The highway runs both ways

Many of you know that I have a strong interest in mentoring and the impact of mentoring on career development in academic surgery. I’ve been wrestling with this question in one form or another since the middle of my own residency.  It’s easy enough for us to be prescriptive about qualities of effective mentors or structures that foster effective mentor-mentee relationships.  What we focus on less commonly is the mentee’s role in the relationship; the reality is that a mentor can be the best mentor in the world, but if the mentee isn’t active in the relationship, it’s doomed to failure (see analogy here: you can lead a horse to water…).

Since the academic year is about to change, I figured there’s no time like the present to provide tips and tricks for being an effective mentee.  Full credit goes to some mid-career and senior women surgeons who I interviewed from 2013-2015, and who provided the following concepts of being an effective mentee.

  • Put yourself in the driver’s seat– No, I’m not telling you to boss your mentor around.  What I am telling you is to be clear about what you want/ need/ expect from the mentoring relationship.  Not only do you need to actively seek mentorship, you need to have a purpose in that relationship. If you come into my office and ask me to mentor you, I’m pretty likely to ask you to think about in what your goal is for our mentoring relationship…and send you away to think about it.
  • You are accountable, and it’s up to you to report back– Let’s pretend that you came to my office and asked me to mentor you, but you didn’t have clarity around what you wanted that to look like or what exactly you wanted from me.  I gave you the task of figuring that out and told you I was happy to meet again once your ideas are better formulated. In general, I’m not going to come find you to get some idea how your brainstorming is going.  It’s your job to do your homework (so, put on your thinking cap) and reach out to me when the time is right.  I’m not clairvoyant so I can’t guess, and if you do your homework then come back I know that you’ve got skin in the game. I’ll make time for you, and please don’t worry about me being busy- I am, but if you’re invested I am invested too.
  • Be receptive to feedback- A high-performing mentor will have to perform acts of radical candor if they’re doing their job effectively. That means that the feedback they give you may not always be sunshine, rainbows, and bunnies.  When I am having to give you hard feedback, I’ll do my best to deliver it respectfully and thoughtfully as long as you try to stay tuned in.  I know how challenging hearing negative things is because I’m not perfect either and have heard plenty of them over the course of my career.  I’m also giving you the challenging feedback because I suspect it’s not part of who you aspire to be, and my job is to help you be the best version of you. Oh, and after I say the hard things? Please act on them!
  • If I open doors for you and provide you with opportunities, please capitalize on them- This is self-explanatory.  Go out there and shine bright if I’ve sponsored you for something!
  • While this may be a long-term relationship, we’re not married- I know that you’ll likely outgrow me someday, or that I may help you meet the goal that you set in working with me as a mentor. If we’ve had a successful run together, I’m always going to be interested in what you’re doing, even when I’m not directly part of it, and it’s not going to hurt my feelings if you tell me you’ve got another mentor(s).  Quite honestly, my best success is shown when you’re succeeding, and perhaps when your own success exceeds mine.

Any other “best mentee ever” tips out there, readers?  Please share!


A bit of kindness

The following is an excerpt from an email I recently received from a mentee:

“I love, love, love surgery, but even as someone who has thrived in this environment, I now acknowledge that there are some aspects of the culture of surgery/academics/surgical and medical education that I am deeply unsettled by and wish very much to change. I see fellow students, residents, fellows, young faculty transform from being full of zeal and goodwill into angry, bitter, jaded people, and it’s absolutely disheartening to see.  What’s more infuriating (to me because of the wrongness of it all and because I’m such a fixer) is that those who have been negatively affected and are the very ones capable of enacting positive change because they’ve “been there” sadly become the very ones who perpetuate the indignities of the broken culture, and they don’t even recognize that they’re doing so.”

Her important question that she asked me, and one that I found incredibly wise, was, “Did you ever struggle with this during your training or see this among your colleagues? Or even now?”

I asked her if I could answer this on the blog, and she graciously said yes.  It was important for me to do so because I feel obliged to make some confessions related to her concerns.

The biggest one?  I had many days during my residency when I was so tired, so broken, so frustrated that I wasn’t a nice person.  While I was able to focus on doing the right thing for my patients, I could be and often was impatient with students who needed nurturing and staff who were still learning too.  I was so Hell-bent on my own survival, on not making mistakes,  on not showing any shred of evidence that I might not be able to succeed as a surgeon that I had no qualms about running over people.  I nearly quit surgical residency during my PGY2 year because I didn’t like what I was my self becoming (then was nurtured by some VERY kind mentors who managed to help me hang in there).

I attribute a significant portion of my behaviors when they weren’t outstanding to sleep deprivation and not having a functional set of skills for coping with my chronic exhaustion.  I also attribute some of my less-than-ideal behaviors to the surgical culture in which we were supposed to prove that we’re tough and don’t have flaws.  Reality check:  I may be resilient- I far prefer that word to “tough”- but I do have flaws. Sometime around my 40th birthday, I became okay with that.

I want to believe I was asked about this topic because I’m seen as someone who is generally patient and supportive.  A few key lessons have helped me get back to this place, one in which I think I existed prior to my 7 years of complete exhaustion and chronic stress.

  • We’re all struggling.  Every one of us is, in one way or another.  That’s not a source of shame, it’s a source of humanity.
  • If those moments in which your lesser self shows up are rare, people believe you when you apologize for your behavior.
  • We are all learning, ever hour of every day.  That’s what we’re here to do in a teaching environment.
  • As someone in a position of leadership, my team and those around my team rely on me to set a tone.  I don’t want that tone to be one of nastiness, blaming, and negativity because I want/ need a high-achieving team.  Therefore, it’s up to me to be supportive, to be patient, to take a deep breath before reacting, even when my gut wants to say, “WHAT were you thinking?!?”
  • When people are intimidated, their ability to think critically is impaired.  Working in an ICU, I need everyone around me to be a critical thinker.  Kindness does much more towards that end than bullying.
  • If all else fails, go for a walk with the dog.  Dogs are masters of this moment being the very best moment ever and that influence is contagious- particularly on a snowy day if one has a Siberian Husky in their life (as I do).

Happy Livvie


If nothing else I wrote tonight resonates with you, it’s my hope that a picture of an incredibly happy husky will help you pause and be a bit kinder.