Developing Doctors of the Future
01 Jun 2017
The first statement in the original Hippocratic Oath deals with how the profession should be passed on. Indeed, the etymology of the word “doctor” is not carer or healer, but teacher.
In more recent times, however, our noble profession has been dogged by bullying, an under-supported junior workforce, and a growing problem with anxiety, depression and suicide amongst doctors in training. These problems, along with our modern culture and advanced, subspecialised medicine forces us to ask the question:
What is the best way to develop junior doctors into highly competent, resilient and compassionate individuals with high levels of career satisfaction and work-life balance?
Making mentoring the norm in medical training
Perhaps I am naïve in thinking it’s possible to address all aspects through one training method. And yet, I also think the failure to account for each of these aspects has become the downfall of our current training methods. Though in recent times medical training has made some important gains, becoming “competent” by being thrown in the deep end without a proper safety net is still too common.
Becoming “resilient” seems to be more about survival of the fittest – where we let the ones who “haven’t got it” burn out, whilst the others become jaded and cynical. And what of career satisfaction and work-life balance? Those concepts seem diametrically opposed to each other, where career satisfaction seems to require being married to the job, too often at the expense of one’s personal life.
One solution is to make mentoring a normative part of medical training. Corporate business has been doing this effectively for years. If we want to train the next generation of doctors, we must invest in them. Because mentoring is by definition personalised, it offers tailored training and advice to develop doctors in accordance with their needs.
Three pillars of mentoring in medicine
I would like to suggest three pillars that mentoring in medicine must be built upon in order to be effective.
- Mentoring should be intentional. Occasionally, two people will fall into a great mentoring partnership based upon personal chemistry and shared experience. But if we left mentoring to these chance encounters, it would not become the norm. Intentional mentoring occurs when mentoring is on the training agenda of those providing the training and those being trained. Potential mentors are seeking out mentees, and mentees seeking out mentors.
- Mentoring should be goal-directed. Too many promising mentoring partnerships do not reach their potential because there are no goals or expectations set at the beginning, or these are not followed through. This is not to say mentoring is not flexible; the personal nature of it makes it the most flexible of all doctor development methods. But a change in direction for the partnership necessitates new goals to be formed.
- Mentoring should be trainee-focused. Of course, the mentor will also derive some benefit from the partnership, but the primary focus is on the development of the trainee. The trainee must be heavily involved in identifying their needs and setting goals with the help of the mentor. The mentor is not there to make a “mini-me”, but to help the mentee become the best doctor they can be.
Mentoring is not a panacea for medical training
When done correctly, mentoring is intensive and time consuming. However, in most hospitals and practices in Australia, we already have the infrastructure present to implement it properly. Institutionally, this can take the form of either formal mentoring programs at the commencement of the training year or, alternatively, leveraging the existing educational supervisor roles that exist in most training programs.
I strongly believe that making mentoring the norm in medical culture and training would do much to address the challenges we face, both now and into the future.
Dr Joel Wight (MDA National Member)
Haematology Research Fellow
Melbourne, Victoria
Dr Joel Wight has recently co-authored The Intentional Mentor in Medicine, a toolkit for mentoring doctors, with Dianne Salvador (a medical education officer with a background in psychology).
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