Mentorship Malpractice MIND

Opinion

A PIECE OF MY Mentorship Malpractice MIND

Vineet Chopra, MD, The delicate balance of mentoring someone is not creating syndrome variant, the mentee willingly gives up lead po- MSc them in your own image, but giving them the opportunity to sitions on manuscripts or grants, mistakenly expecting The VA Ann Arbor create themselves. that the success of the mentor will ultimately cascade Healthcare System, Steven Spielberg down to him or her. It is only when this fails to occur that University of Michigan School of Medicine, mentees realize they have been cheated, but usually the Ann Arbor; and The word mentorship evokes strong emotional and in- damagefromsuchanegativeassociationisalreadydone. Department of Internal tellectualchords.Informalparlance,mentorshiphasbeen Medicine, University of defined as “a dynamic, reciprocal relationship in a work The Exploiter Michigan School of Medicine, Ann Arbor. environment between an advanced-career incumbent The Exploiter torpedoes mentees’ success by saddling (mentor)andabeginner(mentee)aimedatpromotingthe them with low-yield activities. Typified by self-serving 1 Dana P.Edelson, MD, career development of both.” In our careers in academic advice, Exploiters commandeer mentees by thrusting MS medicine, we have seen mentees benefit from mentors their scientific agenda or nonacademic responsibilities Department of Internal through development of critical thinking skills and ad- Medicine, University of onto them, often justifying such behavior as “the price Chicago Medicine, vice on research ideas, scholarship, and networking op- of mentorship” or “a valuable learning experience.” Ex- Chicago, Illinois. portunities. Similarly, now as mentors we have also ben- ploiters may assign mentees to mentor other trainees, efitted by gaining an ally to support our work, developing supervise project staff, or manage projects central to the Sanjay Saint, MD, MPH larger circles of influence, and establishing legacies as mentor, but not the mentee’s area of expertise. In this The VA Ann Arbor academic leaders. It is thus not surprising that mutually Healthcare System, way, Exploiters value managers, not independent sci- University of Michigan beneficial mentor-mentee relationships are a key predic- entists, and have no interest in cultivating mentees. School of Medicine, tor of academic success.2 Ann Arbor; and Whilemuchhasbeenwrittenaboutthequalitiesthat The Possessor Department of Internal 3 Medicine, University of constitute an ideal mentor, little attention has been ThetrademarkofthePossessorisdominationofthemen- Michigan School of given to behaviors that make one less desirable. This gap tee. Possessors are insecure and view seeking assistance Medicine, Ann Arbor. is important because mentor-mentee relationships are, fromothersasathreattotheirposition.Suchanxietieslead by definition, unequal, with mentees being more vul- possessors to take a passive-aggressive approach to col- nerable.Menteesarealsolikelytodisproportionatelysuf- laboration, disparaging potential co-mentors or demean- fer in a dysfunctional relationship, behooving them to ing the mentee for reaching out to others. Like a battered be cognizant of mentor behaviors that threaten suc- spouse,menteesinthisrelationshipbecomeisolatedfrom cess. In our combined 50 years in academic medicine, social and collegial interactions, making it difficult to rec- we have borne witness to—and, sadly, even occasion- ognizeorberescuedfromthePossessor.Rather,mentees ally participated in—suboptimal mentoring. While small are often lured into feeling special by the attention of the intermittent lapses are natural when managing various Possessor,whodoessoonlytofulfillhisorherownneeds. responsibilities, mentor behavior that puts a mentee’s academic career at risk crosses a threshold we term men- Passive Mentorship Malpractice torship malpractice. Here, we outline active and pas- Passive mentorship malpractice is insidious and shares sive prototypes of mentorship malpractice, using inaction by the mentor across three distinct subtypes. tongue-in-cheek names to portray behaviors and char- acteristics of the unwanted behavior. We then offer so- The Bottleneck lutions for mentees to approach these important men- Bottlenecksarepreoccupiedwiththeirowncompetingpri- torship problems. oritiesandhaveneitherthebandwidthnorthedesiretoat- tend to mentees. Their internal focus quickly diminishes Active Mentorship Malpractice mentee productivity, a phenomenon that is particularly Corresponding Characterized by dysfunctional behavior, active men- problematicforearly-careerresearchers.Therate-limiting Author: Vineet Chopra torship malpractice is often blatant and easy to spot. MD, MSc (vineetc behaviorofBottlenecksisaccentuatedwhentheyinsiston @umich.edu). Three classic phenotypes exist. signingoffonaworkproduct,essentiallyhandcuffingmen- Section Editor: teestotheirtimeline.Whilethequalityofthefeedbackmay Roxanne K. Young, The Hijacker offsetthiscost,menteesalwayspaythepriceindiminished Associate Senior Editor. Hijackers are bullies who take hostage a mentee’s ideas, academic output when working with Bottlenecks. Conflict of Interest projects, or grants, labeling them as his or her own for Disclosures: The authors have self-gain. Mentors who engage in this form of malprac- The Country Clubber completed and tice often do so in the setting of career challenges such The mentor who wants to be everybody’s friend and submitted the ICMJE as shortages of funds, publications, or intellectual cre- evades conflict—regardless of need—is the Country Form for the Disclosure ativity. Notably, some mentees are unknowingly com- Clubber. These mentors avoid engaging in difficult but of Potential Conflicts of Interest and none were plicit in this behavior, comforted by feeling valued re- necessary conversations on behalf of the mentee such reported. gardless of the underlying pretext. Like a Stockholm as negotiations regarding protected time, authorship po-

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Table. Diagnosing and Treating Mentorship Malpractice

Phenotype Underlying Pathology Diagnostic Symptoms and Signs Complicit Mentee Acts Potential Countermeasures Active The Self-preserving behavior Academic and intellectual Sacrifice first-author Quick and complete exit. There is Mentorship Hijacker related to string of failures. insecurity, financial challenges, positions; name mentor no way to protect yourself in Malpractice limited creativity, fear of being as principal investigator this relationship. overtaken by others. on projects. The Self-serving philosophy with Assignment of tasks such as Willing to accept Trial of firm boundary setting Exploiter tendency to self-worship; supervising staff, managing nonacademic chores that and use of additional mentors to promotes personal interests projects unrelated to mentee. support mentor rather evaluate requests. If or when over mentees. Believes mentee should be than self. mistrust ensues, exit the privileged to work with them. relationship. The Anxious personality with Specific instructions to not Foster isolation by following Insist on a mentorship committee; Possessor powerful feelings of engage with other mentors or mentor demands; confront mentor with concerns inadequacy, fears loss of collaborators; constant misinterpret undivided regarding siloed approach. mentee to others. supervision of mentee activities. attention. Passive The Internal preoccupation Often busy with own tasks or Allow the mentor to set Set firm deadlines and be clear Mentorship Bottleneck coupled with limited projects; limited time to meet timelines; facilitate behavior about what happens on those Malpractice bandwidth or interest to face-to-face; inadequate by silence or lack of deadlines; follow through with support mentee growth. response to requests for help; insistence on clarity/detail. action and articulate frustration delays in feedback. with mentor inability to prioritize. The Conflict-avoidant Avoids advocating for mentee Fail to ask mentor to Develop a mentorship team so Country personality, needs to be liked resources such as staff, protected advocate for mentee. other mentors may engage in Clubber by colleagues; values social time; discourages mentee from conflict on your behalf. Approach order more than mentee similar debates. conflict/debate with focus on growth. impact if not addressed. The World Academic success fueling Internationally renowned, highly Accept lack of mentor Establish a regular cadence of Traveler personal ambitions, travel sought-after for speaking availability; fail to connect communication. Reserve time well requirements, desire for engagements. Limited with mentor via alternative in advance for in-person meetings. fame/appreciation. face-to-face time due to methods of communication. Use alternative methods for physical unavailability. communication.

sitions, or research support. They minimize the importance of Set Boundaries and Communicate Needs conflict and encourage mentees to do the same. Country Clubbers Effective communication helps prevent mentorship malpractice.4 view mentorship as a ticket to popularity, with the number of men- This is particularly important when dealing with passive pheno- tees serving to promote social capital rather than responsibility. types; with active phenotypes, mentees must set firm boundaries Mentees in this relationship are not only unsupported, but also find and confront mentors when violations occur. it difficult to assert themselves given the “nice guy” routine. Establish a Mentorship Team The World Traveler Allformsofmentorshipmalpracticebecomemoredangerouswhenthe These mentors are highly successful and sought after for meetings, mentee is dependent on one mentor. Having several mentors allows speakingengagements,andleadershippositions.Consequently,they mentees to not only learn from each advisor, but also more easily rec- have little time for their trainees on a day-to-day basis. Ironically,the ognizedysfunction.Forexample,Hijackersstandoutlikeasorethumb more successful a mentor becomes, the more at risk of developing in comparison to Country Clubbers, whereas the World Traveler’s lack this form of malpractice. The world traveler can take a laissez-faire of availability can be partly overcome by the involvement of others. approach, leaving the mentee effectively mentorless from lack of face-to-face time and direction. Know When to Walk Away Some malpractice is so egregious and refractory to countermeasures Preventing Mentorship Malpractice thatitshouldbeviewedasadealbreaker.ThisismosttrueoftheHijacker It is important to understand that mentorship malpractice does not but should be considered for others when countermeasures fail. If a occur in a vacuum; rather, such dysfunctional relationships require mentor is sabotaging the mentee’s career, consciously or otherwise, both parties to participate either willingly or unknowingly. There- mentees must be prepared and willing to end the relationship. fore, a key step in preventing mentor malpractice is recognition of the malady and deployment of key strategies (Table). Conclusions In times of tight research funding, the need for effective mentors Don’t Be Complicit has never been as acute. Mentorship malpractice is a serious bar- Whether it is sacrificing papers to the Hijacker or accepting chores rier to achieving this goal. Mentees must identify these problems with no academic yield for the Exploiter, mentees are tacitly com- within themselves and their mentors in order to remedy such is- plicit when mentors malpractice. Mentees must therefore insist on sues. Failure to do so can result in catastrophic loss. Academic medi- change when mentors malpractice. cine can no longer afford such behavior.

1. Healy CC, Welchert AJ. Mentoring relations: 2. Sackett DL. On the determinants of academic 4. Saha S, Christakis DA, Saint S, Whooley MA, a definition to advance research and practice. Educ success as a clinician-scientist. Clin Invest Med. Simon SR. A survival guide for generalist physicians Res. 1990;19(9):17-21. 2001;24(2):94-100. in academic fellowships part 1: getting started. 3. Humphrey HJ. Mentoring in Academic Medicine. J Gen Intern Med. 1999;14(12):745-749. Philadelphia, PA: ACP Press; 2010.

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