American College of Physicians: Internal Medicine — Doctors for Adults ®

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More than a mentor

Coaches play key role in helping physicians map out careers

From the January ACP Hospitalist, copyright © 2010 by the American College of Physicians

By Janet Colwell

Kimberly D. Manning, ACP Member, was at the airport about to catch a plane bound for a medical conference when she got a call from her hospitalist colleague and mentor at Grady Memorial Hospital in Atlanta. Could she analyze a landmark article for a widely circulated physician newsletter? And, by the way, could she have the draft ready in three days?

Dr. Manning, a general internist at Grady and assistant professor at Emory University School of Medicine, balked at the quick turnaround, but her mentor, Neil H. Winawer, ACP Member and director of the hospitalist program at Grady, wouldn’t let her back away from what he saw as a golden career opportunity. So she got out her laptop and worked between meetings and on the plane to complete the draft on time.

Neil H. Winawer, ACP Member, and Kimberly D. Manni...

Neil H. Winawer, ACP Member, and Kimberly D. Manning, ACP Member, of Grady Memorial Hospital in Atlanta



“When [the issue] came out I was really glad because I got calls and e-mails from people who were talking about my article,” said Dr. Manning, who is also the residency program director for the transition year at Emory. “It involves some tough love sometimes, but Neil knows when to ignore my excuses—he won’t let me ride on what I’ve done before.”

Mentors like Dr. Winawer play a crucial role in helping less experienced physicians develop their careers. Unlike traditional research mentors who guide specific projects, these mentors are more akin to coaches, helping their mentees navigate the system and leading them to other mentors in specific areas, such as research, administration or teaching. A good coach can provide needed perspective and guidance to younger physicians struggling with career choices.

“A coach is someone to draw them out and say, ‘Okay, what are your goals? What do you want to do with your life? Where do you want to be in five or 10 years?’“ said Robert M. Patrick, ACP Member, a staff hospitalist at the Cleveland Clinic who is helping put together a formal mentorship program at the clinic’s Medicine Institute, which encompasses the departments of hospital medicine, internal medicine and related specialties. “You’d be surprised at the number of younger physicians who have never really thought about those questions.”

Kindred spirits

Shared interests are a common thread running through many successful mentoring relationships, but those commonalities aren’t always apparent on the surface. In fact, physicians who have been through the process recommend finding a mentor or career coach outside of your department or specific research interest.

Vineet Arora, FACP, was the attending physician on inpatient service at the University of Chicago Medical Center when Valerie G. Press, ACP Associate Member, began her internship in 2004. They hit it off immediately and soon discovered a mutual interest in health policy.

Mentoring began on an as-needed basis, then evolved to a more formal arrangement with regular meetings and check-ins. Dr. Arora encouraged Dr. Press to become involved with ACP, nominating her to the Council of Associates when her own term expired. She also helped guide her to a research mentor and encouraged her to apply for a grant from the ACP Foundation, which now funds a community project to improve asthma care in Chicago led by Dr. Press.

“Vinny has done everything imaginable. She e-mails me all the time to point out interesting articles, grants, etc.,” said Dr. Press. “I come to her whenever I’m undecided about what should be my next step, what should I do today about this problem.”

The successful pairing would probably not have occurred if Dr. Press had confined her search for a mentor to colleagues with the same research or clinical interests, Dr. Arora noted. To find the best match, she advised, “reach outside your comfort zone and find people in your institution who are doing projects in areas that you’re interested in.”

Similarly, Drs. Winawer and Manning may not seem like an ideal match on the surface: She’s a generalist and he’s a hospitalist. But their mutual passion for teaching has proven to be a stronger bond than their clinical specialties.

“You don’t have to be a carbon copy of each other to have a good mentor-mentee relationship,” said Dr. Winawer. “Teaching and professionalism and making our mark with residents and students is where our roads intersect.”

The two physicians, who work on the same floor, started collaborating in 2004 and formalized the mentorship the following year. At first, Dr. Manning didn’t consider Dr. Winawer to be her formal mentor because their research and clinical interests weren’t exactly the same, but that soon changed.

“I had an ‘aha’ moment when I realized that what I’m really passionate about is teaching and that Neil was absolutely a good fit for that,” she explained. “He was a very successful teacher and there (are) a lot of qualities in him that I would like to emulate.”

Coaching for success without defining it

Just as mentors and mentees do not have to mirror one another’s interests or specialties, a mentor should not try to remake the mentee in his or her own image. Instead, some mentors advise modeling yourself after the professional sports coach who aims to bring out the best in each player for the ultimate benefit of the team.

“What you want to avoid with any sort of coach-player relationship is the ‘Batman and Robin’ scenario where the mentee is in the more senior person’s shadow,” said Daniel J. Brotman, FACP, director of the hospitalist program at Johns Hopkins Hospital in Baltimore. “A good mentor should figure out what the junior person can do that is unique, that would give them a niche—and that isn’t necessarily just like what you are already doing.”

Ideally, a coach should encourage the mentee to do something complementary to what he or she is already doing, said Dr. Brotman, who has spent the last few years as a mentor-coach to Leonard S. Feldman, ACP Member, a staff hospitalist and assistant professor of medicine at Johns Hopkins University. “There should be a sense of individual responsibility and ownership on the part of the junior person,” he said. “If all you’re doing as a mentor is inviting someone to participate in things you’re already doing, you’re not going to foster their independence and growth.”

To that end, Dr. Brotman stepped back into an advisory role after asking Dr. Feldman to become director of education for the hospitalist service.

“Dan could have done that on his own easily, or he could have given me the job and still micromanaged it, but he gave it to me and let me run with it,” recalled Dr. Feldman. “You need to know that you have support, but you also need the freedom to make your own decisions. If a mentee isn’t given enough room, the relationship becomes stifling and not nearly as productive.”

Perhaps most importantly, a good mentor has no ulterior motives and is truly interested in nurturing the younger physician’s career, Dr. Winawer said. An atmosphere of trust encourages the mentee to try new things without feeling pressured.

“As a mentee, you hope you have someone who’s altruistic, who’s doing it to benefit your career, not their own. As a mentor you’re looking for a self-starter that you will help guide in the best direction,” he explained. “You can’t make something work that isn’t a good fit—it ends up feeling too formal and forced.”

Extending the sports analogy, Dr. Brotman advised mentors to direct young physicians’ drive and enthusiasm into areas that benefit the team as a whole.

“Lenny has boundless energy and is interested in a lot of things, and I wanted to encourage that,” he said of Dr. Feldman. “I saw in him someone who would grow in leadership, administrative and academic roles to the benefit of the entire program.”

That kind of encouragement can lead mentees to develop skills that had remained hidden, even to them.

“When I first came to Hopkins I told our division chair that I would never do any research and that my academic niche would be education—not publication,” said Dr. Feldman, who is now an associate editor for the Journal of Hospital Medicine. “But Dan harnessed my interest in evidence-based medicine and pushed me to write review articles, and participate in research projects. I didn’t have a conception of myself as a researcher so it was good to have someone saying, ‘Yes, you can do this.’“

Playing matchmaker

That’s all well and good, some younger faculty might be thinking, but what if you’re not lucky enough to meet your ideal mentor or coach at the right time in your career?

A new program under way at the Cleveland Clinic set out to address that issue. As a young staff physician himself, Dr. Patrick noticed that while he needed mentorship in a lot of different areas, what he needed even more was a coach to help him navigate the entire mentorship process.

“A critical piece for our hospital medicine and primary care docs is having someone whose role is to formulate the questions and think about how to approach the mentorship process,” said Dr. Patrick. “The idea is that the coach brings the mentee in, draws them out, figures out what their goals are and helps them navigate their relationships with all of their other mentors.”

Andrea L. Sikon, FACP, chair of the Cleveland Clinic’s department of internal medicine, sought out Dr. Patrick’s input as she began coordinating the clinic’s first formal mentorship program for physicians almost two years ago. The program is innovative in that it has mentees choose a career coach in addition to other mentors tied to specific projects or interests.

Under the new program, which is voluntary for physicians, potential coaches post “matching statements” highlighting their interests on a project Web site. Mentees are free to interview several potential coaches and choose the best match, the only requirement being that they choose someone outside of their direct chain of command in order to ensure impartiality and foster trust.

Adding structure “levels the playing field” so that finding a mentor isn’t just dependent on luck, said Dr. Patrick. “Older physicians often talk about their mentors and the great experiences they had, but a lot of those people just got lucky by being in the right place at the right time.”

A formal process recognized by the institution also makes it more likely that senior physicians will engage in the process, said Kathryn A. Teng, FACP, a staff physician in the clinic’s department of internal medicine who recently teamed up with a career coach. “In an informal setting, there is very little incentive for one to be a coach because this is a huge time and emotional commitment,” she said.

Dr. Teng, who joined the Cleveland Clinic staff three years ago, said she was looking for a coach, preferably a woman, who understood the politics of her field and could also advise her on balancing career with family. She’s not sure exactly where her career is headed but knows it needs to evolve and hopes her coach can help her focus and plan next steps.

That’s how the program is supposed to work, with the coach helping the mentee “self-define” his or her goals, noted Dr. Patrick.

“We wanted to create as much structure around the [mentorship] process as we could,” he said, “but we also wanted the mentee to own their success, not have it dictated to them.”

Janet Colwell is a freelance writer based in Miami.

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Mentors help UCSD with retention, research shows

A successful mentorship program not only helps younger faculty with career choices but can also be a valuable retention tool, according to research done at the University of California San Diego School of Medicine in La Jolla, Calif.

Researchers set out to determine the impact of UCSD’s junior faculty development program, launched in 1998 with the help of a federal grant that designated the institution one of four National Centers of Leadership in Academic Medicine. A central piece of the seven-month program was a formal junior/senior mentoring relationship focused on a professional development project.

The study, published in the January 2009 issue of Academic Medicine, found that participating faculty (839 assistant professors hired between 1988 and 2006) were 67% more likely to be promoted and remain at UCSD than faculty who did not participate in the program. Besides adding to UCSD’s reputation as an attractive place to work, the findings indicate a positive return-on-investment for the medical school, which puts significant resources into recruiting and supporting new faculty, the authors noted.

While the mentorships were tied to specific projects, they often led to sustained relationships, said study author Deborah Wingard, PhD, professor of family and preventive medicine at UCSD. Meeting around a project focused the relationship in the beginning, she noted, but in the course of completing the project the physicians got to know each other and often veered off into discussing other issues, such as time management or negotiation skills.

In addition to the retention benefits, the program seemed to improve the sense of community at the school, said Dr. Wingard. Because mentees were required to choose mentors outside of their own departments, “people got to know others at different levels and in different departments,” she said.

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