Mentorship is a crucial part of any field, but is particularly important in medical training and the health care profession. At any given moment, you could be functioning as a mentee interacting as a resident working with an attending, and quickly transition to mentor as a resident interacting with a medical student. Because we are unsure when we will become mentors, sometimes we aren’t terrific, but now and then, you meet someone who has mastered the craft and is marvelous at ushering the new trainees into the field. For me, there is one clinical mentor who stands above the rest. Her name is Dr. Laurie.
Dr. Laurie is a seasoned physician who is constantly growing and challenging her skill set. She functions as a transplant pulmonologist and critical care physician. When we first met, I was transitioning from a four-year PhD back to clinical clerkships and rotations. I was significantly “more useless” than the typical early third-year medical student because I had gotten a PhD in biomedical engineering and forgotten everything I learned from the first two years of medical school. I walked into the clinic stressing about my flashcards, Step 1 boards fodder, and other random facts that seemed to evaporate immediately after reading them. I was in a panic.
Dr. Laurie started her interaction with me by laying out the expectations, schedules, and general hospital and clinic mechanics. She showed me her clinical workflow, explained what we would do on pulmonary consult service, and what she expected me to be proficient in at the end of our time. She described these expectations clearly and precisely. They were not vague, like, “See a patient and come up with a diagnosis and plan.” They were concrete, like, “Take a history from a new consult, perform a physical exam, record the findings, review the patient chart for pertinent medical history, and compile the information into a concise presentation with the following components.” As a medical student with almost no clinical experience under my belt, the constraints, specifics, and details were a massive relief. When people clearly understand what is expected, the fear of living up to expectations dissipates, and they can learn and function as team members.
Dr. Laurie also understood that medical education is constructed in phases. First, you needed to learn how to take a history, perform a physical, comb the chart, and present findings. Later in your career, you will come up with detailed diagnoses and differentials, and even further, you can start creating a plan for clinical treatment. She explained over and over that this did not happen overnight and took significant time. However, she was clear about when she expected each phase to be mastered, with the first done at the end of the third year, the second during the intern year, and the third at the end of residency or fellowship.
She also explained what “clinical experience” means to those who work in health care. That phrase has always been thrown around like a simple concept, but the implementation is far more complicated. She did not expect me to know the complex treatment regimen for post-lung transplant patients. But she did expect me to listen and soak in the pearls discussed with her fellows and other team members. She expected me to be present and aware of what was happening. In some cases, she asked me to document the treatment plans or differential diagnoses and ideas, which further cemented them into my memory for future reference.
Dr. Laurie also pushed me hard. We did not “work until collapse” during our short time, but we worked hard when we were working. She held high expectations for me. At the end of the first day, she looked over to me and said, “Tomorrow, you are going to go see your own consult in the hospital and report back to the team.” I think she could see my jaw drop to the floor, even through the mask. I had no clue what I was doing. But Dr. Laurie was confident in me. She told me there was no way I would disappoint her, and there was no way I would hurt the patient. That simple acknowledgment of my apparent anxiety meant the world to me. Just noting that I am a human being, that I get nervous, and that everything would be alright was enough for me to try something frightening and keep an open mind.
These cues made me feel confident and supported, which brings me to how Dr. Laurie delivered feedback. Almost all medical students are evaluated on their patient presentations. During my presentations, she sat or stood attentively and did not interrupt. She let me finish my entire presentation before interjecting or giving feedback. At the end of my presentation, she asked if I had anything else. She then gave me at least one positive thing I did well in the presentation. Following a positive, she provided one (and only one) crucial element to change for the next presentation. She sometimes suggested other changes, but she always started with the most critical and worked with me to get it right. She usually had me repeat that part of the presentation with the correct approach to make sure I understood her suggestions. She also closed each feedback session with another positive comment and encouragement to improve for the next patient.
Finally, Dr. Laurie treated me like a human being. That doesn’t mean she sent me home early, patted me on the back, or bought me lunch. She just shared intimate parts of her life that made me feel like she was human, and it was OK that I was a human. We talked about her kids, biking, and skiing. I am not suggesting that you share deep and dark secrets about your inner workings with every mentee. Still, the value of sharing a couple of personal things builds rapport and success in a mentor-mentee relationship.
After working with Dr. Laurie, I learned that in addition to all I must learn about being a physician, I also need schooling to become an excellent mentor. Helping and supporting trainees should be a top priority anywhere in medicine. The camaraderie and support from the entire system make being a physician one of the most rewarding careers possible. Spending just a few moments with trainees can have a long and significant impact, far beyond the initial time investment. I hope we all can strive to be a little more like Dr. Laurie.
Share a story about the best mentor you've had in the comments.
Brian Zenger has a BS in Biomedical Engineering and is a MD/PhD student in Biomedical Engineering at the University of Utah. In addition to his clinical and research responsibilities he is the founding volunteer coordinator and current director of the No One Dies Alone program at the University of Utah. He is an active member of the community serving as a volunteer and in multiple leadership positions. He is a 2020–2021 Doximity Op-Med Fellow.