Surgical Mentorship and The Mentee to Mentor Transition

For my last AAS blog, I reflected on what qualities define an excellent leader. As academic surgeons, we are all leaders. We lead teams inside and outside of the operating room every single day. In deciding upon what to write about this time around, I wondered to myself “what other daily role defines an academic surgeon?”. I settled on something that became new territory for me lately at my first job – mentors. We function as mentors in various domains – from research, to patients rounds, to performing operations with our trainees. I began wondering what qualities make an excellent mentor, is this studied in the literature, and how does a young academic surgeon make that transition from mentee to mentor effectively? For this blog, join me on a brief tour of surgical mentorship and how to navigate that transition from mentee to mentor!

What is Mentorship?

Mentorship has become harder and harder to define, largely because it manifests in many unique ways. If you ask 10 surgeons you will potentially get 10 different answers. However, it is generally understood to be a series of interactions between a more experienced individual (mentor) and a less experienced individual (mentee) with the primary purpose being the growth and success of the mentee. However, it is almost uniform that both parties (the mentor and the mentee) derive benefits from the mentoring experience. Some ways mentorship materializes in surgery is transfer of knowledge, modeling of operative techniques, conduct of research, and approaches to navigating academic medicine. This is not to be confused with “sponsorship”, which involves the public support of an individual by a person in a higher position because they see untapped leadership potential in that individual. Sponsorship, in contrast to mentorship, focuses largely on networking, promotion, and navigation of complex academic circles. One can mentor without being a sponsor, and vice versa.

How do Trainees View Mentorship?

Several surveys have queried residents’ views of mentorship, what they need from the mentor-mentee relationship, and what barriers may exist in executing this relationship effectively. Resoundingly, residents have responded that they rely on their mentors across multiple domains^1,2. These include clinical decision-making, advice regarding life outside of the hospital (for example family planning, time management, etc.), and professional/academic development¹. As it specifically relates to professional/academic development, residents identified needing their mentor to provide advice pertaining to securing fellowship positions, performing research, and establishing connections with senior members of the surgical community^1,2. From these perceptions, it is clear that mentorship is highly valued amongst surgical trainees.

Surveys have also identified barriers to effective mentorship. One common theme is a perception of serendipity – namely that the connection of a mentor with a mentee seemed to happen by chance. As a result, the “lucky” residents are connected with excellent mentors while others are left behind. Another barrier is heterogeneous quality of mentorship, with some residents perceiving that a subset of mentors are “checking an administrative box” instead of investing in the relationship. In the next section, we will explore how residency programs have attempted to overcome these barriers.

Strategies to Promote Mentorship in Surgical Education

Creating a more uniform culture of mentorship has been a clear focus of surgical residency programs in recent years. A multitude of strategies have been employed to improve access to quality mentorship. One common theme is structured mentorship programs, wherein the residency facilitates pairing of surgical trainees with faculty. This strategy is one way in which programs have attempted to make mentorship more accessible and remove the “luck factor”. In a unique take on this, an academic residency program developed a program that utilizes surveys to match mentors to mentees, matching strengths to perceived needs³. Another university-based residency implemented a 4-week mentorship elective which worked as an apprenticeship model. Herein, a PGY-4 resident was paired with a faculty member of their choice to gain greater exposure to their chosen future specialty and conduct some dedicated research in that area⁴. Despite the short time frame, 80% of the residents that took part in the program completed a significant portion of their research project and developed a stronger relationship with their mentor⁴. Similar mentorship programs have been utilized to facilitate successful matching of medical students into surgical residencies, thus demonstrating that mentorship can be impactful early in the career of young surgeons⁵. Lastly, in the post COVID-19 era it is important to recognize that “virtual mentorship” is becoming increasingly popular. Trainees can access mentorship far outside their institution, and ways to formalize this are in development amongst surgical societies.

The Successful Mentor-Mentee relationship

The mentor-mentee relationship is a coordinated effort requiring input from both parties. An important first step is introspection. The mentee needs to know what they desire to achieve, but not necessarily how to achieve it. A strong understanding of one’s needs and career aspirations facilitates the creation of action items and realistic expectations. Mentees will likely have multiple mentors, each offering guidance in different facets of their career. Mentors must similarly practice introspection. All surgeons have different focuses and strengths. Accepting an invitation to mentor mandates that these strengths align with the needs of the mentee. Importantly, if they do not it is the responsibility of the mentor to guide their mentee to someone who has those abilities.

Once a mentor-mentee pair is established, it is critical that each invests the proper time and energy to promote success. Communication is key. Meetings should be regular. By doing so, the mentor and mentee can dynamically identify which strategies are working and which require modification. Neither can be afraid to shift plans should new needs arise. Ultimately, the success of the mentee should always be at the center of these interactions. For those interested in a more detailed discussion of a successful mentor-mentee relationship, I direct you to a robust review article by the Association of Academic Surgery⁶.

Transitioning from Mentee to Mentor

There is no singular recipe, textbook, or review article which tells one how to do this well. Certainly, it is a daunting endeavor for recent graduates just joining the academic surgical workforce. It is one thing to be responsible for your own career, but quite another to be responsible for someone else’s! In my time spent engaged with the research underlying this article, however, I came to realize that young faculty are well poised to make the transition to mentors from mentees. For one, we are the closest to the processes that generally worry our trainees most (ex. applying to and matching into fellowships). It is much easier to give advice when you recently lived through the same challenges. We also generally have more time than our senior colleagues to invest in the mentorship process as we build our new clinical practices. Good mentoring takes time, and we have this on our side as we start out. Finally, as junior faculty we are often viewed as approachable by trainees; you may be surprised how frequently you are sought after for advice right from the start!

As academic surgeons, we are all leaders and mentors in various capacities. I hope that this article serves to reinvigorate your own personal dialogue and motivations for mentoring the next generation. Take comfort in recognizing that if we always keep the interests of our mentees at the center of what we do, success is all but guaranteed!

Works Cited

1. Myers SP, Littleton EB, Hill KA, Dasari M, Nicholson KJ, Knab LM, Neal MD, Horvath KD, Krane M, Hamad GG, Rosengart MR. Perceptions Regarding Mentorship Among General Surgery Trainees With Academic Career Intentions. J Surg Educ. 2019 Jul-Aug;76(4):916-923. doi: 10.1016/j.jsurg.2018.12.006. Epub 2019 Jan 28. PMID: 30704954.
2. Heeneman S, de Grave W. Development and initial validation of a dual-purpose questionnaire capturing mentors’ and mentees’ perceptions and expectations of the mentoring process. BMC Med Educ. 2019 May 8;19(1):133. doi: 10.1186/s12909-019-1574-2. PMID: 31068162; PMCID: PMC6505175.
3. Ullrich LA, Jordan RM, Bannon J, Stella J, Oxenberg J. The mentor match: A new approach to implementing formal mentorship in general surgery residency. Am J Surg. 2020 Sep;220(3):589-592. doi: 10.1016/j.amjsurg.2020.01.011. Epub 2020 Jan 22. PMID: 31996294.
4. Schultz KS, Hess DT, Sachs TE, Tseng JF, Pernar LIM. A Structured Mentorship Elective Deepens Personal Connections and Increases Scholarly Achievements of Senior Surgery Residents. J Surg Educ. 2021 Mar-Apr;78(2):405-411. doi: 10.1016/j.jsurg.2020.08.016. Epub 2020 Aug 27. PMID: 32863175.
5. Deivasigamani S, Jimenez D, Grenda T, Tholey RM. Implementation of a Structured Surgery Mentorship Program and Success in the Surgical Residency Match. J Surg Res. 2022 Nov;279:97-103. doi: 10.1016/j.jss.2022.06.001. Epub 2022 Jun 23. PMID: 35753107.
6. Nassour I, Balentine C, Boland GM, Chu D, Habermann E, Holscher C, Idrees K, In H, Kimbrough MK, Mitchem J, Warner SG, Karakousis G; Committee on Academic Advancement of the Association for Academic Surgery. Successful Mentor-Mentee Relationship. J Surg Res. 2020 Mar;247:332-334. doi: 10.1016/j.jss.2019.09.066. Epub 2019 Nov 14. PMID: 31733816.