Mary Magdi, Education Lead
(Edited by Riya Sawhney , GIEGS Co-Chair )
For over ten years, women have comprised approximately half of medical school students, yet they continue to be notably less represented in several specialties, particularly many surgical fields. Despite efforts, the advancement of women in the field of surgery has seen little improvement, with fewer than one-third of surgeons globally being female. Numerous factors shape the choices of junior female doctors in pursuing a surgical career. One such factor, reported across both high and low-income countries, is the absence of guidance and mentorship along their career path.
Formal mentorship initiatives surfaced in professional medical education environments during the 1990s, providing medical students with increased research chances, support in career choices, and improved personal and professional growth. So what precisely constitutes mentorship? What factors contribute to its effectiveness? How can mentorship help in various surgical settings to support the advancement of women?
The term "mentor" originates from Homer's Odyssey, where Mentor, a character, was entrusted by Odysseus to counsel and educate his son, Telemachus, during his absence for the Trojan War. Over time, "mentor" evolved to signify a guide and educator, and mentoring became synonymous with a teacher-student dynamic.
Mentorship can have various definitions. For the purpose of this blog post we will define mentorship as a reciprocal connection and form of personal growth whereby one person dedicates their knowledge, effort, and time to aid another individual in their journey towards achieving their fullest potential and success.
Mentorship for women in surgery
Mentorship in surgery is important during different stages of one’s surgical career and provides different forms of support, including technical and non-technical skills. In the realm of global surgery, mentorship plays a pivotal role in shaping the careers and trajectories of aspiring surgeons, particularly women who often face unique challenges and barriers.
In many parts of the world, gender disparities persist within the surgical field, with women encountering obstacles ranging from cultural norms to systemic biases. The influence and absence of mentorship during training were examined across several articles, with discussions spanning high-income countries (HICs) and low-income countries (LICs). While mentors may be of any gender, female physicians have demonstrated higher satisfaction in reaching professional milestones when mentored by women, as opposed to those mentored by men.
Barriers faced
When it comes to securing mentorship, women encounter challenges regardless of the gender of potential mentors. In some instances, women have described difficulties in finding male mentors. Additionally, the search for senior female mentors presents another hurdle, as there is a scarcity of accessible and available senior women in the physician workforce willing to take on mentoring roles. These instances underscore a systemic barrier preventing women from accessing the benefits of mentorship, despite its well-documented advantages.
Impact on women's careers
For women in surgery, mentorship plays a pivotal role in overcoming systemic barriers and achieving success. Tailored mentorship programs for women in surgery can effectively address gender-specific obstacles such as work-life balance, discrimination, and barriers to leadership roles. Women face a myriad of workplace challenges, including occupational segregation, wage disparities, biased evaluation and promotion processes, heightened risk of sexual harassment, and the impact of parental leave on career progression. Research also indicates that mentorship significantly influences career decisions, with female medical students more likely to pursue surgical specialties when exposed to female surgical role models. Moreover, mentorship addresses the gender disparity in leadership positions by providing women with access to advocacy, networking, and leadership opportunities.
Types of mentorship
Various forms of mentorship present distinct dynamics and advantages. We will explore several of these approaches in the following discussion:
1- Dyadic mentorship: This refers to a one-on-one mentoring relationship between a mentor and a mentee. This form of mentorship involves direct interaction and personalised guidance tailored to the specific needs and goals of the mentee. It emphasises a close and individualised approach to mentoring.
2- Peer mentorship: This involves colleagues providing coaching and guidance to one another, leveraging their shared experiences and expertise.
3- Reverse mentorship: Here, junior employees mentor leaders, offering fresh perspectives and insights from the viewpoint of a younger generation.
4- Group mentorship: In this setup, a mentor supports and guides multiple mentees simultaneously, fostering a collaborative learning environment.
5- Flash mentoring: This entails brief sessions where employees interact with various mentors, facilitating quick knowledge exchange and networking opportunities, particularly beneficial for new hires seeking to connect with experienced leaders.
Stages of mentorship
Mentoring differs from coaching, advising, teaching, tutoring, advocacy, sponsorship, and role-modelling by encompassing the creation of intricate, emotionally profound, and enduring relationships.
Mendler delineated 10 distinct phases of relationship progression within mentorship, a framework later elaborated by Pellegrini (See Table 1).
Citation: Steelman K, Fleifel D, Waheed M, Vaidya R. Mentorship in a Surgical Residency: A Comprehensive Review of the Literature. Cureus. 2023;15(8):e43422. Published 2023 Aug 13. doi:10.7759/cureus.43422
How to have a successful mentor-mentee relationship
Building a successful mentor-mentee relationship is a vital component of professional growth and development. In this section, we provide some actionable tips to help you cultivate a fruitful partnership with your mentor, ensuring mutual benefit and growth.
Be prepared for meetings by anticipating questions or challenges – set clear agendas.
Act on your mentor's advice and suggestions to demonstrate commitment – ask questions as you go to ensure clarity of action.
Maintain open communication about progress and developments – find ways to track and measure goals.
Foster a personal connection by showing genuine interest in their lived experiences, research areas, and/or clinical specialty.
Communicate and co-regulate through any potential tensions.
Stay flexible with scheduling while striving for consistency.
Share your learning journey and personal insights to enrich the relationship.
Express gratitude for your mentor's guidance to strengthen the bond.
As viewed from both the mentor and mentee angles, the effectiveness of a mentorship program relies on three essential elements: the expected objectives of the mentorship bond, the attributes of the participants involved, and the framework of the program.
How to get involved
Initiatives and programs that offer opportunities for mentorship include various organisations dedicated to advancing gender equity and supporting women in the medical and surgical fields. Some notable examples are:
1- Gender Equity in Global Surgery (GEIGS): https://gendereqglobalsurg.wixsite.com/geigs
2- Association of Women Surgeons (AWS) :https://www.womensurgeons.org
3- International Student Surgical Network (InciSioN) :https://incisionetwork.org
4- The American College of Surgeons (ACS) :https://www.facs.org
5- Women in Surgery Africa (WiSA) :http://www.womeninsurgeryafrica.org
Conclusion
From my perspective, mentorship is a cornerstone of global surgery, offering invaluable benefits to both mentees and the broader surgical community. It provides aspiring surgeons, including women, with essential guidance and support to navigate the complexities of surgical practice in resource-limited settings. Through mentorship, mentees gain access to valuable insights, techniques, and best practices, enhancing their professional development. Additionally, mentorship fosters collaboration within the global surgical community, facilitating knowledge exchange and capacity-building initiatives crucial for addressing healthcare disparities. For women in global surgery, mentorship offers a unique opportunity to access networks and opportunities for research collaborations, furthering their academic and professional growth, as I have experienced personally in my journey as well.
References and further reading
Clutterbuck D. Everyone needs a mentor, 4th ed. London: Chartered Institute of Personnel and Development; 2004. https://dx.doi.org/10.1016/b978-0-7506-3695-7.50002-0
Abudayyeh I, Tandon A, Wittekind SG, et al. Landscape of Mentorship and its Effects on Success in Cardiology. JACC Basic Transl Sci. 2020;5(12):1181-1186. Published 2020 Dec 23. doi:10.1016/j.jacbts.2020.09.014
Luc JGY, Stamp NL, Antonoff MB. Social media in the mentorship and networking of physicians: Important role for women in surgical specialties. Am J Surg. 2018;215(4):752-760. doi:10.1016/j.amjsurg.2018.02.011
Singh C, Loseth C, Shoqirat NWomen in surgery: a systematic review of 25 yearsBMJ Leader 2021;5:283-290.
Umoetok F, Van Wyk JM, Madiba TE. Does gender impact on female doctors’ experiences in the training and practice ofCochran A, Neumayer LA, Elder WB. Barriers to careers identified by women in academic surgery: A grounded theory model. Am J Surg. 2019;218(4):780-785. doi:10.1016/j.amjsurg.2019.07.015
Zhuge Y, Kaufman J, Simeone DM, Chen H, Velazquez OC. Is there still a glass ceiling for women in academic surgery?. Ann Surg. 2011;253(4):637-643. doi:10.1097/SLA.0b013e3182111120
Makama JG, Garba ES, Ameh EA. Under representation of women in surgery in Nigeria: by choice or by design?. Oman Med J. 2012;27(1):66-69. doi:10.5001/omj.2012.15
de Costa J, Chen-Xu J, Bentounsi Z, et al.. Women in surgery: challenges and opportunities. IJS Global Health 2018;1:e02.
Garvey B. Philosophical origins of mentoring: The critical narrative analysis. In: Clutterbuck DA, Kochan FK, Lunsford L, Dominguez N, Haddock-Millar J, editors. The SAGE handbook of mentoring. London, UK: SAGE Publications; 2017. 10.4135/9781526402011.n2.
Buddeberg-Fischer B, Herta KD. Formal mentoring programmes for medical students and doctors--a review of the Medline literature. Med Teach. 2006;28(3):248-257. doi:10.1080/01421590500313043
Frei E, Stamm M, Buddeberg-Fischer B. Mentoring programs for medical students--a review of the PubMed literature 2000-2008. BMC Med Educ. 2010;10:32. Published 2010 Apr 30. doi:10.1186/1472-6920-10-32
surgery? A single centre study. S Afr J Surg. 2017;55(3):8–12.
Yi S, Lin Y, Kansayisa G, Costas-Chavarri A. A qualitative study on perceptions of surgical careers in Rwanda: a gender-based approach. PLoS ONE. 2018;13(5):e0197290.
Mendler, A., 1994. Teaching Hard-to-Reach Youth. Journal of Emotional and Behavioral Problems, 3(2), pp.23-24.
https://www.togetherplatform.com/blog/how-to-build-a-successful-mentor-relationship
https://www.togetherplatform.com/blog/building-an-authentic-connection-when-mentoring
Enani GN, Brydges R, MacRae HM,Louridas M. Exploring mentorship in surgery: An interviewstudy on how people stick together.Med Educ. 2023;57(11):1028‐1035. doi:10.1111/medu.15157ENANIET AL.1035
Steelman K, Fleifel D, Waheed M, Vaidya R. Mentorship in a Surgical Residency: A Comprehensive Review of the Literature. Cureus. 2023;15(8):e43422. Published 2023 Aug 13. doi:10.7759/cureus.43422
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