Mentorship in otolaryngology has historically happened spontaneously and organically during daily interactions between faculty and residents. However, the lack of a formal process for providing resident mentorship and support can have career-impacting limitations.
Explore This IssueSeptember 2021
For example, if an otolaryngology resident is taking a passive approach to their career planning or doesn’t feel comfortable engaging in active dialogue, some things may fall through the cracks. Further, residents may not appreciate the timing sensitivity and need for active engagement that’s necessary for career preparation, said Abtin Tabaee, MD, associate professor of otolaryngology at Weill Cornell Medicine in New York, faculty member at New York-Presbyterian Hospital (NYP), and co-director of the American Rhinologic Society residency mentorship program.
These programs are engaging new otolaryngology residents to help jump start their careers in the specialty.
New York Presbyterian Hospital
Now in its sixth year, the NYP residency mentorship program provides different experiences for the juniors and seniors, with the creation of a fresh agenda on a year-to-year basis. The philosophy is that junior house staff are still working through residency acclimation, learning how to be doctors and starting to explore career pathways. Dr. Tabaee described it as a hybrid program that includes group mentorship for the PGY1-3 classes, and one-to-one and resident-faculty pairings for the PGY4 and PGY5 classes.
The PGY1-3 mentorship experience is based on a group model with residency-wide meetings discussing important career topics in addition to PGY class dinners with different faculty members. Twice a year, a group meeting is organized to discuss a career-oriented nonclinical topic. Past topics have included managing stress and burnout, malpractice prevention, financial planning, managing complications, and coding and billing. Last year, a multidisciplinary seminar was held on microaggression in the workplace as it relates to gender and race. These programs are developed and led by the resident co-directors with faculty support. “Watching our residents embrace the leadership role in organizing and engaging these important discussions has been a proud accomplishment,” Dr. Tabaee said.
For the PGY4 and PGY5 classes, each resident selects a faculty member, often aligning with their career interest, for a one-on-one mentorship experience. The resident and faculty member meet three to four times over the course of the academic year, with specific agenda items for the meetings, including a general check-in about the resident’s well-being, residency issues they may be working through, and extended discussions regarding fellowship and career preparation.
Dr. Tabaee explained that, prior to the program, mentorship happened naturally over the course of the five years of training, with residents receiving meaningful career counseling and support from faculty. “It made sense to create a formal mentorship program to complement the rest of the residency experience,” he said. “Having regularly scheduled, organized mentorship events allows us to actively engage with all of our residents throughout each stage of their training.”
Having regularly scheduled, organized mentorship events allows us to actively engage with all of our residents throughout each stage of their training. —Abtin Tabaee, MD
The NYP program leadership includes faculty from the different campuses, along with one PGY-3 and one PGY-5 resident who serve as co-directors. “Resident leaders on the mentorship committee provide a sensitive and connected direction to the program. Additionally, it’s a great opportunity for them to take on leadership roles within the department,” said Dr. Tabaee. The year-to-year development of the program is largely based on resident feedback and the leadership of the two residents on the committee. “There are new resident leadership and fresh perspectives each year. This collaboration allows the mentorship experience to continue to evolve,” Dr. Tabaee said.
University of Colorado Anschutz Medical Campus
At University of Colorado Anschutz Medical Campus, each incoming otolaryngology resident is assigned a faculty mentor as soon as they start their intern year. They’re expected to meet at least twice per year to discuss upcoming goals and review previous goals. Additionally, each junior resident is assigned a more senior resident for peer mentorship. Residents are also encouraged to develop mentorship relationships with other faculty and residents on a more informal basis, depending on who they “fit” with, according to Cristina Cabrera-Muffly, MD, director of the residency program and an associate professor at the university’s department of otolaryngology–head and neck surgery.
While residents may change their formal mentor as much as they would like after PGY-1, most do stay with their original assignment, although a few change mentors once they decide on a subspecialty. Dr. Cabrera-Muffly explained that sometimes there isn’t a good fit between a mentor and a mentee, but a key component to success is that residents can change their mentor without the concern of insulting or disappointing them.
Dr. Cabrera-Muffly sees benefits to both formal and informal mentorship relationships. Although assigned formal mentorship relationships can develop over time if there is a strong bond, a deeper connection may develop in informal mentorship relationships because they require more up-front investment than do random pairings of a mentee and a mentor.
How we cultivate diverse talent has major implications for what our specialty will look like in the years to come. —Michael J. Brenner, MD
Mentorship at the residency level can help residents focus much more on what they want their life to look like throughout their career, which differs from mentorship for medical students, whose main goal is to absorb as much knowledge as possible while deciding what specialty to pursue. “The mentorship program helps residents to reflect on their progress and career goals at definite intervals throughout their training. This helps them refocus their efforts and make the most of their experiences,” Dr. Cabrera-Muffly said.
Ohio State University
The otolaryngology residency program at Ohio State University includes multiple levels of mentorship. PGY-1 residents are assigned to PGY-3 mentors for two years to help guide them through the process of becoming a resident physician and navigating the first two years of training. Every resident also selects a research mentor, who may be a clinical physician or PhD researcher who assists them with their research projects and rotations. In addition, each PGY-1 resident is provided with a faculty mentor when they start their residency training.
“This is meant to be a Big Sister/Big Brother type of experience, where the faculty mentor and resident mentee meet outside of the hospital on a quarterly basis and discuss various topics that relate to life in medicine and building a clinical and academic career,” said Brad deSilva, MD, director of the university’s residency program and vice-chair for education in the department of otolaryngology–head and neck surgery. According to Dr. deSilva, who’s also the laryngology fellowship director at Ohio State University, every resident during the past 10 years who has sought a fellowship has been able to achieve a fellowship position in the field they have chosen.
Dr. deSilva explained that residents have support from day one to help them navigate the challenging process of residency training. Thanks to the mentorship program, the residents are more successful at creating work–life balance and building strong academic careers. From a leadership and research standpoint, these mentorship relationships are most beneficial in helping the residents achieve the fellowship match or future employment opportunity they desire.
Dr. deSilva said the program takes effort from both faculty and residents, and it requires dedicated faculty who are engaged in teaching and mentorship. He noted that evaluating faculty engagement is the first step, prior to creating relationships and mentorship pairings. “An engaged faculty member is a true asset to helping the resident physician reach their full potential,” he said.
Research on residents and their futures has validated the need for strong, targeted mentorship, particularly in terms of gender and diversity equity.
In a study published online in July 2021 in Ear, Nose & Throat Journal, Madeline Goosmann, MD, PGY-2 otolaryngology–head and neck surgery resident at Henry Ford Hospital in Detroit, and her colleagues looked at the importance of female career and research mentors, co-residents, and program directors/chairs to current female otolaryngology residents when applying to residency (Ear Nose Throat J; doi:10.1177/01455613211029805).
Mentorship during residency is essential not only academically and surgically, but also as a human being. —Madeline Goosmann, MD, PGY-2 otolaryngology–head and neck surgery resident
Surveys were emailed to 119 programs; program directors were asked to distribute the surveys to female residents. Of the 62 participants nationally, 87% stated that having at least one female attending or coresident was “very important” or “important.” The authors concluded that residency programs with women in these roles may gain a higher number of female residents, as they may be more desirable places than those without women in these roles.
“As a woman in a traditionally male-dominated specialty, fitting in can sometimes be a challenge,” explained Dr. Goosmann. She noted that when she met Kathleen L. Yaremchuk, MD, department chair of otolaryngology–head and neck surgery at Henry Ford Hospital, as a medical student, “She was someone who served as an advocate and was a beacon for women entering the field.”
In special communication published earlier this year, Michael J. Brenner, MD, an associate professor in the department of otolaryngology–head and neck surgery at the University of Michigan Medical School in Ann Arbor, and colleagues covered the concept of mentoring, with key shifts from passive to active engagement, unstructured to structured relationships, and near-peer and reverse mentorship (JAMA Otolaryngol Head Neck Surg. 2021;147:389-394). Dr. Brenner explained that success is based on approaches including utilizing deliberate outreach, establishing a track record of success among diverse mentees, and cultivating new opportunities. It’s also important to create spaces for sharing knowledge, experiences, and challenges as part of the larger goal of championing diversity, equity, and inclusion. (Several of the authors of this work will also be featured in a live-streamed session at the 2021 American Academy of Otolaryngology–Head and Neck Surgery Annual Meeting in October 2021.)
While having a peer group plays a vital role in a resident’s training, Dr. Brenner said that care should also be taken to ensure that opportunities for clinical activities, research, and leadership are distributed equitably among all residency learners in a program. There can be surprisingly large differences in the size of individuals’ available mentorship and sponsorship networks, and these differences have key implications for personal growth and career advancement.
“I’d like to reiterate the importance of being a talent scout for learners—seeing all of our bright aspiring learners as individuals with unique gifts,” he said. “Also, we as mentors have a duty to work in service of our mentees’ vision, rather than our own. The leaders of tomorrow will include both those who follow in the footsteps of today’s great leaders and many who blaze a new, less familiar trail: patenting technology, disrupting current approaches to care delivery, or adopting novel models of care. How we cultivate diverse talent in new otolaryngologists has major implications for what our specialty will look like in the years to come, and diversity is an engine for innovation and progress in our vibrant specialty.”
“Mentorship during residency is essential not only academically and surgically, but also as a human being,” added Dr. Goosmann. “Residency is a time of condensed learning, and it’s easy to live day to day without taking a step back and allowing time for yourself. Having a mentor to help mold you as an otolaryngologist is wonderful, and mentors can also keep you centered on the big picture of practice and being a compassionate and competent provider. Mentors allow you to view ideas and situations in a new light. They can help you reframe ideas and problem solve clinically, in research, and in career planning.”
Katie Robinson is a medical freelance writer based in New York.