Career Focus

Mentoring for overseas doctors

BMJ 1998; 317 doi: (Published 11 July 1998) Cite this as: BMJ 1998;317:S2-7151

Doctors working in Britain for the first time have particular needs for support. Sabaratnam Lingam and Romesh Gupta of the Overseas Doctors' Association outline their scheme

  1. Sabaratnam Lingam, Consultant community pediatrician,
  2. Romesh Gupta, Consultant Physician
  1. St Ann's Hospital, London N15 3TH
  2. Chorley and South Ribble District General Hospital, Chorley PR7 1PP

    Mentoring is a process by which one person acts towards another as a trusted counsellor and guide. In mentoring, the relationship between mentor and pupil (mentee) is all important. There must be a high level of mutual trust and respect.

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    Mentors help mentees to realise their potential. In medicine, a junior doctor's mentor is usually a senior consultant under whom the doctor works. In some circumstances an outside consultant may also be a mentor - particularly for overseas doctors working in Britain. About 20% of doctors in the United Kingdom are from overseas, and the Overseas Doctors' Association has developed a mentoring scheme for its members. This article describes the scheme.

    Purpose of the scheme

    The Overseas Doctors' Association recognises the need for overseas doctors entering the United Kingdom for the first time to have a focal point for advice and support. The purpose of the mentoring scheme is to help mentees identify their career goals, assess their current educational situation, and develop an action plan to enable them to achieve their professional goals. This includes guidance about appropriateness of postgraduate exams, diplomas, and courses; advice on research; and help in preparing curricula vitae and improving interview techniques. In addition, the mentoring scheme helps people to understand and change attitudes, and helps to prevent overseas doctors getting into trouble because of their cultural or religious background.

    Have you been mentored?

    Almost everyone has someone who took an interest in their welfare and development. You may not have thought of that person as a mentor, but you know that it was an important relationship and a valuable influence

    • Who was a useful role model in your medical school?

    • Who helped you uncover and use your hidden talent or ability?

    • Who helped you resolve a difficult situation in your life?

    • Who challenged you to acquire a new direction in your life?

    • What was it about these people who helped you?

    Mentoring helps people to learn, to achieve self development, and to modify some habits or behaviour. It is not for educational supervision. An educational supervisor is essentially a consultant under whom a trainee works, who gives the trainee pastoral care, is concerned with educational objectives, and who should develop and facilitate an individual educational plan. The educational supervisor should also discuss the trainee's needs for study leave and facilitate them. It is generally recognised that the educational supervisor will meet the trainee on a regular basis and carry out assessments and appraisals and liaise with the college tutor (the doctor within the specialty in the hospital or trust who is responsible for delivering education while the trainee is in post).

    Mentors help mentees to:

    • Establish themselves quickly in learning and social environments

    • Gain knowledge and skills

    • Understand the organisation of British medicine

    • Understand appropriate behaviour in different situations

    • Understand different and conflicting ideas

    • Develop values and an ethical perspective

    • Overcome setbacks and obstacles

    • Acquire an open, flexible attitude to learning

    • Enjoy the challenges of change

    In contrast, mentoring is about helping a person to learn within a supportive relationship. Appreciating the difference between educational supervision and mentoring rests on the mentor being clear and confident about the role.

    No blueprint for mentors

    An exact specification for the ideal mentor does not exist. It can be a single intervention or a long relationship, part of an existing friendship, or highly structured. The Overseas Doctors' Association scheme is designed to last a long time. It starts when the overseas doctor first comes to Britain and ends when the doctor leaves, supporting and guiding the doctor throughout his or her stay. It may be a mentee's first experience of being mentored, and it can continue after the doctor leaves Britain.

    The various mentoring approaches include peer mentoring (consultant to consultant, particularly in the case of problems related to performance procedures or at times of stress) and mentoring of trainees, but, as a rule, the mentor should not be the mentee's educational supervisor, college tutor, or regional adviser as these have to make appraisals and assessments and are involved in the review of in-service training assessment for specialist registrars. The role of the association's mentors is to empower overseas doctors to get the best out of their training. Members of the association are trained in mentoring, study leave guidelines, immigration and employment laws, grievance procedures, GMC performance procedures, and equal opportunity laws.

    It might be possible for the mentor to set a target for the mentee to achieve. Common to all mentoring is that mentees come to view things in a new light. Mentoring is about change - both responding to change in the environment and promoting change in the mentee. The basis of change is a new vision of the possibilities: “It was my mentor who convinced me that I needed to change the way I approached [my problems] and suggested ways to overcome them.”

    Could you be a mentor?

    Do you have:

    • experience of being a mentee?

    • relevant experience and skills?

    • a minimum of one hour a month outside working hours?

    • well developed interpersonal skills?

    • an ability to relate well with people who want to learn?

    • an open mind, a flexible attitude, and a recognition of your own need for support?

    • willingness to support a relationship with mentees?

    Over the next few months the Overseas Doctors' Association will be looking for more mentors; interested consultants can get further information from the association's head office:

    ODA (UK)

    28-32 Princess Street

    Manchester M1 4LB.

    Tel: 0161 236 5594

    Mentoring is about challenging as well as supporting. Constructive criticism can help a mentee to face the need for change. The mentor has wider or different knowledge, experience, and skills than the mentee and should use these during a mentoring session. Each mentoring relationship has a natural life span. Further learning will occur in new mentoring relationships. Mentoring is about helping: “Mentoring gives a real buzz and makes me feel unbelievably good that somebody can learn and develop with my help. It has enabled my influence to spread and thus assisted the change process in a way which is more powerful than any other process I know.”

    How the scheme works

    The Overseas Doctors' Association is setting up mentors in all specialties and in all regions in the United Kingdom. If an overseas doctor is looking for a mentor the association will have a list of doctors who are interested and trained in mentoring, and the doctor may be able to find a mentor from the list. Most mentors are consultants, and not all are from overseas as many British doctors have also become involved in the scheme.

    Mentees select a mentor, preferably near to where they live and work, and contact him or her directly. It would be possible for the doctor to have an informal discussion with someone from the association's executive. The chairman or secretary of the hospital doctors' forum or a senior member will be able to recommend mentors in the region. At most association meetings there should be a senior member with whom a newly arrived overseas doctor could discuss the need for and select a mentor. The suggested mentor may also be attending the meeting, and initial contact could be made then.

    Also, the doctor's educational supervisor might know about the association's mentoring scheme and be able to provide information.

    There are some basic rules for mentoring relationships. Maintaining confidentiality is essential, and mentor and mentee should agree the boundaries of the relationship. Mentoring takes time: how much and how often should be agreed between mentee and mentor, as should the location and method of recording the meetings.

    The only certain event in a mentoring relationship is that it will end. This may happen when the mentee has reached a stage when he or she no longer feels the need for regular contact. In the association's scheme, it will formally end when the doctor leaves the United Kingdom. It is important to consider how the relationship will end. Mentor and mentee may agree to meet socially or less often, or simply stop completely. If it has been successful there will be cause for celebration and a sense of loss, and both should be considered in the final discussion.

    Mentors should look back and review the relationship, considering its value, the original goals, and whether they were achieved. The goals may have changed over time as new aspirations were discovered.

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