by Betsy Tuttle-Newhall, MD, FACS
As we start a new year of eConnections,
and continuation of the mission of the Association of Women Surgeons (AWS) Foundation,
the members of the Foundation Board want to dedicate this year of fundraising in
honor of Mentors and the Concept of Mentorship. The overall mission of the AWS Foundation is to provide opportunities
for the educational and professional growth of women in Surgery. Many of the
signature programs of the AWS are supported by the Foundation including the Kim
Ephgrave Visiting Professor program as well as several national awards
including the Nina Starr Brunwald Award, Olga Jonassan Distinguished Member
Award, Honorary Member Award, Hilary Sanfey Outstanding Resident Award and the
Patricia Numann Medical Student Award. The Foundation also supports the
Resident and Poster Competition at the Annual AWS meeting to encourage and
facilitate interaction between students and residents training in Surgery. The
Foundation was started in 1996, and has provided many of the AWS members ways
to heighten their visibility and created advancement opportunities. The
Foundation and its board have been and continue to be the “mentor” organization
for the AWS.
What is
mentor? What is mentorship? And why is this important? A mentor is defined as a
“wise and trusted teacher, an influential sponsor or supporter”. Many of us
during our careers have benefited from people who have taught us, encouraged us
and supported us during specific or all phases of our careers. Mentors are
often responsible for bringing Surgery to our attention when we are students.
They are also responsible for teaching trainees, especially in Surgery, those
lessons that are not described in a text or journal article- lessons in such
things as rules of surgical culture, compassion, professionalism, communication
skills, and ethics. They also knowingly or unknowingly teach us
about personal matters, and self-preservation or lack thereof. Mentors are
responsible for teaching us, often lessons that are transferred across
generations.
"Mentoring is
to support and encourage people to manage their own learning in order that they
may maximize their potential, develop their skills, improve their performance
and become the person they want to be." Eric Parsloe, the Oxford School of Coaching &
Mentoring
There are many ways to
mentor- formally via programs in your institution or via society programs such
as the American College of Surgeons, or informally, by establishing a
relationship to support a trainee or trainees in professional or educational
matters. Mentorship relationships can involve formally assigning a faculty
member to a trainee, and setting up a schedule for meetings, for adequate time
to discuss issues. As for the trainee, there are many themes in a mentor-mentee
relationship. These can include issues of the mentor being the professional
role model, being compassionate and supportive, acting as a critic or a career
counselor. Mentees often need specific goals for their relationships with
mentors and they need to appreciate that their goals and expectations must be
kept in the context of their training program and their expected level of
professional performance.
There are many
difficulties in establishing a successful mentor and mentee relationship. The
most prevalent barrier to this relationship is lack of time. Mentors are often
overcommitted with busy clinical or academic schedules, and trainees have their
own time limitations with training hour restrictions and mandatory lectures and
labs. Scheduling time in advance and scheduling those meetings at regular
intervals can help make these meetings a priority for everyone involved. Secondly,
there are often a limited number of faculty members who are interested or
qualified to be a mentor. In the current era of declining re-imbursements and
lack of funding for educational activities, faculty members are pressured to
produce clinically and academically, limiting their time for non-reimbursed or
credited activities. Similarly, issues of different generational priorities,
gender and cultural differences in the available mentors can adversely affect
the establishment of the relationships between the trainee and the mentor.
While more and more women, gay and lesbians as well as international trainees
are currently training in surgery, the diversity of the academic faculty has
not kept up with the diversity of the training population. It is imperative
that available mentors are sensitive to issues in the diverse population of
trainees that are different than their own, and that issues are evolving over
time to ensure that any mentor can have a mentorship relationship with any
trainee. Often, it is not one person that is a mentor to a developing surgeon
but a group of people over years, that train, influence and support the
trainee. It does take a village to raise a child, and I would argue a
well-trained surgeon as well.
As an example, for many
years, early in my career, I was one of the only women I knew, interested and
eventually training in Surgery. Women in Surgery were few and far between in
the Southern part of the United States at that time. During my third year
medical student rotation, I happened to be on service with teams of all male
residents, and all male attendings. I spent a lot of time with several
individuals that were professional role models for me including Chuck Harr, MD,
Curt Mosteller, MD and Gary Craddock, MD. There was one woman trainee when I
was student- Ginger Chiantella, MD and I thought she was marvelous. There were
more over time including Catherine Share, MD who had a great influence on me as
well. I also started a life-long
friendship with one of the Surgical Attendings, Dr. Jesse Meredith, the “old
dad”. When I was student, I would often round with “Old dad” at night, where he
would tell me stories, and teach me about what was important to Surgeons-
patients ( “who always come first”), compassion (“you can never have enough”),
integrity and work ethic. When I was a fourth year student, I did not match in
Surgery for post graduate training out of medical school mostly due to my own
lack of insight into how the system worked at that time, but also due in part to
the attitudes of the program directors and some of the surgeons I interviewed
with. I often heard in interviews that as a woman, I did not have the “stamina
to train “as a surgeon. I was also accused by some of trying to “take a man’s
position”. Despite, the disappointing turn of events, I eventually found my way
to Boston to train with the help of many faculty along the way including the
Dean of Students at Wake Forest, Patricia Adams, MD who at the time was a
transplant nephrologist who would go on to become the first woman President of the
United Network of Organ Sharing, a Pediatric cardiac surgeon at West Virginia
University, Robert Gustafson, MD and of course, Dr. Meredith. I have never
forgotten their support and frankly, their ability to judge my performance not
my gender. Training in Boston opened many doors for me with the help of all of
the Surgical Faculty at The Children’s Hospital of Boston (especially Drs.
Hardy Hendren, Jay Schnitzler, Jay Wilson, and Bob Shamburger). Drs. Al Bothe
and Glenn Steele gave me a chance to train at the Deaconess and Dr. Roger
Jenkins told me I could do anything I wanted to but to try transplant. It was
Dixie Mills, MD that reminded me that there are still issues for women in
Surgery, and Susan Pories, MD who taught me a lot about grace under pressure.
As I have progressed
over my career, I have had many challenges, and while there has been a
significant increase in the number of women training in Surgery, the number of
senior women in Surgery in leadership positions academically has not kept pace
for many reasons. At the completion of my training in Boston, I eventually completed
a Transplant Surgery fellowship at Duke University Medical Center. I was the
first woman fellow in Surgery at Duke, and the first woman attending in General
Surgery to be pregnant and have children. Without the support of my chairman
Dr. Robert Anderson and my Division Chief and friend, R Randall Bollinger, MD
it would have been impossible for me to continue my career and have my
children. My mentor and fellowship director, Dr. Pierre A. Clavien, now
Professor and Chief of the Department of Surgery in Zurich Switzerland, taught
me many things clinically, as well as teaching me how to be academically
productive and know “how” to support and mentor junior faculty.
I never had a formal
relationship with any agendas working with these people who were and are my
mentors, but I learned by listening and watching, occasionally asking for
guidance and support. I still call the “old dad” often who is now 90 to discuss
issues of management and development as he has more common sense than anyone I
know. As for mentors in how to progress in academic rank, time management and
my career, I have the members of the AWS to thank for that guidance and
support. Without the support of past and present members of the council, the
Foundation Board and the management personnel, I would never have known how to
write a real CV, a letter of recommendation, a division chief and chairman
prospectus, a budget and many other things. Thank you Drs. Ephgrave, Hooks,
Numann, Walsh, Scott, Bergen, Cochrane, Sanfey, Dunn, Nuemeyer, Gantt and so
many others. I have had the opportunity to be supported and work with so many
wonderful mentors. How do I honor them? By being a mentor myself. I have tried
as I have risen through the academic ranks, to support, encourage, and train
women with a focus on teaching clinical care, and precise operative skill. I
have a list of trainees with whom I feel particularly close on my CV and who I
have advised and promoted during my career. I now find myself the only woman
Division Chief at my institution and have been a woman chair. In order to honor
our mentors, we must work tirelessly to make sure no matter where we are, that
there are the basics for equitable treatment (ex: a maternity leave policy and
paternity policy), and performance based assessment for every trainee. We as
more senior members, need to take advantage of our seniority and position to
often place ourselves “in the line of fire” to demand justice and fairness for
all of trainees and junior faculty- if the need arises. We need to be the
mentors that some of us didn’t have and give out career advice and support, and
make phone calls to ensure that the all of our trainees, but especially the
women, have access and opportunities to train at the best places they can
train. Times are changing and it is a great time to be a surgeon. We are all
beneficiaries of the people who have supported us and trained us over our
lifetimes, and we can honor them by being mentors to our cadre of students. I
would encourage all of our members to honor their mentors with a donation to
the foundation, so that the AWS can continue what we do to support all of us. This
is their year !
My favorite “old dad”
story:
Dr. Jesse H. Meredith is
currently Professor of Surgery, Emeritus at Wake Forest University. He was a
pioneer in many aspects of surgery including portal hypertension surgery, renal
transplantation, reattaching severed limbs and the formation of Critical Care
Units. He won the AMA’s distinguished service award in 2011 for his meritorious
service in the science and art of Medicine and the Order of the Long leaf Pine
in 2010, from then Governor of North Carolina Beverly Purdue. However, he is
originally from Fancy Gap Virginia, plays a great fiddle and speaks with the
native tongue of the South. He is a man of few words but when he speaks,
everyone listens. When I was a third year medical student, I was rotating on
trauma surgery of which Dr. Meredith attended. Being my first rotation, and
being extremely uncomfortable and not knowing how to actually “do” anything, I
would stand as close to the wall in the trauma bay when our team had a trauma
patient, hoping no one would notice me and I could watch but not be in the way.
One night, a young man came to the ED with a stab wound to the chest and was
rolled in the trauma room in full arrest. There was a flurry of activity and
everyone seemed to be moving at once, drawing blood, giving blood, examining
the patient, achieving IV access. It was a hive of activity. Finally, the chief
resident called out that there was a stab wound over the left nipple and he was
going to open the chest. The chest tray was opened, calm came across the room
and the incision was made, the retractor placed and the pericardium opened. A
large hemopericardium was released with some improvement in the patient’s
hemodynamics; however a small laceration
was noted in the right ventricle that started spurting blood over the patient
and the tray. It seemed like time stood still, with everyone watching the blood
spurt when a gloved hand came through the back of the crowd, and a long gloved
finger plugged the hole in the heart. Suddenly you heard the “old dad” say
“well.., y’all know what to do now don’t cha…..” and off they went to the OR in
a rush. He had appeared as if he were out of nowhere to solve the issue and
save the patient. I do not remember to this day if anyone called him, he just
knew when he was needed and he showed up.
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Do you have a story to share about your mentor? Email us at info@womensurgeons.org or tweet us @womensurgeons and #HonorYourMentor.
Or make a donation to the AWS Foundation to #HonorYourMentor today.