What’s Important: Mentorship and Sponsorship

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“To hold my teacher in this art equal to my own parents…to consider his family as my own…; to impart precept, oral instruction, and all other instruction to my own sons…, and to indentured pupils who have taken the physician’s oath….”1
Contrary to popular belief, the Praeceptori quidem (as stated above) is the first vow of the Hippocratic Oath, rather than the pledge to Primum non nocere (First, do no harm)1. The importance of mentorship in medical training is fully embodied in this first passage of the ubiquitous physician’s oath. Prior to the more modern concept of mentorship, the apprentice model of education served as the cornerstone of medical and surgical training for the better part of history. Even after true apprenticeships were supplanted by hospital residency programs, America’s first generation of modern physicians and surgeons were actively mentored by the likes of Sir William Osler and William Stewart Halstead. These trainees, including Hugh H. Young and Harvey Cushing, established mentoring networks and new residency programs at the institutions where they ultimately practiced.
But what happens after the mentorships that almost naturally develop during residency and fellowship training? What about mentoring for surgeons who are beginning that first tenuous foray into academic or private practice? For the orthopaedic clinician-scientist, a mentor can particularly help in the search for an initial position after training. In the research arena, a mentor can assist in navigating the choppy waters of research-paper and grant submissions, and serve as a sponsor for those all-important career development awards2. Indeed, some in our field maintain that without the right mentor, attainment of a career development award is nigh but impossible, given that funding agencies are reluctant to invest millions of dollars in nascent researchers without someone already established in the field who is willing to vouch for their potential.
However, not all graduating residents or fellows will actively seek out mentors in their department or practice. Nor, conversely, is there a general assumption that more experienced clinicians should or would be willing to take time away from their own busy practices to help young physicians mature in their careers. It is logistically difficult for many private-practice physicians and surgeons who are “in business for themselves” to serve as mentors, although the rise in the last few decades of multiphysician and multispecialty practices and hospital-based organizations perhaps makes mentor-mentee relationships more convenient. Whatever the setting, I believe that effective mentorship, especially in the first 5 years following training, can help inure young orthopaedic surgeons to the very real dangers of burnout, frustration, and emotional exhaustion.
Some liken mentors to personal coaches who help individuals reach their greatest potential through structured meetings that identify career challenges and near-term deliverables2. Others recommend a “mentorship team,” which includes a career advisor, a separate research advisor, and a physician who can help with technical aspects of clinical practice. Each individual should seek a mentor or mentors based on his or her perceived needs and practice environment.
My experience thus far suggests that the ideal mentor is more than someone who provides insight on a difficult case, recommends the best conferences to attend, or helps you prepare for the board examination. Mentors also represent an identifiable bulwark of support that can be called upon should interpersonal conflicts present in the hospital or practice setting, or if career challenges arise that seem insurmountable. It is both helpful and comforting for the surgeon who is just starting out to know that there exists an experienced and supportive colleague who has seen others go through similar trials, or has handled such episodes himself or herself.
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