S P E C I A L
F E A T U R E
C o m m e n t a r y
Insights into Mentorship for Endocrinologists
Emma Eggleston, Zhenqi Liu, Raghavendra G. Mirmira, Corrine M. Silva,
Jianfen Shu, and Richard J. Santen
Division of Endocrinology and Metabolism (E.E., Z.L., R.G.M., C.M.S.), Department of Internal Medicine,
University of Virginia, Charlottesville, Virginia 22908; Department of Public Health Sciences, Public
Health Sciences Administration (J.S.), University of Virginia, Charlottesville, Virginia 22908; and Division
of Endocrinology and Metabolism (R.J.S.), Department of Internal Medicine, University of Virginia,
Charlottesville, Virginia 22908
Context: Effective mentorship is considered a prerequisite for success during medical training and an
ensuing professional career in academic medicine. The Endocrine Society established sessions on mentorship at the Trainee Day during several annual meetings. These requests motivated a group of endocrinologists at the University of Virginia to assess prior literature on mentorship and collect opinions on the
importance of the various characteristics of mentorship from endocrinologists, general faculty, and trainees. This information served as the basis for in-depth reflection and discussions on mentorship.
Objective: The goal was to identify and prioritize the quintessential elements involved in mentorship and to reach practical conclusions that would be beneficial to academic endocrinologists.
Commentary: A multigenerational mentorship tree emphasizes that successful mentors can influence generations of mentees and that this represents a multiplier effect. The authors propose that
trainees who are informed about the most important characteristics of an effective mentor can
make better choices of a mentor. On the other hand, mentors can best define expectations when
mentees know what to expect from a mentor, based on key characteristics.
Conclusions: Similarities and differences in expectation about mentorship can be leveraged for
better communication between mentor and mentee and for the development of stage-appropriate educational curricula on academic mentorship. (J Clin Endocrinol Metab 97: 3891–3896, 2012)
ffective mentorship is considered a prerequisite for
success during medical training and an ensuing professional career in academic medicine. Because of the importance of this issue, The Endocrine Society had asked
one of the authors (R.J.S.) to conduct sessions on mentorship
at the Trainee Day during several annual meetings. These
requests motivated an overall assessment of various aspects
of mentorship. The goal was to identify the quintessential
elements involved in mentorship and to reach practical conclusions that would be beneficial to academic endocrinologists. To achieve this goal, a multistep iterative process was
undertaken, including literature review, formation of a discussion group involving the authors, and questionnaire development, and implementation. This commentary, while
not a scientific study, shares the insights gained from this
E
process and suggests practical steps to enhance the mentorship process.
Definition: The term “mentor” is defined in the Oxford
English dictionary as “a person who acts as guide and adviser
to another person, especially one who is younger and less
experienced.” The term “mentor” is derived from the name
Mentor, the man described by Homer in the Odyssey who
served as the tutor for Telemachus, the son of Odysseus.
Example of Effective Mentorship
Effective mentors provide prismatic examples of their influence on mentees as well as their impact on future generations
of trainees. An excellent example of mentorship was pro-
ISSN Print 0021-972X ISSN Online 1945-7197
Printed in U.S.A.
Copyright © 2012 by The Endocrine Society
doi: 10.1210/jc.2012-2215 Received May 14, 2012. Accepted August 21, 2012.
First Published Online September 11, 2012
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FIG. 1. The first and second generation mentees of C. A. Paulsen are shown as on a genetic diagram. The symbols represent those individuals
who were involved in academic medicine and research and who went on to become division heads or department chairs. The third and fourth
generations of trainees have been identified but are not shown.
vided by Dr. C. Alvin Paulsen, a leader in the field of male
reproductive endocrinology, who influenced several generations of trainees in this field before his passing. The “Paulsen
Genetic Tree” (Fig. 1) illustrates the long-term impact of
mentorship that extends well beyond one’s influence on individual mentees. This figure shows that the influence of a
successful mentor on training, academic leadership, and clinical care can extend over several generations. The effort as a
mentor can be enhanced severalfold through a generational
effect. Cognizance of this multiplier effect provides a strong
motivation for one to devote a major effort to mentoring.
Distinction between Mentorship and
Stewardship
During the authors’ process of obtaining advice from multiple sources, William Alexander (personal communication),
a Wharton School of Business professor, pointed out the
important differences between stewardship and mentorship.
Stewardship, as defined in the Merriam-Webster dictionary,
represents “the conducting, supervising, or managing of
something; especially: the careful and responsible management of something entrusted to one’s care.” In essence, stewardship is primarily directed toward groups, not individuals,
and is the primary role of department chairs, division chiefs,
and laboratory directors. Mentors, on the other hand, focus
on individual needs and career development. Importantly,
conflicts of interest may arise when stewards also act as mentors. As an example, a department chair may advise a department member to remain at his/her own institution when
acting as a steward but, when acting as a mentor, would
advise that member to go to another institution if greater
opportunity existed elsewhere.
Literature on Mentorship
An extensive review of the medical literature identified
several characteristics of mentorship (Supplemental Ta-
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TABLE 1. Prioritization of mentorship characteristics
Rank
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Score
97.5
95.7
95.3
94.5
94.5
91.5
91.1
91.1
89
88.5
87.2
85.5
85.2
84.9
84.3
84.1
81.3
79.8
77.6
76.6
76.4
76.3
73.7
69.4
68.4
66.4
55.3
52.6
29
22.6
Name of characteristic
Ability of mentor to provide feedback and constructive criticism to mentee
Ability of mentor to foster and support intellectual independence of mentee
Communication skills
Commitment to the idea of mentoring
Commitment to time required for successful mentoring
Selflessness of mentor in giving appropriate credit to mentee
Accessibility
Mentor as role model who leads by example
Insight into qualities and skills of mentee
Ability of mentor to advise and guide mentee on grant opportunities, promotion and tenure, etc.
Enthusiasm about research (fire in the gut)
Ability to network in the scientific community to provide opportunities for mentee
Ability of mentor to guide mentee in the identification of testable hypotheses and doable project
Selflessness (has best interests of mentee at heart)
Ability to collaborate with others
Knowledge of ideal career pathway components/strategies to develop plan leading to independence of mentee
Scientific vision
Energy
Ability of mentor to motivate mentee
Ability to provide structure and support
Institutional selflessness regarding counseling mentee on continuing work at mentee’s own institution or another
Experience in training
Scientific reputation/respect of mentor by scientific community
Potential for interpersonal chemistry between mentor and mentee
Compassion/empathy
Track record in training (successful careers of former mentees)
Ability to form a friendly relationship with mentee
Ability and willingness to teach specific aspects of mentee’s project (lab techniques, data analysis, scientific
concepts)
Ability to serve as counselor for personal issues
Score indicates the percentage of responders who ranked a characteristic in the highest (i.e. as 5) or next highest (i.e. as 4) on the 1–5 Likert scale.
bles 1–3, published on The Endocrine Society’s Journals
Online web site at http://jcem.endojournals.org) (1–30
and http://www.hhmi.org/resources/labmanagement/
downloads/moves2_ch5.pdf, pages 97–111). Three were
considered to be indispensable: honesty, trustworthiness,
and high moral standards. However, it became apparent
while reviewing the literature that minimal emphasis had
been placed on the relative importance of each individual
characteristic, and no studies attempted to prioritize
among the various characteristics.
Ranking of mentorship qualities
The questionnaire results from the 238 responders prioritized the perceived value of mentorship characteristics
(Table 1), ranking from the highest downward using Likert scores. The top five characteristics included provision
of constructive criticism, provision of support to foster the
intellectual independence of mentee, communication
skills, motivation of mentor, and commitment to the time
needed for mentoring. Several characteristics were considered to be of low priority, including compassion/empathy, ability to form a friendly relationship with mentee,
and ability to serve as counselor for personal issues.
Prioritizing Mentorship Qualities
Questionnaire
To prioritize different mentor characteristics, a questionnaire was developed (see Supplemental Material for
specific details) and sent to faculty and trainee members of
the Endocrinology Division and to general faculty members at the University of Virginia. Forty-four members of
the Endocrinology Division (73%) and 194 general faculty members (15%) responded, resulting in a total of 238
responses.
Comparison of priorities across specific groups
For the majority of characteristics, no significant differences were found among the various subgroups of responders. However, senior faculty members judged five of
the characteristics to be more important and two to be less
important than did their more junior counterparts (shown
in Fig. 2). An interesting aspect was that students rated the
majority of aspects of mentorship lower on the Likert scale
of importance than all of the other subgroups. We considered that this probably reflected their lack of experience
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of Virginia charged with examining the
development of clinical investigators
(see Supplemental Material for details).
As shown in Table 2, the committee recommended that mentorship should involve a template with three main components: 1) a formal evaluation and
decision-making process; 2) a required
knowledge base that the mentor must
attain and that is considered essential
for providing effective advice; and 3) a
specific schedule of formal meetings as
well as the provision for ad hoc meetings. These recommendations, and the
specifics detailed in Table 2, serve to
identify elements that the mentor as
well as mentee should understand before entering into a special mentor/
FIG. 2. Responses of trainees compared with junior and senior faculty. The full description of
mentee relationship. The authors note
categories include: scientific vision, enthusiasm about research, selflessness of mentor in
giving credit to mentee, ability of mentor to provide feedback and constructive criticism,
that other opinions might hold that
scientific reputation/respect by scientific community, ability and willingness to teach specific
meetings between mentors and mentees
aspects of mentee’s project, and ability to form relationship with mentee. Statistics represent
might optimally be held weekly or even
Cochran-Armitage trend analyses. *, P ⫽ 0.05; **, P ⫽ 0.02; ***, P ⫽ 0.001.
several times weekly and that that the
in interacting with mentors. Gender influenced percepideas identified in Table 2 do not represent concepts tested
tions regarding mentorship very little, but there were two
in a randomized trial but are the collective suggestions of
exceptions. Women considered the ability to collaborate
the committee.
as more important than did men. The “ability of the mentor to guide mentees in the identification of testable hypotheses and doable project” was rated more highly by
Practical Considerations
men.
Committee Deliberations on Mentorship
Further insight into mentorship was derived from the deliberations of a medical school committee at the University
After examining these various aspects of mentorship, we
would consider several issues to be worth understanding
and implementing. Effective mentorship is a prerequisite
for achievement in any scientific field and is equally applicable to the field of endocrinology (5, 9 –11, 16 –19, 24,
TABLE 2. Committee recommendations on mentorship
Expectations
Interactions between mentor and mentee will be collegial, cooperative, and coproductive, and all written approval processes by
the mentor are designed to create a framework to facilitate the mentorship relationship but not provide unnecessary
paperwork or roadblocks
Formal evaluation and decision-making process
Writing yearly written evaluations of mentee to assess progress of mentee in research
Reviewing a written research plan by mentee at yearly intervals and providing critical judgment regarding its strengths and
weaknesses
Helping to prepare, reviewing, and approving a yearly budget for expenditure of mentee’s start-up funds
Assisting in all stages of grant preparation, and reviewing/approving all grants prior to submission
Knowledge required for provision of advice
Being responsible for knowing the current status of all applicable career development awards (e.g. National Research Service
Awards) to allow provision of advice about submissions
Being responsible for knowing the criteria for promotion and tenure in the mentor’s institution
Being cognizant of the need to allow a mentee to become recognized as independent and for general guidelines for inclusion
of mentor as coauthor on mentee’s publications
Being cognizant of requirements for membership in prestigious national societies, such as the American Society for Clinical
Investigation, to allow effective advice about strategies conducive to later membership
Formal meetings
Holding yearly meetings to review the written progress report on research
Holding ad hoc meetings at least bimonthly to review research results and plans
J Clin Endocrinol Metab, November 2012, 97(11):3891–3896
and www.aamc.org/postdoccompact). Trainees evaluating and choosing a mentor would benefit from knowing
the most important characteristics required for mentors to
guide and support their mentees. The ranked list provided
in Table 1 provides a template upon which to judge a
prospective mentor. Mentors and mentees should recognize that perceptions about mentorship change with increasing experience. Senior mentors judge scientific vision, enthusiasm for research, and scientific reputation/
respect of mentor by scientific community as more
important than do younger mentees. In addition, these
mentors also judge other characteristics to be less important than their younger peers, such as ability to form
friendly relationship with mentees, selflessness of mentor
in giving appropriate credit to mentee, and ability to teach.
Understanding the differences in expectations as a function of academic rank may be helpful to both mentor and
mentee in developing and communicating about a productive and mutually rewarding research relationship.
It may be helpful to students to recognize that their
perceptions about mentorship might be influenced by their
lack of experience interacting with research mentors. For
example, students undervalued most characteristics of
mentorship that were valued by more advanced trainees
and by faculty, and they viewed mentors primarily as
teachers. Recognizing this fact, we suggest that a formal
educational process about the goals of academic mentorship would empower the student to make informed decisions in selection of a research mentor. Such a process
would instruct students what to look for in a mentor and
why these characteristics are important. Finally, mentors and mentees should understand the important distinction between stewardship and mentorship. An
important corollary would be that mentees should consider choosing at least one mentor without coexisting
stewardship responsibilities.
Limitations
Critical constraints compromise the effectiveness of the
mentor/mentee relationship in the current milieu with respect to the successes emphasized by the genetic tree (Fig.
1). Mentees have incurred large debts. Marked reductions
in National Institutes of Health support for trainees limit
their chances for success in obtaining funding. Fiscal support for specific training mechanisms such as K awards is
diminishing. Excellent mentees and mentors will fail to
propagate themselves in the absence of grant support.
Additional issues could have been added to the questionnaire but were not considered. These include the willingness of a mentor to allow the mentee to establish their
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own areas of research, an issue that can be called “generosity of turf,” a key to success. It was also not considered
whether mentors be of the same gender or ethnicity as the
mentees. Finally, we recognize limitations in our data collection process. Although 73% of endocrinologists responded to the questionnaire, only 15% of the general
faculty did so. A separate analysis of responses by endocrinologists and the entire group did not differ greatly
(Supplemental Table 4), which provided us a measure of
confidence in the results.
Summary
The authors propose that trainees who are informed about
the most important characteristics of an effective mentor
can make better choices of a mentor. On the other hand,
mentors can best define expectations when mentees know
what to expect from a mentor based on key characteristics.
These similarities and differences in expectation can be
leveraged for better communication between mentor and
mentee and for the development of stage-appropriate educational curricula on academic mentorship.
Acknowledgments
Address all correspondence and requests for reprints to: Richard
J. Santen, M.D., P.O. Box 801416, 450 Ray Hunt Drive, Aurbach Medical Research Building, Room 2313, Department of
Internal Medicine, Division of Endocrinology and Metabolism,
University of Virginia, Charlottesville, Virginia 22908-1416. Email: [email protected].
Current address for E.E.: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care
Institute and Brigham and Women’s Hospital, Division of Endocrinology, Diabetes, and Hypertension, Boston, Massachusetts 02120. Current address for R.G.M.: University of Indiana
School of Medicine, Indianapolis, Indiana 46202. Current address for C.M.S.: Division of Diabetes, Endocrinology, and Metabolic Diseases in NIDDK at the National Institutes of Health,
Bethesda, Maryland 20892.
Disclosure Summary: The authors have no conflicts of interest to disclose.
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