Mentorship: Building Perspective and Foundations

In one of my previous reflections, I alluded to the role of mentorship in medicine by addressing Dr. HPK’s intriguing style of teaching. Teaching alone, however, does not equate to mentoring; a teacher has greater knowledge than a student, but a mentor can provide greater perspective. While knowledge is important and forms the foundation of our clinical engagement during medical school, perspective is what separates a student from a seasoned physician. Perspective is gained through years of experience –both positive and negative; through critical reflection of one’s strengths, vulnerabilities and limits; and through formation of relationships with colleagues and patients. During this selective, my colleague and I have been regularly exposed to Dr. HPK’s perspective on medicine. The holistic approach he takes with his patients is a clear indication of how much he takes interest in their lives and his genuine investment in their health. His discussions cover anything from the patient’s ancestry to their last vacation; and there seems to always be a focus on family pets. By approaching the patient as a story ready to unwind, you begin to understand how they have been affected by the disease, how they are coping, whether they are in control or feel out of control, and what they ultimately want to achieve. We’ve always been taught to treat patients holistically; I don’t think I’ve learned what true holistic medicine is until this rotation, and it’s all thanks to this new perspective on patient care.

There is no formal mentorship program here at Toronto. Instead, students are encouraged to explore non-academic areas of medicine with their preceptors, which often occur non-intentionally after working with preceptors during rotations with whom they share similar interests, career aspirations or personal/religious values. Other students may develop “mentorship”-like relationships with their longitudinal research supervisors, especially if the student hopes to enter the specialty of the supervisor. All of these opportunities operate on an informal basis usually initiated from the student’s end. The longevity of these relationships range anywhere from a single rotation’s length to formation of life-long friendships. The closest thing we have to a formal mentorship would be our portfolio curriculum, which runs throughout clerkship and centred around student reflection. Unlike mentorships however, portfolio sessions are more structuralized and focus on student experience rather than the dialogue between student and mentor.

Studies have shown that successful mentorships are experienced as a “free zone”, a neutral place, where students can bring up concerns they normally don’t discuss with their preceptors. This facilitates a space free from judgement and assessment. Students are more likely to inquire about the process of becoming a doctor, with emphasis on professional development, ongoing perception of the health care system, and personal uncertainties. Students may seek validation, comfort, new perspectives or more; as such mentors are perceived most often as counselors, providers or ideas and role models. One study in Munich described several benefits to a mentorship program, including using it to establish a feedback loop to address patterns of student concerns which can be implemented in overall medical curriculum changes.

For a mentorship program to be successful, explicit goals should be established: does the student want to focus on academic or personal growth, or both? At the beginning these expectations should be clearly discussed and allowed to evolve over time as the mentorship evolves. Both parties should be motivated and actively involved in the mentorship; as with all relationships, there needs to be balanced contributions and personal drive from both ends in order to make it meaningful. Mentee should be forthcoming with his/her needs in an honest manner and the mentor should be aware of and respect the potential personal nature of some of these needs from the student. Disengagement from any side may lead to disintegration of the mentorship, devolving it to generic periodic “check-in’s” on academic progress which defeats the purpose of a formal mentorship program.

-JJ