COMMENTARY

How to Mentor Millennials in Medicine: Bridging the Intergenerational Impasse

Kolin M. Meehan

Disclosures

July 03, 2018

In a recent op-ed in JAMA's "A Piece of My Mind" series, Jennifer Waljee, MD, and colleagues highlighted the tension between the different rungs of medical training. The authors report that millennials have acquired labels ranging from "impatient, distracted, overly socialized, and entitled" to "deeply empowered, collaborative, and innovative." These characteristics clash with the hierarchical and regimented nature of hospitals, potentially hindering a productive learning environment vis-a-vis mismatched expectations between physician educators and their trainees.

Students, residents, and early-career physicians lean heavily on faculty and peers for a sense of direction, but help remains lost if specific needs aren't translated efficiently; in fact, the authors of the JAMA op-ed re-create common scenarios in which opposing communication styles leave junior members of the medical team at odds with senior staff. The culprit lies partially in millennials' unique upbringing: Early adoption of sophisticated technology and social media platforms has birthed wildly disparate definitions of appropriate interaction from even those of Generation X. Waljee and colleagues explain that millennials expect "virtually instant communication and information dissemination…accessibility, fast responses, rapid turnaround, and frequent short meetings" compared with a more formal system appreciated by current faculty.

Bridging the Intergenerational Impasse

The JAMA authors propose a remedy to the generation gap using three tools: micromentoring, reverse mentoring, and mentorship teams. The first is akin to coaching, essentially holding brief, targeted meetings where simple answers to direct questions would suffice. The second relies a new system that weighs the input of trainees similarly to that of their superiors, intent on "fuel[ing] a sense of leadership and broader collaboration [and] empowering mentees in their relationships." The final model focuses on creating a diverse panel of advisors, using their various life experiences to tackle everything from a new project to career advice from multiple angles.

In my experience, this last approach is a great starting point for any mentee. A cabinet of advisors reels in information much more efficiently than any single members' input. Medical students require guidance at virtually every phase of development, and evidence suggests formal channels have the potential to foster a rich network between mentors and mentees.

A 2015 study of German medical students demonstrates just that. Administrators at Ludwig-Maximilians-Universität (LMU) in Munich paired trainees with both peer and faculty mentors through a voluntary online portal called "MeCuM-Mentor." Students chose attendings from a preselected cohort based on similarities ranging from gender and cultural preferences to specialties and research interests; the process appears similar to the sorting process found in online dating. Students could also register their own faculty advisor if he or she was not already listed. In addition, upperclassmen chosen as peer-mentors attended formal leadership workshops and learned to create student-centered events to guide their younger peers.

After 5 years, the authors tallied 842 of the 1440 clinical students registered with at least one mentor. Formal surveys of student satisfaction were not reported; however, the continued use of the voluntary system suggests that students found some utility in the mentorship platform.

At my school, second-years link up with the incoming class in a similar peer-to-peer arrangement as the LMU program. But whereas second-years volunteer their time, all first-years are automatically paired with each other and matched with an upperclassman. These relationships conferred the first social link to the medical school for new students. I considered my peer mentor an invaluable source of information right as I entered school. However, students whose home institutions lack structured mentorship programs should remember that informal avenues will always exist. Even a brief curbside consult with an upperclassman generates insight into the best test prep materials, notes for upcoming exams, and strategies to prepare for clinical rotations.

More important, fourth-years and interns possess fresh exposure to Match Day that, in some ways, outweighs the most recent National Resident Matching Program data. Those statistical spreadsheets fail to capture the essential human elements of selecting programs: no report can highlight soft components, such as the general attitude of different departments; living experiences in widely disparate locations; or even concrete details, such as technical problems with EHR interfaces on different services.

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