A small audience of healthcare providers gathered in a theater on West 27th Street for a private performance of the one-man play, Side Effects, written and performed by Michael Milligan. My closest friend from medical school sat to my right. The house lights cut to black. For the next hour, Milligan's character—a primary care doctor and heir to his father's practice—eerily reenacted the frustrations of being an American physician. He exuded his resentment toward the larger healthcare system; his exhaustion; and his sense of helplessness and the consequent alienation from his patients, loved ones, and ultimately himself. Milligan's character was a tragic archetype who hit a little too close to home for many of us. When the house lights came on, we sat tearful and stunned.
During the Q&A, a commonality emerged. No one needed a theatrical performance to watch a physician worry about his marriage or hear whispers about a colleague's leave of absence for a "mental health emergency." The burnout epidemic in healthcare is well-documented across all levels of clinicians, not only experienced doctors but interns as well. As attending physicians and residents navigate the choppy waters of modern healthcare, how can trainees best rely on their mentors for guidance about burnout prevention?
The role of "mentor" within medicine is evolving. Today's doctors cannot simply mimic the teaching styles of their mentors who preceded them. As Wilkes and Feldman wrote in their January Lancet article, "Mentoring Clinical Trainees: A Need for High Touch":
Typically, a trainee engaged in book learning and progressive clinical responsibilities until the senior physician was confident that the trainee was capable of providing patient care independently. This transfer of knowledge and skills was expected to take place through an apprenticeship-like arrangement between the senior clinician and his or her trainee, a relationship we would now recognise as mentoring. Before the past decade, mentorship was not explicitly taught or articulated; there was an assumption that this relationship was mutually beneficial and arose naturally.
They go on to describe the current state of affairs. Trainees have limited time to develop strong mentor-mentee relationships. Yet, their needs now extend beyond clinical learning; they also need to create the emotional capacity to do their work.
Given the constraints around mentorship, alongside the necessity for it, here are some steps to cultivate a supportive mentor-mentee relationship during your training. Although much of this advice is specific to trainees and young doctors, some of it applies to clinicians at all levels.
Step One: Choosing Your Mentor
As Wilkes and Feldman mention, in the past, the mentoring relationship arose naturally. Nowadays, many residency programs have a faculty mentoring system in place. The matchmaking process varies widely across programs. In some cases, preceptors are assigned to mentees during the onboarding process. In other cases, a resident identifies a research mentor during intern year.
Whether assigned or chosen, successful mentors have four general qualities:
The mentee wants to emulate them;
The mentor is approachable and trustworthy;
The mentor can, wants to, and will help the mentee; and
The mentor makes himself or herself available to their mentee and is responsive.
Trainees tend to gravitate toward mentors who seem familiar, whether it be because they share an alma mater, come from the same hometown, or have a cultural connection. Relatability is extremely valuable, regardless of the specific commonality. It helps the mentee envision herself in her mentor's shoes one day. Meanwhile, the mentor may have a more holistic context for the mentee's goals and factors that play a role in potential burnout.
Finally, many interns are tempted to pursue mentors based on a professional rank or academic achievement. Those connections have obvious potential advantages. Nonetheless, the value of your mentee experience—and the quality of what you get out of it—is rooted more deeply in the mentor-mentee relationship than in prestige by association.
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Cite this: How Mentors Can Help Young Doctors Prevent Burnout - Medscape - Mar 09, 2017.