Article 1
Power of mentorship for civilian and military acute care surgeons: identifying and leveraging opportunities for longitudinal professional development. Knowlton LM, Butler WJ, Dumas RP, Bankhead BK, Meizoso JP, Bruns B, Van Gent JM, Kaafarani HMA, Martin MJ, Namias N, Stein DB, Tadlock MD, Martin RS, Staudenmayer KL, Gurney JM. Trauma Surg Acute Care Open. 2023 Feb 27;8(1):e001049.
Mentorship has been a known critical part of success in surgical careers, and specifically in the realm of acute care surgery that encompasses trauma, emergency general surgery, and surgical critical care, there is a need for a robust mentorship structure. It is important to recognize there are not a lot of trials specific to mentorship in trauma specifically, and this piece highlighted a panel from September 2022 at the American Association for the Surgery of Trauma which provided realms to mentorship in the trauma space.
From the standpoint of clinical mentorship, it is important to recognize that mentorship does not end after formalized training does such as in residency and fellowships. When challenging cases arise, trusted mentors offer ongoing guidance and support as well as feedback. This requires time, respect, and honestly. From a research standpoint, mentees should remain introspective and remain responsible for their own academic productivity. Mentors in the meantime should provide clear expectations with deliverables. For both parties, communication is important. The article’s final broad categories include mentorship through professional societies highlighting those organizations (including EAST) through which surgeons can seek out mentorship and then military mentorship which is a unique set of responsibilities. The article itself offers questions mentees should consider regarding goals in their career and maintaining an open mind to what one’s career may look like long-term.
What this article offers by publishing the panel highlights is a space to read how many of the common elements of mentorship we discuss apply specifically to a trauma career, which is one full of nuance and specificity. As more research is done going forward in surgical education, these nuances can be studied in a randomized or retrospective fashion, however, this article is a great resource for trainees and surgeons at all levels.
Article 2
Feeling like an imposter: Are surgeons holding themselves back? Joseph B, Tseng ES, Zielinski MD, Ramirez CL. Lynde J, Galey KM, Bhogadi SK, El-Qawaqzeh K, Hosseinpour H, EAST Equity, Diversity, and Inclusion in Trauma Surgery Practice Committee. Trauma Surg Acute Care Open. 2023 Aug 8;8(1):e001021.
This review by Dr. Joseph and colleagues discusses the causes and effects of imposter syndrome in surgeons at all levels of training. While not a recognized mental health diagnosis, it is understood to be characterized by feelings of inadequacy, self-doubt, or fear of being “exposed” as a fraud, regardless of how much success one has achieved in his or her field, and is commonly seen in fields that are high-stakes and evaluative in nature. A quarter of physicians have reported frequent or intense imposter feelings. In surgery, both faculty and trainees suffer imposter syndrome, though trainees do so at significantly higher rates. Imposter syndrome is generally more prevalent in females, younger physicians, those from underrepresented backgrounds, and foreign medical graduates. However, among surgical trainees, imposter syndrome did not vary based on gender, ethnicity, PGY year or USMLE or ABSITE scores, but among faculty did vary based on gender and experience. The negative effects of imposter syndrome include burnout, suicidal ideation, and decreased professional fulfillment.
Individuals who experience imposter syndrome tend to attribute their successes to circumstances rather than skill and disregard positive feedback. They may be struggling and often positive feedback alone may not be enough. Help for individuals with imposter feelings begins with recognition of those feelings. This includes focusing on factual evidence that challenges their feelings of inadequacy. Successes should be recognized no matter how small, and one should take pride in their accomplishments and acknowledge positive feedback. Mentors of junior faculty and surgical trainees also play an essential role in providing support for their mentees.
While imposter syndrome has many negative effects on the individual, it also has consequences that extend far beyond the individual. At the system level, burnout and lack of professional fulfillment increases the risk of losing top faculty talent. Burnout and compromised physician wellness are associated with patient safety outcomes. Imposter syndrome is therefore a systemic issue that also needs to be addressed at a system level. This involves institutional culture change away from perfectionism to one of excellence, challenging mindsets that portray physicians as invincible, and promote seeking help when needed and normalize vulnerability. Formal mentorship and coaching should be considered for surgeons at all levels of training, as well as screening for imposter syndrome during periods of high-risk transitions in roles and responsibilities such as residency, fellowship and faculty onboarding.
Article 3
Effects of Mentorship on Surgery Residents' Burnout and Well-Being: A Scoping Review. Gaeta ED, Gilbert M, Johns A, Jurkovich GJ, Wieck MM. Journal of Surgical Education. 2024 Nov;81(11):1592-1601.
The authors of this scoping review set out to identify how mentorship may impact well-being and burnout among surgical residency trainees, and to determine what measures have been used to assess these areas. A total of 1,468 unique articles were examined, and 19 were included in the final analysis. These studies spanned several surgical disciplines, including general surgery, vascular surgery, neurosurgery, orthopedic surgery, otolaryngology, and urology.
The authors report several key findings from their examination of the literature. The definition of well-being was not standardized, although emotional well-being was most commonly emphasized. Mentorship was also not well-defined in most studies. Burnout was the most frequently assessed outcome and was most frequently evaluated using validated instruments. Ten of these studies used the Maslach Burnout Inventory, and seven of them demonstrated a positive benefit from mentorship. Well-being was assessed less frequently than burnout. Of the well-being studies, five demonstrated a positive impact. However, three of these did not present evidence of survey validity. One qualitative study was conducted, which suggested that burnout was reduced because mentors provided safe spaces to express concerns and served as intermediaries to program leadership. Although no qualitative study was conducted regarding well-being, the authors theorized that mentors might offer a similar safe space with social support and increased workplace control.
The scoping review identified several gaps in current knowledge about the impact of mentorship on surgical trainee well-being and burnout. First, there is significant variability in mentorship models, and a need remains for the development of mentor training programs to ensure high-quality mentoring. Second, there is a need to increase the rigor of wellness and burnout studies in surgical training. Most non–burnout well-being outcomes were not assessed using validated measurement tools. Additionally, most studies in this area are single-center, cross-sectional studies. Finally, most studies have been conducted at large academic institutions, highlighting the need to improve generalizability by including a broader range of training environments.
