that really helped me be a mentor is experience um humility to embrace my own mistakes and share them uh honesty to tell them what i think even though that may not be what they want to hear and to always emphasize that there is um usually a way out of this that they probably have not necessarily considered [Music] so couple of years ago i did a course that's called surgeons as educators but on the american college of surgeons and and noticed they didn't say teacher surgeons as teachers teaching is standing in front of a classroom or putting together a curriculum or teaching an exam or how modeling different that is that is the teaching part education looks at a much broader idea of how to manage the process and what i found for being a program director now for about six years is mentorship is one of the key things that i do yes i still teach and give lectures but other people can give those lectures quite honestly i fill in the ones that nobody else wants to do um i organize and that's probably an important aspect of what i do and i also um problem solved and do a lot of documentation to keep the program uh still certified and able to do that but if you ask me at the end of the day what my role is is i'm a professional mentor uh to a large group of people and that's what i do so these are the things that i think about whenever i am trying to put together um how to help people be a mentor um direction support goal setting goal resetting normalizing behavior understanding things that have happened outside the the everyday classroom are all very important so i put down there what the cost i say this is this is not something if you agree to do this think that you'll see somebody twice a year and that'll be good enough that may work out for certain relationships but i i talk about and i think about needing to have the commitment to spend time and this does take time because it's a relationship it initially requires some selflessness meaning it takes time that i'm not getting compensated for and oftentimes or sometimes after hours or times that i'd rather be doing other things i have to be adaptable and think about how people are going to react to things different than i may have reacted and i think the openness is key i think you have to be honest for people to really buy into any relationship i think that one of the things i think about when i'm sitting down is residents students and and many of us we live in the moment and what seems like it wouldn't work or is a very immediate reading of that information around us rather than saying well whether you take off one or two years for research or you come back after delivering a child and spend an extra three weeks at home in the end of the day at the end of 10 years one month is not going to matter at all but in the moment it seems like i've already taken off plan to take off five weeks for a new child how can i take out eight perspective i can give them that that the end of the day what really mattered uh how pressing are these things um i think emphasizing the positive i've said it a couple times it is i think people i find this a lot that most highly committed and very driven people tend to look out in their failures rather than their successes so one of the things about mentorship is simply redirecting people to try to give them a bigger sense of their accomplishments and reinforcing the progress that they've made and the other thing is there's you're gonna you're gonna have to navigate the negative um as as these young people come up it seems that they're more and more that they're navigating illness and death in their family one of our residents last year lost their brother sort of sort of mid-covered time that was a very difficult thing and required somebody to navigate the negative with them um and that is part of the job and i and i think it's one of the more rewarding things because helping anyone out from a difficult time is very rewarding um i'm going to switch gears a little bit hoping to finish on time um this is i found and i was doing my reading a couple years ago before presenting someone said the mosaic model and i'm like okay what's that the idea that any one of us should and can serve as the sole mentor for any given person is probably overestimates our ability i've had a number of female mentees but for have a female mentee and say how do you work out managing a pregnancy during reagan's residency i can give them facts about the different ways to take time off that are congruent with the acgme i can give them experiences of other residents but i certainly cannot talk about the physical changes the tiredness and how to manage that and they'll be much better served by somebody who'd actually been through that process personally than me but it doesn't mean that we can't combine to uh advise that resident to a specific issue and it's it perhaps one mentor is the person is more about research the other one is helps you navigate work-life balance the other one can speak more to the professional aspirations you have surgery like a lot of the basic residencies now very few people become general surgeons they do a fellowship and identify as a colorectal surgeon surgical oncologist acute care surgeon vascular etc and the tendency is for people to seek their mentor in the specialty that they believe they want to do which i don't discourage but i tell them that's probably not the most important thing because eventually you need a mentor in that specialty but your main mentor may be somebody who more understands you and the fact that you can add on pieces or tiles to your mosaic as you need them shoot something you do really throughout your career and what you need as a second year resident as opposed to that person going to their fellowship as opposed to person signing their first contract maybe very different people i think it realistically addresses the fact that very few of us are exact matches for people and i would i would argue that this occurs naturally so within our program actually i'll i think i'll mention that here in just a second but the mosaic model i think still speaks realistically about how we put together a web of support rather than a single poi of support and this becomes important if your mentor then decides to leave the institution or various things which we've had in the last couple years from the people who've been really good mentors but decided for professional reasons to move to a different city then it becomes important that you have multiple layers to back you and support you during that time um and i and i think i alluded this like there's a lot of different roles that a mentor provides and you may not be the right person to provide all of these and that's okay as a mentee that you need to put together more like a panel of people rather than a necessarily a single person one person may be able to give you really good advice on what they've seen but they may have very limited view in terms of providing a personal perspective on that um and i i think about this as once again putting other pieces together as a to make a whole ah and this goes into our next section how do you choose a mentor um i would suggest a common interest or goal and often outside of medicine is actually one of the ways you can anchor the relationship because you can understand the same value so if you are somebody who as a resident who's married has several children several children somebody who's also married to have a single childhood may be able to give you a very good viewpoint despite the fact that they're a vascular surgeon as opposed to you want to be an acute care surgeon i think you identify maybe you're both into some sort of fitness activity and it creates a natural bridge it's a personal fit it's not a collecting of prestige one article i read suggested how you can test out your person as how the match is start off smaller with i have a question i'm going to go to this person and see if they will meet with me and give me advice about a specific item and so that meeting goes well and you say that actually may be the person that i would like to take other things to or it may not go that well that person may be it's hard to engage them they're not really giving you um tangible advice maybe seek somebody else out that may be a way that you can identify who who really suits your needs emphasize the different mentors for different tasks and and understand that there's we talk about a formal mentorship program but i try to emphasize uh to our resident group that there's a number of informal mentorships and that sometimes is a senior resident or just somebody who's been through something that you haven't been through and they you don't have to necessarily create this formal relationship these are actually fairly organic and how they happen final one i mentioned for people especially as they finish their residency go into practice or go to a fellowship in a different location there's no reason that the mentor has to be that person that is you see every day in fact sometimes somebody that you have to make the effort to talk to them maybe better because it becomes more intentional i can tell you one of my faculty i've known for at least eight years when he makes decisions about um life choices he always calls back a person that was his fellowship director to discuss them with him and it's something that i i've never done but it's a very thoughtful way of doing it it's somebody who he's been able to trust their advice and even though he doesn't see them every day he knows that this person when he wants advice for a specific career planning this is where he wants to seek the advice i wanted to talk briefly about our um what we've utilized um when i first was here uh there was no mentorship model at all and then prior well prior to me becoming program director associate program director my program directors decide that everyone would have a faculty mentor and as as residents matriculated they were assigned to a mentor and i actually had a couple of people that i picked up and it was a really good relationship but i would suggest that that is that was more luck than um and good fortune rather than something i would suggest is the best way of doing things what our present model is we assign people coming through the door to either myself or one of our two to other associate program director and really about march i start suggesting to them to look to transition to somebody else it's not unusual for the resident to want to stay with the person that they identify with because i would say both myself and associate program directors uh one of the reasons we do what we do is i think we do that fairly well and what i have moved to over the last last five years is i tell them they need to pick a second set for one the reality is they should always be able to walk into my office and let me serve in this role and quite honestly our associate program directors and i'm purposefully trying to get them to develop a network of mentor rather than a single one so that's purposeful and and thought out as a way to do that but try to limit the number of mentors to mentees otherwise people tend to flock to one person rather than trying to develop relationships in others we really made all available core faculty to be mentors and sometimes i get who would you seek out and i will suggest a few people um i we you allow people to change their mentor in fact i've been more often to suggest it than uh residents have been because residents tend to make the best of the situation and sometimes that's not really the ideal um way of doing that and some people are just afraid of offending people and i've gotten into a few over over 50 of these i've probably gotten involved in two or three where i just said it just was counterproductive two people were just two alpha it just didn't work out and i thought it would be a similar personalities and it turned out i was right just too similar um and so there's various ways to work around this um i would go back to those initial studies saying that residents don't necessarily always pick out the person that is most suited to them and i try to give advice and guide this process and once again make it flexible should it not work out um i wanted to talk next about what's the responsibility on the mentee side and i think the big things is is one of them is to drive the making appointments and don't and not just i saw the person in cafeteria and we talked for five minutes i actually uh identify a time to meet prepare for the meeting so that you have a list of things that you want to talk to with your mentor and in the same way of being respectful of the time by organizing it i think it's like for all adults not all relationships work out and be an adult enough to understand when it's not um seek the appropriate mentor and i and i've actually found that residents are pretty good about this i've seen a lot of senior residents when they start to look at jobs usually have shocked it by two or three different people to um to see what what their response is um follow through you know if you say you're going to do something you're going to get back with this person you're going to uh this works on both sides but please do follow through and the idea of just how's it going going well that's not a very useful meeting um as opposed to a couple of mine when they have major um forks in the road i have one of my residents who's taking two years off to do an education fellowship and a master's and the opportunity she had planned to do this uh really before she entered the program between her second and third year and she an opportunity came her way that she could extend this to two years that she could join a and actually have it funded and and when it presented to her she very carefully said i'm going to think about it i'm going to talk to my husband and i'm going to talk to my faculty mentor and and then got back with me which i thought was a very intentional way of just scott working with your mentor dr so and so i have this question when do you have time to discuss this i think this is the way this is the ideal person utilizing the relationship to help themselves um i think that and you'll see this is my identification of why or where things are useful uh in medical school i think mentorship is identifying what area you're going to succeed in and facilitating this this transition which i still find to be one of the most different the difficult things in training uh young physicians and and really providing support during this phase of transition and struggle sometimes especially with the match and this last year has been a very interesting year for those people in the mentorship role later in residency it's often about career plans or fellowship tracks and i think also in a longer term sort of thing personal issues become a big thing how do you respond to things outside of work marriage children illness in the family all of these things are ones thing something you want to leave open and become a big part of and i think you also become that person addressing sometimes burnout depression this is i'll emphasize you you're not supposed to diagnose this you're not supposed to offer treatment you're supposed to offer support and perspective which is something that we can offer not necessarily specific help for that but perspective of other people that you yourself have gone through or that you know of colleagues have gone through and seen the other side i think that's very important and early in practice i think it's negotiating the job demands the more long-term goals and really the same two things you see in residency the personal issues and the support because it becomes more of an issue i think going on within that time getting close to the end i want to talk about some challenges in mentoring for surgeons we recognize for a long time that women have more of a difficulty finding appropriate mentors simply from the reason that at the more senior experience level that there are fewer women in those roles that is changing of course but it still is a bottleneck and there are fewer women that can serve as faculty for the women in in training and there's actually literature on this they would suggest that women [Music] actually have a poor relationship it's with a man as opposed to a woman though most of them will admit that's a very that seems to be uh relationship specific i would i would give you our own program since i allow people to do this i'd say about half our women choose female attendings and we do have enough that they can be supported in that way a lot of them do very well with the male attendants but i think that assuming that that is always going to work is not necessarily i think being aware of that challenge um when i was taking individual mentors actually all of mine were female for whatever during that time and i think it as a male to do that it requires just a different viewpoint but i would also tell you that in our program we've actually had a number of the male residents who sought out the female faculty so hopefully that's one of those things that one can move beyond gender to just simply understanding and an emotional intelligence will allow you to do that um the diversity representation in faculty is not always what we want to make available to our residents and that's a bigger problem and i can tell you having tried to address that that does become something that is not always conducive to creating every mentor that the exactly perfect mentor i think acknowledging it and trying to expand that group is the most important thing but that's going to be a challenge um mentors for international graduates is both two-way two-fold there's some cultural barriers that that person's values may not exact or life expectancies may not be exactly what mine are and also the language barrier also plays a role in that and there's been literature regarding that difficulty supporting that group of trainees and learners and i put in a quick thing about the difference between diversity inclusiveness i don't think it's really necessarily i always put this one in take it out it's a good thought i'm not sure if it makes it into this talk exactly um so i'll finish up i'll try to close with um the take homes for mentors you're trying to get your mentee to see the bigger picture not where they're going to be in six months but where they're going to be in five years and and you're trying to allow them to see past the the short term issues that they're going through to see where there are long term and and if where they're heading now is real wherever they really want to be um you have to be remain value neutral meaning if you are somebody who truly values for instance being an academic clinician and they really don't while it's okay to point it out you have to support them in a way that supports what their vision of their practices rather than what your vision is you need to be positive but honest and sometimes the honest thing is to say this particular part of the profession that you're thinking of going in this is the type of hours that you're going to look for and this is not going to change that much as opposed to certain specialties outside of general surgery have met much more controlled hours after residency that's a welcome change but how they um to be on to tell them that you're going to finish your cardio thoracic residency and it's going to be very nine to five is just not very accurate or very helpful so whereas and then you say is this what you really want or is are you just going to make it through residency and fellowship and then feel like you need to have more time available that you have you've been putting things off for so honestly a positive message support what they want but be very honest in terms of what their choices are well finally this is my bibliography uh it's been like i said it's i've tried to make this a more literature-based and most of these i understand are some of them are available on the american college site i'm happy to provide any of these articles if anybody wishes them and thank you um looking forward to fall and the temperature going down i'd be happy to take any and all questions thank you so much dr padgett um if there are any questions feel free to unmute or you can type a question to the chat and we can relay that for you either way feel free to speak up or raise your hand well dr paulie says thank you very thoughtful so we have comment no questions yet and um dr padgett's a recording of this session will be posted on the teach site within the next couple of days along with on the slide so the bibliography will be available there if people want to reference any of that material dr music says excellent presentation thank you thank you from zoom land exactly i think i'm using the office and the downstairs of community hospital that recently had to be evacuated because of water leakage so if it looks like in a cell we're in the middle of nowhere it's because i'm in this in the middle of nowhere uh dr skolnick is wondering where you got that beautiful photo of krillian this one at the end i think that's what he's referencing yes i'm happy to provide for you i think i got it from the internet one time [Music] it is quite lovely it showcases the fall uh colors quite nicely taking this on the road i i think we get to work in an incredibly beautiful place and just to let people know what roanoke uh so this has been a slide i've used for a number of years whenever i um leave roanoke to let them know what what why they should come back here [Music] it looks like it's it's that cold after school metric only dated from the fact that the medical school looks like it's built in that photo i don't think that the new building is that's the most i can tell you um and dr paulie has a comment she said you mentioned coaching a sponsor is another important term a sponsor is someone who puts his or her reputation on the line and is visible a mentor can be behind the scenes yeah so yeah they've talked about i think this is very much about um faculty and they and how you can be a sponsor as opposed to a mentor the mentor is the one who talks to you about hey um there's there's some here's some places that you might want to consider whether the sponsor like volunteers you or say i need a faculty member to be on um to participate or give a talk or something like that and the sponsor says you really ought to take a look at this person you can be but they are separate ideas and you talk about especially in the early mentorship and sponsorship of faculty i think that becomes really important um i think we um what one of those is that you may want to as you're mentoring say a resident and they want to go into something that you don't know but what you can do is send them to somebody who can sponsor them and and your role is kind of did you know there oh you wanted to go to east carolina did you know that dr music spent a number of years there for instance and he and and we and that becomes a very important thing too um it's interesting what i found a lot of times what people thought mentorship was they were gonna they were personally gonna solve all the problems so you were going to be the one who sat down and went you you're struggling in this area of your education i will fix that i'm like that's why that's nice if you do that's not really what you need to do what it's more reflective for the resident or learner you are struggling in this way how do you think that there's ways that you could work on that what are things are available as opposed to necessarily providing them with the answer and then another uh question from uh dr music commenting question uh there is sometimes confusion between coaching and mentoring and i know you talked about coaching a little bit with some people using the terms almost interchangeably can you comment more on the difference so i think in terms of coaching you really have a specific issue that you want to work on and it may not be necessarily i think a lot of time as a mentor while you can recognize that you can't don't have the skills necessarily do that well say i've noticed when you get up you're not a very good public speaker you tend to fumble that's the mentor's role now there's a place i can send you for coaching on this aspect and i've used a lot of times eap for a number of different coaching strategies for residents i i can help identify it the need for coaching but i don't provide the coaching necessarily so it's more of a holistic look um whereas coaching as we usually do we think of some skill that needs to be developed it's that can be by active intervention be improved and i think of that as coaching um i differentiate i think sometimes a i i i have seen people that in the role of the term coach who really are mentor and they may do both but in a professional sense we think about coaching as a specific skill development as opposed to recognizing that you you know or reflecting with the learner hey i really seem to struggle when i get up to present i get very nervous have you considered that you i think you struggle as a public speaker yes i've never felt comfortable with that what if we develop that and then you'll feel more comfortable when you're dealing with that uh and not being the person who actually okay where can i find that and sometimes as a mentor i don't know but here's where i'd start looking um and so that's i think the difference wonderful thank you dr padgett um i haven't seen any other questions come in but it's usual to for the mentees to select a mentor any idea on the other way around the me as a mentor you look around who's in your team like residents fellows and then select somebody to mentor that you think that probably i can seeing this person interacting with it for a period of time i can certainly guide this person in a certain direction um i think part of it as a professional the reason i think we emphasize usually the mentees selecting that is you're hoping to um develop this independence and and a way to for them to feel who they feel comfortable with i think that however that happens a lot what you're describing is people will reach out to certain individuals and they won't necessarily identify that as relationship they'll just safely say hey if you ever want to talk about this aspect or that aspect and often we reference commonalities we i came to a similar i think experience from what i know about your experience i came from a similar experience i think i might be and you can certainly extend that invitation and i think that's a very positive thing what you want at the end of the day is the person who has less power in this relationship to hopefully identify that you're the one that they want to work with but i think or they may not know about your your own pathway as a mentor i may not know that this person also went to a very similar pathway because we don't necessarily advertise our pathway i i came from a different profession i came from a different country i had to go through these things and i see i know that we matched you and i know that you've had a similar pathway i think i could be give you some perspective i think that's very appropriate um because like i said they may not know um the uh what you have to offer so i think that's very appropriate all right so i think we're actually out of time for today but thank you again dr padgett mentorship is such an important hat worn by educators and you've given us lots to think about as we approach that critical role.