Intended for healthcare professionals

Career Focus

Mentoring for doctors

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7447.s179 (Published 01 May 2004) Cite this as: BMJ 2004;328:s179
  1. Rhona MacDonald, editor
  1. Career Focusrmacdonald{at}bmj.com

Abstract

Jolyon Oxley has recently completed a project on mentoring for doctors on behalf of the Department of Health. So what does he think mentoring is all about? Rhona MacDonald finds out more

For someone who has just completed a project on mentoring for doctors, Dr Jolyon Oxley, honorary secretary of the National Counselling Service for Sick Doctors, has some interesting views: “I would hope that mentorship within medicine will become more part of our culture but that it won't be only available within a kind of formalised arrangement.” He continues, “I would hate it if you couldn't actually have a private conversation with a colleague unless you are embraced within some sort of scheme.”

The project

Jolyon was commissioned by the Doctors' Forum (part of the Department of Health's “Improving Working Lives” initiative) to perform a literature review on the subject, investigate what mentoring schemes for doctors are out there now (in England only), and, with the help of a team of colleagues, find out from doctors what they perceived to be the benefits of mentoring. The results are now available as PDF documents (see box and further information).

In collaboration with the Doctors' Forum, Jolyon then went on to develop some guidance, which will be available later in the year. In the meantime, he shares with us what he feels are some key points about mentoring.

Definitions

One of the biggest difficulties when talking about mentoring is defining what it is. The SCOPME term is often widely quoted: “The process whereby an experienced, highly regarded, empathic person (the mentor), guides another individual (the mentee) in the development and re-examination of their own ideas, learning, and personal and professional development. The mentor who often, but not necessarily, works in the same organisation or field as the mentee, achieves this by listening and talking in confidence to the mentee.”

Some of the main findings

  • There are many shared understandings about the main objectives of mentoring and the principles and values that should underpin it

  • There are just as many differences in terms of organisational processes that have been adopted

  • The use of the terms mentor and mentoring to cover almost any activity associated with learning assisted by another person is not that helpful

  • Doctors can benefit from participation in mentoring at almost any stage of their careers

But in the real world, as Jolyon explains, it is often very different: “Doctors take from each other in different ways, various forms of support, advice, information, encouragement and criticism, which can all be wrapped up in mentorship. Whether doctors actually call that mentoring is a different issue and perhaps sometimes doesn't matter too much.” He adds, “I think it only begins to matter when you talk about formal arrangements.”

The formal versus informal route

“If you go down the formal route then I think you do need clarity about what you are trying to achieve, how you are going to achieve it, who is going to achieve it with you, and what qualifications they have and the standards they work to, and what kind of criteria you have for success.

“If you stay away from the formal route then I think you are into a different arena of discussion around the people involved, their personalities, the environments in which people work and interact and the opportunities that they are given for informal supportive discussion.

“Because we are all adults and I think we can judge the relevance, quality, timeliness of what other people say to us and how they say it and whether it is appropriate or not at that time.” He adds, “I am a great believer in all that because it is how people behave.”

Training?

But say we go down the more formal route, which is becoming increasingly popular (there are at least 50 formal schemes in England alone—see further information)—should mentors be trained?

Jolyon replies: “Training is not a word I like, for various reasons. Training implies certainty—for example, you always do this and you never do that—and so I think this is inappropriate for mentoring. Instead I would say that it's mandatory that mentors need opportunities to prepare for that role in an informed way, assisted by people who are experienced and skilled in mentorship. Doctors' previous experience is often highly relevant but it's not enough on its own.” He continues, “This rightly leaves the door wide open to different models of mentor preparation and mentorship schemes.”

Different models

What about models where mentors and mentees are matched without a choice on either side? Jolyon replies. “People inevitably want choice, and I think that is good and healthy. How they choose and why they choose who they choose is fascinating, and I can see no real advantage in just handing people a mentor.” He adds, “I suspect that the allocation goes on because people don't always ask for a mentor even when there is one on offer, and that worries some of us, and it may be that some scheme organisers feel that it is easier, quicker, simpler, neater, and tidier.”

Further information

  • The three background documents based on this inquiry are all available at www.ncssd.org.uk and follow the links to mentoring

  • The final guidance will be launched at the next “Improving Working Lives” for doctors conference on 6 December 2004

“So I'm not an allocator. I would seriously question what it achieves. I think that those schemes that actually introduce prospective mentees to the scheme, how it works what mentorship is all about and, what it is not all about, are likely to bear fruit. We could also do much more to prepare mentees for their role.”

Different meeting arrangements

Mentors and mentees are busy people. What does Jolyon think about meeting virtually through email or by telephone? “I think that people who are going to offer to be mentors without actually meeting their mentee probably need a lot of experience and possibly other skills in order to be able to negotiate that relationship. I think telephone contact is fine, preferably after you have got to know the person face to face. I am less sure about email. It's convenient and quick but it can be very treacherous. There is a little bit of literature on e-mentoring from the United States, so I wouldn't put it aside completely. I think it depends on how much in tune you are with the other person and your own preferences.”

Other key elements

What else are key elements to mentoring, in Jolyon's opinion? “Privacy is an extremely important element to it. Another is to recognise that the time is for the mentee and the mentee's agenda not for the mentor's. If mentors overwhelm mentees with their own material (`my advice to you is...') then it moves away from good mentorship. There are times where it is good to pass on information, but there are also times when you need to listen and encourage. If you follow the model of mentoring that is being developed in the United Kingdom, you need to be able to challenge the mentee in a positive supportive way, not too little and not too much. It is also about assisting the mentee to re-evaluate their perceptions, beliefs, preconceptions about things and not to do it for them.”

Take home messages

“Firstly, make the best of all the informal opportunities. Secondly, formal mentorship can be a huge benefit to some doctors at different stages in their careers. Before setting up a scheme, think hard about the time and resource needs. They are considerable. Look to see what other schemes exist and could be tapped into. But if you think that you will benefit from mentorship, go and bang on someone's door and ask for it.”

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