Mentoring: the VA experience.

The exact origin of the word and concept “mentor” is unclear. Many attribute its origin to Greek mythology when Odysseus entrusted his son Telemachus to an old man named Mentor. During part of Telemachus’ travels, Mentor’s advice saved him from his death. In some accounts, Mentor is described as an advisor to Odysseus as well [1]. African scholars note that mentors were commonplace in Africa long before the ancient Greek civilization. The true origin of the modern use of the word is probably with 18th century French writer Fenelon [2]. Mentoring is described as “the attempt to educate the whole person through a one-on-one learning relationship with an emphasis on individual transformation intellectually, socially and spiritually” [2]. There are many synonyms of mentor: coach, role model, compatriot, challenger, guide, cheerleader [3]. For many, a mentor is a combination of all of its synonyms. Aspiring surgeons in the 20th century could look toward one mentor. Aspiring surgeons in the 21st century usually need more than one mentor. Jill Conner Browne advocates in her book, “Sweet Potato Queens Book of Love,” that women need five men in their lives: one to talk to, one to fix things, one to dance with, one to pay for things, and you can guess the duties of the fifth one [4]. Similarly, the aspiring 21st century surgeon may need at least four mentors: one for clinical surgery, one for research, one for personal life, and one for “community service.” This is in part necessary because of the explosion in medical knowledge over the last several decades. Doctor Hanlon stated, “Teachers at every level must know their subject. In addition, they should have a personal passion to learn and to transmit that attitude to others” [5]. There are many great examples of mentor-protege relationships. Some of these have been showcased in motion pictures (Table 1). There is a Website that lists many more of these [2]. Perhaps you have experienced a mentoring relationship, either as the mentor or the protege. In the middle of the last century, there were many surgeons who stood out as mentors. These men and women usually ascended to the position of head of the department. Names such as Waagenstein at Minnesota, Grossman at UCLA, Dunphy at UCSF come to mind. However, the responsibilities of a mentor and protege were like many things of the time, handed down via experience, not through writing or study. A recent PubMed search on the key word “mentor” revealed more 100 citations [6]. Prior to 1990, however, most of these had to do with prostheses manufactured by the Mentor company. I am not sure of the choice of names for this company, as they make all kinds of prostheses. Times are so different now. Fifty years ago in surgery, you could develop a relationship with a mentor that would last most of your career. You and your mentor would likely stay in the same institution and you would gradually employ what you had learned from your relationship in a relationship where you became the mentor to a new generation of proteges. In the 21st century though, there are many other demands and few rewards for mentoring. Academic excellence still hinges on your own personal productivity, likely in basic science research. Citizenship is a given, but is not rewarded appropriately for the amount of effort it entails. Our need to generate income, be it from grants or clinical output has increased as the economy of healthcare has been declining of late. There don’t seem to be enough hours in the day to do all that we are tasked to do. Although the perceived time for mentoring is in diminishing supply, the reasons to mentor are plentiful. We have a declining number of students pursuing careers in surgery, attrition out of surgery residencies into other specialties continues at 20% to 25% [7]. Attrition of junior faculty from academic jobs is also high. In these cost conscious times, leaders need to understand the large investment made in the recruitment of a young faculty member. In most institutions, there is still a 7-year up or out policy on the tenure track and * Corresponding author. Tel.: 1-801-581-2431; fax: 1-801-5852425. E-mail address: leigh.neumayer@hsc.utah.edu The American Journal of Surgery 186 (2003) 417–419