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Medical Teacher
ISSN: 0142-159X (Print) 1466-187X (Online) Journal homepage: https://www.tandfonline.com/loi/imte20
Mentoring for doctors. Do its benefits outweigh its
disadvantages?
Kasra Taherian & Mina Shekarchian
To cite this article: Kasra Taherian & Mina Shekarchian (2008) Mentoring for doctors.
Do its benefits outweigh its disadvantages?, Medical Teacher, 30:4, e95-e99, DOI:
10.1080/01421590801929968
To link to this article: https://doi.org/10.1080/01421590801929968
Published online: 03 Jul 2009.
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Article views: 4030
Citing articles: 64 View citing articles
2008; 30: e95–e99
WEB PAPER
Mentoring for doctors. Do its benefits
outweigh its disadvantages?
KASRA TAHERIAN
1
& MINA SHEKARCHIAN
2
1
Northern Lincolnshire and Goole NHS Foundation Trust, UK,
2
Leeds Teaching Hospitals NHS Trust, UK
Abstract
Background: Mentoring is widely used in medicine and is an established means of professional development. We have all been
mentored, knowingly or otherwise at some stage of our careers.
Aims: To provide an overview of mentoring in clinical and academic medicine, review the literature, discuss various mentoring
styles and weigh the advantages and disadvantages of mentoring.
Method: A discussion paper that describes good mentoring, promotes mentoring as a performance enhancer and gives examples
to illustrate issues. It draws on available literature and introduces several novel ideas in mentoring.
Results: Doctors at all career stages including medical students can benefit from mentoring. Benefits of mentoring include;
benefits to the mentee, benefits to the mentor and benefits to the organization.
Overall, both mentees and mentors are highly satisfied with mentoring. Nevertheless, problems exist, such as conflict between
the mentoring and supervisory roles of the mentor, confidentiality breaches, mentor bias, lack of ‘‘active listening’’ and role
confusion. Problems usually stem from poor implementation of mentoring. Mentors should not be the mentee’s educational
supervisor or line manager or otherwise be involved in their assessment or appraisal to avoid blurring of these distinct roles.
Safeguards of confidentiality are of vital importance in maintaining the integrity of the mentoring process. Good mentoring is
a facilitative, developmental and positive process which requires good interpersonal skills, adequate time, an open mind and
a willingness to support the relationship.
Mentors should encourage critical reflection on issues to enable mentees to find solutions to their own problems.
Conclusions: Mentoring is an important developmental process for all involved. There is a perception amongst mentors and
mentees that well conducted, well timed mentoring can reap enormous benefits for mentees and be useful to mentors and
organizations. However strong evidence for this is lacking and there is need for further research in this area.
Introduction
The term ‘‘mentoring’’ originates from the Greek language and
literally translates as ‘‘enduring’’. Greek mythology holds that,
before setting out on an epic voyage, Odysseus entrusted his
son Telemachus to the care and direction of his old and trusted
friend, Mentor, who was renowned as a wise counsellor.
There are many definitions of mentoring that are in use.
The one most widely cited in the UK literature defines it as a
process whereby an experienced, highly regarded, empathic
person (the mentor) guides another usually younger individual
(the mentee) in the development and re-examination of
their own ideas, learning, and personal or professional
development. The mentor, who often but not necessarily
works in the same organization or field as the mentee,
achieves this by listening or talking in confidence to the
mentee (SCOPME 1998).
We have all been mentored, knowingly or otherwise at
some stage of our careers or life in general.
Practice points
. The aims of a mentoring relationship depend upon the
needs of the mentee and can change over time.
. Improperly conducted mentoring can result in
individual stress, role confusion and disillusionment
with the task.
. Mentors should encourage critical reflection on issues
so that the mentee is able to find solutions to his or her
own problems.
. Both mentees and mentors are highly satisfied with
mentoring and that there is some evidence that
mentoring seems to work.
. Further qualitative and quantitative research is
required to study the cost effectiveness of mentoring,
develop new and more effective mentoring strategies
and to explore issues of gender and ethnicity within
mentoring.
Correspondence: Kasra Taherian, Department of Ophthalmology, Scunthorpe General Hospital, Northern Lincolnshire and Goole NHS Foundation
ISSN 0142–159X print/ISSN 1466–187X online/08/040095–5 ß 2008 Informa UK Ltd. e95
DOI: 10.1080/01421590801929968
Purposes of mentoring in medicine
The aims of a mentoring relationship primarily depend upon
the needs of the mentee and can change over time as the
mentee develops and his/her agenda changes. Common
examples of such needs include; identifying career goals,
developing action plans, guidance about exams and courses;
research advice; help in preparing curricula vitae and
improving interview techniques. Mentoring can also provide
support to those who are newly qualified or are undergoing
transition of some sort.
In addition, mentoring can help both parties understand
and change personal and professional attitudes (Lingam and
Gupta 1998) and has an important influence on personal
development, career guidance, career choice and research
productivity (Sambunjak et al. 2006).
Advantages of mentoring
The benefits of mentoring can be considered under three
groups.
Benefits to the mentee
Mentoring enables the younger colleagues to learn about
the environment they are entering, including its priorities, its
customs and usages and the identities of the leading figures,
institutions and structures. Further, in academic medicine,
mentoring is especially important in the shaping of an
academic persona and in the formulation and acceleration of
a career trajectory (Barondess 1997).
Bowler et al. (1998) have suggested that mentoring is a
commonly recommended strategy to promote the socializa-
tion, development and maturation of academic medicine
faculty.
Other examples of benefits to the medical mentee can
include establishing oneself quickly in new learning and
social environments, gaining requisite knowledge and skills,
developing a better understanding of the organization they
work in, developing values and an ethical perspective,
developing attitudes and behaviour appropriate to the
circumstances, learning to appreciate different or conflicting
ideas, learning to overcome setbacks and obstacles and
acquire an open, flexible attitude to learning (Lingam and
Gupta 1998).
Apart from learning how to promote themselves, mentees
can also learn ‘the unwritten rules of the game’, networking,
negotiation skills, conflict management, academic writing
and presentation skills. Mentoring can also promote; the
emergence of relationships, sharing experiences, mutual
problem solving, peer collaboration, and team working skills
in the mentee (Pololi et al. 2002).
While there may be other settings in which the above
benefits can be attained by the mentee, the process of
mentoring offers the added advantage of providing these in a
risk free environment away from the pressures of day to day
work. Often without proper mentoring, certain developmental
processes may be those of trial and error only.
Benefits to the mentor
Philosophically speaking mentoring is a selfless act and no
prospective mentor should indulge in it with self-benefit as
the primary aim. Nevertheless the process does have some
benefits for the mentor as well, which lie chiefly in the sharing
of experiences and learning with junior colleagues and the
sense of satisfaction that is derived from the mentee’s
developmental process (Setness 1996) as well as encouraging
the mentor to learn about current research techniques.
Connor et al. (2000), based on a questionnaire evaluation of
an initiative to develop a network of senior doctors as mentors,
found that the participants came to the programme with the
intention of helping others, but soon found that they were
being helped themselves by becoming part of a supportive
network of senior doctors. Sackin et al. (1997) proposed that
mentoring leads to a reduction in stress both as a result of
establishing the mentoring relationship and due to acquisition
of new knowledge and skills during the process.
Also some progressive organizations have started allocating
continuing professional development (CPD) points to mentors
for their mentoring activities (BMA 2004).
Benefits to the organization
Of the many factors that contribute to a thriving and successful
work environment especially in medicine, none is more
important than its workforce. Mentoring can help doctors
develop and feel valued. Such doctors are more likely to
provide better care to patients. Mentoring also has a
contribution to make to the development of clinical govern-
ance in an organization (Young 1999) and provides the
opportunity to air potential problems at an early stage. This
reduces the risk of major difficulties and consequently both
referrals to regulatory bodies and the time employing
organizations spend dealing with problem doctors.
Difficulties involved and
disadvantages of mentoring
Many of the disadvantages attributed to mentoring in the
literature are in fact not so much disadvantages of mentoring
itself but are problems associated with the improper conduct
of the mentoring process.
In medicine, often a junior doctor’s mentor is a consultant
under whom the doctor works. This type of mentoring
has been termed ‘faculty mentoring’ (DOH 2004), and is an
approach that is still much advocated in USA academic
medicine. However, this approach can often lead to a conflict
of interest between the mentoring and supervisory roles of
the mentor (e.g. training versus service provision issues) and
consequently may interfere with the mentoring process.
Hence, the mentor should ideally not be the mentee’s
educational supervisor or line manager at work or otherwise
be involved in any way in the mentee’s assessment or
appraisal to avoid blurring of these distinct roles. Shaw
(1983) has also referred to these inherent tensions in the role
of the mentor if he or she also contributes, at whatever
distance, to an assessment of performance at work.
K. Taherian & M. Shekarchian
e96
Another potential downside of mentoring is that over a
period of time mentors tend to develop a considerable
personal and private knowledge about their mentees and
this knowledge base if shared even during mentor support
group meetings or fed to professional regulatory bodies can
lead to problems such as breach of confidentiality, mentor
bias, or a perception of mentors as agents of the establishment
(Alliott 1996). Safeguards of confidentiality are hence, of vital
importance in maintaining the integrity of the mentoring
process and should be observed at all times (Freeman 1997)
barring exceptional circumstances when the safety of the
public would be at stake.
During the mentoring process it is sometimes easy for
the mentor to develop a patronising attitude towards the
mentee and it is important for the mentor to be aware of this
tendency and resist it. Hence, mentoring should not always
be about the mentor advising the mentee what to do in a
particular situation, but rather should be about the mentor
facilitating exploration of the issues by the mentee, at his or
her own pace. Thus by encouraging critical reflection on the
issues the mentee should be able to find solutions to his or
her own problems. In this way the mentee is more likely to
enjoy the process and the challenges of change. This
technique is also called ‘‘active listening’’ Sackin et al. (1997).
It proposes that active listeners do not offer solutions, but try
to enable those speaking to find their own.
Unfortunately doctors as mentors often find this approach
difficult, as it differs fundamentally from the approach they
commonly apply in a clinical setting, where they are seen as
the expert and are required to intervene. What they should be
doing is to master the art of active listening and even apply it
selectively in their clinical practice as some patients may also
find this approach useful (DOH 2004).
Therefore a good mentor should resist jumping to
conclusions or offering immediate ready made solutions but
instead try to guide the mentee to think through the issues
impartially, knowledgably and clearly and as a consequence
realise his/her own potential. Considering that the aims of a
mentoring relationship can vary depending primarily on the
mentee’s stage of development and other requirements this
can present a challenge for the mentor.
A dysfunctional mentoring relationship could also result
from possession of certain personality traits that are not
compatible with the process. Hence the importance of the
mentor and the mentee having some common interests to give
the relationship a good start.
Other difficulties that may at times be encountered during
mentoring include frustration due to lack of progress and
strains and conflicts, which can occur in any caring relation-
ship. Improperly conducted mentoring can result in individual
stress, role confusion and disillusionment with the task.
Styles of mentoring
The fact that mentoring is a relationship rather than just a set
of activities is emphasised in the literature (Barondess 1997).
The mentoring relationship may be as a part of a well-
established scheme which tend to be highly structured or
may be more informal and personally arranged. Even then,
some previous formal training for the mentor in mentoring
techniques is highly desirable if not an absolute pre-requisite.
The training provided to prospective mentors in established
mentoring schemes includes areas such as; skills development,
particularly active listening, non-directive facilitation of
change and problem management techniques. It also usually
encompasses using mentoring skills in a variety of situations,
including working with colleagues (sometimes co-mentoring)
in clinical and managerial contexts, in educational supervision
and in supporting people in difficulty. The idea is to provide
prospective mentors with a greater insight into their strengths
and development needs, and a greater understanding of
their own and other people’s behaviour.
The highly structured formalized mentoring programmes
can provide benefits to the organisation as well as personal
benefits to the mentee and the mentor alike by way
of accelerated learning and personal development. Their
downside, however, is that they have a high cost in terms of
resources and time. These costs are for role preparation,
support, agreeing the processes, conduct, monitoring of
performance and evaluation of effectiveness of such
schemes. Measuring the cost effectiveness of such schemes
though desirable and important remains difficult as the
rewards generated by such schemes are hard to measure
quantitatively. Another downside of such schemes is that due
to their complexity and costs many of them fall by the
wayside because of lack of sustained funding or time
(Hutton-Taylor 1999).
Informal mentoring on the other hand is delivered with
minimal if any cost to the organisation and carried out properly
can still be very rewarding. In fact, Bligh (1999) suggests
that most mentoring remains informal and invisible.
The downside of informal mentoring, however, is that it is
more difficult to standardise, advertise, monitor and evaluate.
Though usually a relationship between two individuals,
a shared approach to mentoring has also been advocated
which involves a team of mentors providing joint or individual
mentoring sessions to the same mentee depending upon
practical constraints such as time etc. It is proposed that such
a model can be advantageous, providing a broader range of
skills and exposing mentees to multiple styles, perspectives
and philosophies (Levine et al. 2003).
Hence as Larkin (2003) suggests, mentoring may mean
different things to different people but the central role of
guidance and protection remains. Perhaps this versatility in the
process of mentoring is one of its major strengths. Freeman
(1997) however, challenges the tendency to define the term
mentoring rather loosely as this encourages the use of this
term to cover a wide variety of activities, thus creating
confusion and threatening the ability of doctors to make
accurate choices about the type of support they might need
in facing their professional challenges.
Mentoring has itself evolved with the passage of time.
Souba (1999) distinguishes between an older model of
mentoring which was characterized by a paternalistic,
authoritarian, strict approach towards the mentee and the
newer approach which involves empowering, partnership,
inspiring, liberating and independent development of the
mentee.
Mentoring for doctors
e97
Initiation of the
mentoring relationship
The stimuli for the initiation of the process of mentoring
can vary, often depending on the type of mentoring relation-
ship. In informal mentoring the process is usually but not
invariably initiated at the behest of the mentee. On the other
hand in structured mentoring the process often starts as part
of an organizational policy or project. Only rarely does
a mentoring relationship initiate as a sole initiative of the
mentor.
Who needs mentoring?
Doctors at all stages of their careers including medical
students can benefit from mentoring. However those who
need it most are mentees who are new to an organisation
or position, those concerned with their career plans, those
being developed for future leadership positions, those in
professional or personal difficulty, and those with cultural
barriers at work such as ethnic minority or overseas
doctors.
Common mentoring examples in medicine include
mentoring of trainees and peer mentoring (i.e. consultant
to consultant, particularly in cases of newly appointed
consultants, those with problems related to performance
procedures or under undue stress).
However, as a rule, the mentor should not be the mentee’s
educational supervisor, college tutor, or regional adviser as
these have to make appraisals and assessments and are
involved in in-training assessments for specialist trainees and
hence role confusion may result (Lingam and Gupta 1998).
Qualities of a good
mentoring relationship
Good intentions and knowledge and experience of a subject
area are not sufficient pre-requisites for good mentoring.
For good mentoring it is important that the approach of
the mentor is constructive and non-judgemental and the
process is positive, facilitative, and developmental. A good
mentor should also have good interpersonal skills, adequate
time, an open mind and a willingness to support the
relationship.
The process of mentoring is essentially a relationship
between two people and for it to succeed, there must be a
high level of mutual trust and respect between the two parties.
Though a mentor is essentially a friend, good mentoring is
as much about challenging as supporting, and constructive
criticism and emphasising the need for change, where
required, should be an integral part of the process. Medical
mentors should also be trained and/or knowledgeable in
study leave guidelines, immigration and employment laws,
grievance procedures and equal opportunity laws (Lingam and
Gupta 1998).
Souba (1999) describes the many hats a mentor has to
adopt which include: 1. adviser and counsellor; 2. friend;
3. agent; 4. teacher/helper; 5. coach; 6. manager/leader.
He further argues that a mentor should:
Motivate;
Empower and Encourage;
Nurture self confidence;
Teach by example;
Offer wise counsel and;
Raise the performance bar.
In addition to the above the mentor needs to be clear about
his role and confident enough to be able to set boundaries on
the relationship in terms of its limits and duration. These need
to be defined and agreed between the two parties. The mentee
should preferably choose a mentor near to where he/she lives
or works to enable at least occasional face to face meetings
between the two. These can supplement more regular distance
communication via telephone or email.
Ideally potential mentors and mentees should meet in
social as well as in professional settings to begin the
networking process (Jackson et al. 2003). A good mentor
should be prepared to go beyond obligatory relationships
and remain truthful, committed and unselfish (Souba 1999).
Bould (1997) suggested that reflection is an integral part of
the mentoring process which can provide a fresh impetus to
the personal and professional development of doctors, whose
collective morale, she felt, was at a low level.
The principal lessons of the Standing Committee on
Postgraduate Medical and Dental Education report on mentor-
ing were that mentoring should be informal, separate from
assessment, and confidential, and that prospective mentors
should be trained (SCOPME 1998).
Measures to promote mentoring
Mentoring is well established as a means of professional
development in other professions (Merriam 1983), but
Okereke (2000) suggested that in medicine mentoring is
an under-researched area and advocated qualitative studies
such as interviews with mentees, observation of mentoring
process and focus groups to research this important issue
further. Hutton-Taylor (1999) suggests that coaching, mentor-
ing, and the skill of networking are concepts that need to
be portrayed as highly desirable and enjoyable from the first
year of medical school to encourage a greater uptake of these
by doctors throughout their professional lives.
This promotion of mentoring to doctors early in their
careers as something desirable and useful, can help to dispel
the mistaken notion amongst a section of the medical
profession, that seeking mentoring is only for those who are
weak and cannot cope or who have career or personal
problems. Also the opportunity to access mentoring should
be made more widely available allowing prospective mentees
a choice in the scheme they wish to participate in.
Recent developments in mentoring
Recent changes workforce demographics have highlighted
issues of gender and ethnicity within mentoring. For example
K. Taherian & M. Shekarchian
e98
whilst women now form the majority of medical student
numbers in US and UK medical schools, in academic medicine
they are not promoted or paid on a par with men. Recent
studies have also shown that women perceive that they had
more difficulty finding mentors than their colleagues who are
men. Hence groups like women and ethnic minority doctors
represent both a challenge as well as an opportunity for
mentoring.
Also recently there has been a greater focus on translational
research in medicine which may have an impact on mentoring
since this type of research utilizes different methods and
specialties and brings together a variety of professionals with
differing mentoring skills and needs.
Conclusion
Mentoring is an important developmental process for both
parties involved and carried out correctly can enhance
professional and personal life in a fruitful way.
There is a strong perception amongst both mentors and
mentees that mentoring if well conducted and well timed can
reap enormous benefits for the mentees and at the same
time be useful to the mentors and the organization as well.
However strong evidence in the literature to support this
perception is lacking at present and there is a need for
further qualitative and quantitative research in this area to
make the concept and practices of mentoring more evidence
based.
Notes on contributors
KASRA TAHERIAN MD, FRCSEd, FRCOphth, FEBO is a Locum Consultant
Ophthalmologist at the Northern Lincolnshire and Goole NHS Foundation
Trust. He also has a special interest in Medical Education.
MINA SHEKARCHIAN MD, is an Ophthalmology Senior House Officer
at the Leeds Teaching Hospitals NHS Trust. She also has a special interest
in Medical Education.
References
Alliott R. 1996. Facilitatory mentoring in general practice. BMJ classified
suppl: career focus 313:Sep 28.
Barondess JA. 1997. On mentoring. J Roy Soc Med 90:347–349.
Bligh J. 1999. Mentoring: an invisible support network. Med Educ 33:2–3.
Bowler DJ, Diehr S, Morzinski JA, Simpson DE. 1998. Support-
challenge-vision: a model for faculty mentoring. Med Teach 20:
595–597.
Bould J. 1997. Mentoring in Medicine. University of Leeds. Counselling
and Career Development Unit (CCDU), Training and Consultancy.
BMA (British Medical Association, Board of Medical Education) 2004.
Exploring mentoring. Available online at: http://www.bma.org.uk/ap.
nsf/AttachmentsByTitle/PDFMentoring/$FILE/mentoring.pdf (accessed
13 Jan 2007).
Connor MP, Bynoe AG, Redfern N, Pakora J, Clarke J. 2000. Developing
senior Doctors as mentors: a form of continuing professional
development. Report of an initiative to develop a network of senior
doctors as mentors. Med Educ 34:747–753.
DOH (Department of Health) 2004. Mentoring for doctors. Signposts to
current practice for career grade doctors. Guidance from the Doctors’
Forum. Available online at: http://www.dh.gov.uk/assetRoot/04/08/93/
96/04089396.pdf (accessed 13/1/2007).
Freeman R. 1997. Information shared in mentoring must remain
confidential BMJ 314:149 (11 January) Letters.
Hutton-Taylor S. (1999). Cultivating a coaching culture. BMJ Career focus
318: Saturday 3 April.
Jackson VA, Palepu S, Szalacha L, Caswell C, Carr PL, Inui T. 2003. ‘Having
the right chemistry’: a qualitative study of mentoring in academic
medicine. Acad Med 78:328–334.
Larkin GL. 2003. Mapping, modelling and mentoring: charting a course for
professionalism in graduate medical education. Camb Quart Healthcare
Ethics 12:167–177.
Levine RB, Herbert RS, Wright SM. 2003. The three-headed mentor:
rethinking the classical construct. Med Educ 37:486.
Lingam S, Gupta R. 1998. Mentoring for overseas doctors. BMJ Career focus
317: (11 July).
Merriam S. 1983. Mentors and proteges: a critical review of the literature.
Adult Educ Quart 33:161–73.
Okereke CD. 2000. Mentoring—the trainee’s perspective. J Accident
Emergency Med 17:133–135.
Pololi LH, Knight SM, Dennis K, Frankel RM. 2002. Helping medical school
faculty realise their dreams: an innovative collaborative mentoring
program. Acad Med 77:377–384.
Sackin P, Barnett M, Eastaugh A, Paxton P. 1997. Peer supported learning.
British J Gen Pract 47:67–68.
Sambunjak D, Straus SE, Marusic A. 2006. Mentoring in academic medicine:
a systematic review. JAMA 296(9):1103–15.
Setness PA. 1996. Mentoring. Postgrad Med 100:15–22.
Shaw R. 1983. Can mentoring raise achievement in schools? in: M Wilkin
(Ed.) Mentoring in Schools, pp. 10–11 (London, Kogan Page).
Souba WW. 1999. Mentoring young academic surgeons, our most precious
asset. J Surg Res 82:113–120.
SCOPME (Standing Committee on Postgraduate Medical and Dental
Education). 1998. Supporting Doctors and Dentists at Work: An
Enquiry into Mentoring (London, SCOPME).
Young G. 1999. Mentoring should be more widespread. BMJ 319:852–853.
Mentoring for doctors
e99
