Hi. Welcome to National Grand Rounds. Thank you all for coming. My name is Dr. Karen Barr. I'm moderating today's session on mentoring. I have three hopes for this session. One hope is that if you're not currently a mentor, this session will be inspiring to you and you'll learn some knowledge and skills to begin mentoring. The second is if you already are a mentor, that you'll be able to improve and find strength to move forward in this really important part of our field. Then the third is if you're a mentee, that you'll learn some pearls on how to get the most out of that relationship. I think the big joy of today's session is that you're going to get to see a little piece of what one of our panelists, Felicia Skelton, called a mentoring web. You'll see how we're all part of a mentoring team. We're hopeful that during this session, you'll use the chat to really give the shout out to some of your mentors and mentees that you've worked with and that you'll learn some knowledge and skills and inspiration to really strengthen and increase your own web. We're going to start with introductions to the panel. I'll go first. My name is Karen Barr. I work at University of Pittsburgh, UPMC. I work with residents and medical students. Mentoring them has really been the joy of my career. Clinically, I do EMG and musculoskeletal medicine on complex and sick patients. Shout out to my mentors. The first is the center of today's mentoring web, Dr. Mike O'Dell. You're just going to see just a little portion of the influence he's been able to have on our field through mentoring. I worked with him when I was a resident. He inspired me to enter academic medicine, and it's just been the best decision I ever made. Thank you very much. He also introduced me to my second mentor is Dr. Kathy Bell. Many of you know her from being an academy president. Dr. O'Dell invited me to join him on a scholarly project, the AAPMNR. I met Dr. Bell. She was on the hiring committee that got me hired at University of Washington. She was my service chief there, was such an inspiration as a clinician scientist, but particularly as the mom of three boys. She has three successful young men. I had two young children while I worked with her, and she was so helpful to me. Then the third mentor I wanted to give a shout out to was Dr. Terry Misagly. She mentored me into the role of residency program director when I was at University of Washington. She's also mentored several other people on this panel. You'll start to get this idea of a web and how we're all connected. Dr. O'Dell, we'll let you go next. Thank you, Karen. My name is Mike O'Dell. I'm a professor of clinical rehabilitation medicine at Cornell Medical School, and also adjunct professor at Columbia as well. I posted my mentors from medical school, a couple of people you're not even going to know, Arthur Provisor, really mentored me and helped me gain some confidence in myself. Anybody that was at Penn during the 80s and 90s will know Lori Jufra. Lori was a great mentor in terms of my developing a great pride in our field in physical medicine and rehabilitation. Then I have a group of mentors for different things. At a 10,000 foot level, Bruce Gans has been a mentor my entire life. For stuff, practical stuff down on the ground, nobody's been better than Gary Clark. Gary's not a whole lot older than I am. We're very much contemporaries and yet he has really served as one of my mentors. Then from a brain injury research and clinical standpoint, Betsy Sandal, my mentor in fellowship. I still tell her the best thing I ever did in my entire career was doing my fellowship with her, and John White. Depending on what aspect I have questions about or I need some help, I have different people that I go to. Great. Dr. Custodio. I'm Chris Custodio. I am an associate professor at Weill Cornell Medicine. I work with Mike very closely. I am an associate attending at Memorial Sloan Kettering Cancer Center, where I'm also the Cancer Rehabilitation Medicine Fellowship Director. As Felicia said, I am part of that web where I have mentors like Mike O'Dell, and I have transitioned, I think, hopefully smoothly into the mentor role with my fellows and my residents. My first introduction to physical medicine rehabilitation was in medical school. Originally, I went in thinking I wanted to be an orthopedic surgeon and I knew I wanted to go into sports medicine. I sought out the sports medicine attendings, and the first physiatrist I ever met was Scott Nadler, and he was instrumental in me pursuing the specialty. Then when I did my acting internship in PMNR, I wanted to do it in sports medicine. I lost the lottery and it ended up getting a palliative medicine rotation under Elizabeth Narcession, who opened my eyes as to what the rest of PMNR could be. In residency, too many attendings to mention, but key were Jeff Strumman, Kate Stulp, and Gail Gamble, who has served as my initial cancer rehabilitation mentor. As I was developing my career at Memorial Sloan Kettering, certainly Mike O'Dell, since there weren't too many physiatrists at Sloan Kettering at the time, he helped me transition back to New York, back to academic medicine, and the intense academic medicine hub that is the Upper East Side of Manhattan. Certainly have had so many peer mentors throughout my career, too many to mention, what I like to call drive-by mentorship. People like Michelle Gitler, Carol Vanderknacker, Gary Clark, a lot of my colleagues in the American Board of PMNR that have helped guide me and hopefully refocused me in my career. So I could go on forever, but I won't. So thank you. Thank you. Dr. Reif? Hit the wrong button there. That's all right. Hi, everybody. My name is Katie Reif. I am still in residency with this wonderful esteemed panel here. I am a PGY-4 resident. I'm one of the chief residents at the New York Presbyterian Program that combines Columbia, Cornell. We also get to rotate at Memorial Sloan Kettering. So there are some familiar faces on this call to me and certainly some of my early career mentors. I think moving forward, my academic interests are a little unusual. I'm planning to pursue a second residency in emergency medicine, and I'm hoping to combine those fields, which is something that is not known to me out there. There is not an exact mentor for that. So I think this is a perfect session to talk about how you really find people that don't do exactly what you do, but can guide you in your path. So shout out to some of my mentors, certainly on the panel. Dr. Custodio wrote one of my letters for my second residency interview season. I go to him with anything that I really respect his critical thinking and how you think through a problem. Dr. O'Dell, of course, is the king of research at our institution and how to design a study and really the long view of what you want out of life, what you want out of a career. And then also at our program, our APD, Dr. Beckley, as well as Dr. Chris Fisco, who's our program director, have been really so supportive of this unusual career path for me. And then I just wanted to touch on the web aspect. Dr. Kathy Bell, I actually went to UT Southwestern for medical school. And although we didn't have a close relationship, she really inspired me as a woman in medicine and her role as chair there. So I think everything comes back around, and it's a small world out there, and that's a really great thing. Absolutely. Dr. Skelton. Hi. I'm really excited to be here this evening, not afternoon. I'm Felicia Skelton. I'm an assistant professor at Baylor College of Medicine, an investigator at the Center for Innovations and Quality Effectiveness and Safety, which is the health services research center of excellence here associated with the Houston VA, and an assistant professor in the Department of Human Arts here at Baylor College of Medicine. I am a clinician scientist, and so I'll be providing some of my perspectives on mentoring from that aspect. I have a VA health services research and development career development award looking at infections after spinal cord injury. And so I've had to work with people in rehab, but also cross-cutting across different specialties, across different disciplines, across different professions. I work with pharmacists, epidemiologists, physicians, and so I've really valued, again, the mentorship, sponsorship, encouragement, just kind of personal life coaching that I've gotten from all those folks again. So I put some of my mentors in the chat box. I forgot one giant one, and I know she's on the call. Ileana Howard was my mentor all throughout residency, and I'm going to type her in in a second, but she was so gracious with her time and her energy. It was so supportive of me during residency, but also again, Drs. Barr and Dr. Singh, Virtaj actually recruited me to UW. We have that kind of Baylor connection, and so he was definitely kind of the highlight of my interview day. But obviously, Dr. Misogly, I feel honored that I was the last class that she graduated. I will always, that will always be really special to me. Kathy Bell as well, I think a couple of people have mentioned her. Maria Reyes, Debbie Craig, Steven Burns, because spinal cord injury is a very small, tight-knit subspecialty, and I'm so thankful for that. As far as like getting my research career off the ground, I will always be thankful to the knowledge passed on by Drs. White, Boninger, through the RMSDP program. Amy Houtro, who I still kind of interact with and collaborate with, and eventually Allison Stern, and she was at the NIH, but she's moving on. She was over in CMRR. And then here at Baylor, Dr. Holmes, who is my SEI Carolina exec here, and just my kind of clinical career mentor, Jim McDevitt was the chair that recruited me. And again, way too many other physicians and other disciplines and researchers and other disciplines to name. So I'm really excited about this talk today. Great. Dr. Singh? So I'm Virtaj Singh. I'm out here in Seattle, Washington. Just finished up my work for the day. I'm in private practice at a place called Seattle Spine and Sports Medicine, but I also have a faculty appointment at the University of Washington, so I sort of bridge those two worlds. I also trained at the University of Washington. So you've heard this name already twice, but I will throw out Carrie Misagly as a very important mentor. Anybody who trained at the University of Washington around this time will count her as a mentor. I did a pain fellowship. So of course, when you're in a one-year fellowship, your program director during that one year is very crucial to your career. So Dr. Andrea Trescott, I would throw out there as another mentor. And then now that I'm in private practice, you'll find that it is very critical that you have somebody who can teach you the world of private practice. So I'd have to say my boss, Dr. Richard Cerusi, as another important mentor for me. Great. Thanks. Well, now we're going to move on to the meat of our panel discussion, and we'll let Dr. Adel kick it off with some thoughts on mentoring and what makes somebody a good mentor. Thanks, Karen. Appreciate it. Quite honestly, mentoring has been one of the most personally rewarding aspects of my career over 40 years, actually, since starting medical school. I don't have children. And so this is very much like watching my kids grow up and that same kind of great satisfaction. It's so wonderful, the warm feelings that you see when people, the Karen Bars of the world and the Tom Watnabes of the world and the Lisa Ruperts and Eric Wisotzkis and David Chang. To see your mentees grow professionally and become successful and become great mentors themselves is just so, so rewarding. The peak of this was five years ago. On match day, I had spent quite literally hundreds of hours mentoring three different medical students over probably three or four years. And on the same match day, Paul Haffey matched to us at New York Presbyterian, Marco Massi matched at Shirley Ryan Ability Lab, and Hector Osorio matched at Spalding, all in the same day. And dear colleagues, talk about professional satisfaction. It really doesn't get any better than that. Actually, before we head into the other talks, I want to throw some terms out to you as well, because I think it's important to distinguish for certain aspects. Coach, a advocate or sponsor, and a mentor. So a coach is what a coach does. A coach is somebody who tells you what to do. For example, I have a junior faculty member at Cornell now who is starting a new program. This is something that we really aren't taught much in residency. And so this person doesn't need theoretical underpinnings or infrastructure from me. They actually need lists of things to do. They need guidance and very concrete guidance on what to do. I'm serving as a coach. A sponsor advocate is somebody who tells other people about you. Perfect example. Last week, I grabbed the CV of one of our junior faculty at Cornell and sent it to the editors of one of the rehab journals, suggesting, hey, this would be a great person for you to keep in mind the next time you need to add somebody to your editorial board. A mentor is somebody who talks to you, who gives you advice over time. It's a longitudinal experience. Now, as it turns out, those two folks that I just talked about, I also serve as their mentor, but I wouldn't have needed to. It easily could have been a one-off, here's what you need to do for the program. A one-off, hey, can you send my CV to the editorial board? And that would have been done with it. But mentors suggest that there is something ongoing. You are talking. I listen to these folks' goals, their challenges, particularly what problems they're having in their practices. I offer my opinions and my experiences, scenarios where I have failed utterly and miserably at trying to do the same things that they're doing. Those stories are really important. And I think really important, I help folks that are younger tease out what's important and what's not important, because it's not always obvious. It really isn't. Karen wanted me to comment on what benefit mentorship could be to the institution. I would argue that a well-mentored faculty is more likely to be a successful faculty. A successful faculty is more likely to be a happy faculty, and a happy faculty is more likely to stay put. And so in terms of faculty turnover and the recruitment process, I think any chair will tell you that that is so time-consuming, wickedly expensive, and it's disruptive to the department. So great mentorship helps add to the stability of the department. I would also argue that if your faculty is well-mentored, they have role models that helps them become good mentors themselves. And they can pay it forward to the medical students, the residents, the fellows, the administrators, the OTs and PTs, the research staff. I think there are any number of directions that those skill sets can be sent. But not only the department, but the medical school or the hospital, perhaps PMR in general, or even medicine in general. How has mentoring evolved over my career? I think I leave the initiation of almost everything to the mentee now. If something needs to be done, they come to me to ask to get it done. I think, hard to believe, I listen more and talk less than what I used to do. I start lots of sentences with, hey, you can do this however you want to. But if it were me, I would, and go on from there. Like my teaching style, I think I've become more Socratic in my interactions with my mentees. Teaching them not how to think through solving a problem, whether or not they actually solve it or not. But the process is really, really important. And these are mostly non-clinical problems, folks. These are political issues. These are, how do I interact with this chunk of the organization? How do I influence an administrator more? This isn't bread and butter daily patient care. These are different kind of problems that they face. And then finally, the question of nature or nurture. Can you create a mentor? Well, I think it's a little of both. So I think a good mentor should have, and so consequently, a mentee should look for the innate qualities of really good listening skills, empathy, honesty, even if it's painful to relate something, and a decent measure of both self-confidence and also selflessness. It's very difficult to have a mentor who has their best interest in mind rather than your best interest in mind. And then also the learned qualities, I guess learned qualities of having some degree of political prowess. You've got to know the system and how to work your way around the system. And somebody who's had a bunch of both successes and failures and knows what those things look like and smell like so they can help the mentee figure that out. So a mentee should search for a mentor with these qualities. But even if you find somebody that has each and every one of those qualities, if the spark isn't there, if the chemistry isn't there, if the connection isn't there, then my recommendation be that you probably need to keep looking. Excellent. Yeah, I think you made some excellent points about the qualities that make a good mentor. And I love how you talk about the, as you become more experienced, it's a lot of the mentee has to pick up their half of the ball, right? It's a relationship. Maybe more than half of the ball. Yeah, yeah. So I think that's a great transition to Dr. Custodio, who can talk about his role as a mentee and mentor and what you found worked for you well as a mentee. I think, certainly, I've always been of the paradigm of see one, do one, teach one. So just having mentors that I've approached, like with Dr. Nadler, what do I need to do to become more competitive in PM&R? What do I need to read? What do I need to practice on in physical examination? So part of it, as a mentee, starts off very basic, like what skills, what knowledge base do I need to do to get to the next level? So you retain that as a teacher, as an attending, working with medical students and residents and fellows. As you progress through residency, it's not just developing the knowledge and the clinical skills, it's how do you integrate this into what practice you want to end up doing? What kind of practice do you want to be? What do you want to be when you grow up? Do you want to go into academics? Do you want to go into private practice? Do you want to pursue a fellowship? What are the skills necessary? What are the resources I need to tap into to get into that? So learning these things as I'm progressing through my clinical career kind of stuck with me and trying to relive that, learn from the mistakes and the successes, like Michael was saying, on going through that and guide my mentee in that direction. The thing to keep in mind as a mentor is, yes, it's reciprocal, but it's really not about you. It's about guiding your mentee in the right path. As a mentee, they really need to have a lot of self-assessment and reflection on what they want to get out of the mentor-mentee relationship, where they want to pursue as far as their career. It certainly helps if the mentor and the mentee have a shared value system. Like Mike says, it's the start of hopefully a beautiful relationship that is going to persist throughout each of our academic careers or our professional careers. Like life, mentors can drop in and drop out. You're going to have different mentors at different stages of your career, depending on what your needs are. So at times, yes, I'm a professional development mentor, helping my fellows land the right jobs or getting them networking with certain individuals. At times, I'm a life coach mentor, having raised two kids in New York City, having gone through a couples match in medical school. Knowing all of those types of logistical challenges in balancing career and family can serve in that way. Working on program development, having started the fellowship program, and guiding some of my former fellows into establishing fellowships of their own at their own institutions or their new institutions. I've trained my competition to a certain extent, but that's good. Yeah, bring it. I love it. I want to hear some more about that experience of being a mentee from Dr. Reif. What are your thoughts on that? Sure. I think as a resident, as a medical student and a resident, that finding a mentor is a difficult process. I think where a lot of the panel is talking about this, and they found all of these great mentors, and I think as a resident, it's sometimes like, how do I do this? Where do I start? I think the best way to start is that it doesn't have to be, you don't have to know exactly what you want to do with your life. You don't have to know the person that is your mentor doesn't have to do exactly what you want to do. You just have to find those people that, when you work with them, when you hear them speak, you think, wow, they're so smart. I so admire them. I would want their advice when a tough topic comes up. That's where you start, and then you reach out to those people, and I think they're, like Dr. O'Dell mentioned, there has to be that spark, but there also has to be that availability. So some people, it may be the person has your same interests, and they're amazing, and they are super smart, and a wonderful physiatrist or physician in whatever realm, but at this point in their career, they do not have the bandwidth to mentor someone, and that it just may not work. So I think reaching out and sending an email saying, hey, do you have a few minutes to talk about this, and if you get that response, then yeah, sure, set up the time. Be respectful of their time. People don't have unlimited time to talk to you about different things, and have prepared questions, specific things that you want to know to start that conversation. I think also have lots. No one person can be everything for you. So there are the person that is going to be the absolute guru at research may not be the same person that you go to for a specific teaching ultrasound or something like that, and for me with bridging two different specialties, I do have very different mentorship groups. So that would be another piece, and then in terms of the other side of things, give it back wherever you can. I love talking to medical students. I love talking to other residents, and really some of those relationships are some of the most valuable, because you're creating this web. You're creating that chain, and you also get the value of realizing, oh, I do know some things now. Like I have something to share, which is really a little validating, and is helpful, and a great part of our specialty and growing as a physician. Wonderful. Dr. Skelton, I'd love to hear your experience, because I think you really had, you know, going the clinician-scientist route, you really have had maybe a different experience than some of the rest of us that are more clinicians. Absolutely, and so you specifically asked me to talk about kind of some of the specific challenges to mentoring as being a researcher, but I really think that they're opportunities, because I think in general, the classical kind of research mentor-mentee relationship is very structured. There's very tangible goals that you're working towards within the mentoring relationship. You know, if you plan on submitting a career development award, you have to have an entire mentoring plan, and so it's very structural. It's very intentional, and I think not everyone wants to be a clinician-scientist, and not everybody wants to be a researcher, but if we can take some of those ideas and translate that to clinical mentorship and educational mentorship, that could be really helpful. So I'm really big on, you know, when I sit down with my resident mentees, you know, what are your goals? What's important to you? What would you like to accomplish out of this relationship? You know, make smart goals. I think everybody's familiar with that term at this point, you know, specific, measurable, actionable, you know, time-bound goals that we want to accomplish in this relationship, because I think, like Dr. Reeve hit it on the head, you know, not everybody has an abundance of time. You know, nobody has an infinite amount of time, and so you want to maximize the time that you have with that person, and so I think that's really important, writing it down, you know, and being clear about what your goals are and what you need out of that person. Definitely in research, you have multiple mentors doing multiple things. I have a primary research mentor, but I have a primary clinical research. I have an epidemiologist that I work with. I have a medical anthropologist that I work with, you know, because I do a lot of qualitative research, and so no one person can be all of those things, and so you have to pick and choose, and you also have to know that you're going to outgrow those people. You know, as I'm moving on and moving into different, you know, my research portfolio is expanding and moving on to different things, you know, what my primary mentor used to be able to help me out with, I'm going to have to seek out new people as I'm working new skills, moving into different areas, and that's okay, but I think your mentors kind of tell you how to navigate that transition gracefully because transitions can be difficult sometimes. I'm also going to touch a little bit about diversity and mentoring, you know, how we can use mentoring to build a workforce that is more representative of the patients that we serve, which there's, you know, indisputable research right now that knows that, you know, patient outcomes are better, people are healthier when they have physicians and people that take care of them that are representative of them, and I think mentoring is a great way to do that because Dr. O'Dell touched on it, you know, you can have a mentor that kind of guides you longitudinally, a coach that's teaching you a specific skill, but that idea of sponsorship is super important, and the way that it was always defined to me is that that's that person that is talking about you in rooms that you're not in yet, you know, gets you seats at tables that you don't have a seat at yet, and that's huge, and so if you want to kind of create a diverse, you know, network, you need to sponsor people that don't look like you, you need to sponsor people that haven't traditionally, you know, occupied those spaces that folks are occupying, and that person is going to bring folks along, and you're going to give them the skills, give them the knowledge, you know, give them the finesse to navigate those rooms and navigate those circles, and that's going to make everybody better. It's going to make everything better, and just know that you don't have to do it alone. There's lots of research out there through national organizations that show you how to be a good sponsor, how to be a good mentor, you know, diverse mentorship teams in research and in clinical medicine and education. It's something that I'm really proud of what we're doing here at Baylor as far as we're trying to kind of home grow our own, you know, diverse network of folks, and so, you know, giving them the skills that they need, and then I think as some of the other panelists have already alluded to, give back and be a mentor when you don't think you're ready, because you're never gonna think you're ready. I mentor a couple of different postdoc fellows now, and I'm just like, wait, you know, I'm on a Career Development Award. There's no way I can mentor somebody in research. I barely know what I'm doing myself, but they kind of sought me out and say, hey, you're doing the same sort of thing, and so can you help me do this, and I'm like, I don't know, I'll try, but those have been some of the most fruitful and successful collaborations that I've had, you know, is, I mean, tangible, not only that I enjoy them and I consider them my colleagues and my friends, but, you know, we've gotten publications, we've gotten grant, you know, proposals funded through these relationships and these kind of mentoring relationships that I didn't think I was ready for, so start before you think that you're ready, because if you wait till you're ready, you'll wait the rest of your life. Yeah, and I love how I could even, when you were talking about that, I could see the joy that that gives you, and that sort of harkens back to what Dr. O'Dell was saying about the career, you know, the career satisfaction, how mentoring can make you really enjoy your work more, and it adds, like, another layer of value to the work that you're doing, and then that, and that makes you more enthusiastic to put back more into it. Absolutely. I'm wondering, and anyone in the panel that wants to chime in, because I do feel like if I had to say if there was a dark side to mentoring, and you know, Felicia and I were talking about this earlier, but if there was a dark side to mentoring, I would say it would be propagating what, you know, we used to call the old boy network, right? You pick somebody who looks like you, or you know, someone who you went to Princeton with their dad, or you know, someone who you feel would fit in great, because she's just like you, everybody else there, and then you sponsor that person, or you mentor that person, and I'd love to get some thoughts from the panel on how we can not do that. So, I think some of that is the particular institution that you work in, and how diverse, you know, are you surrounded by mentees, potential mentees of some degree of diversity. I don't know how you do this other than it always has to be at the very top of your mind that if you're going to invest that time in someone, if you're going to try to propagate somebody's career forward, exactly as Felicia is saying. Who is not at the table? Who would be the best person to add a new perspective, a new career perspective, and a new life perspective as well? How do we make these groups that are making decisions look more like the people that we're making decisions for? Constant vigilance. I don't know other way to do it. It does start at the recruitment level, you know, where you're recruiting new faculty or new fellows or residents, you know, and try to make it as diverse but still talented a population as you can, and, you know, guide, you know, again, it has to come from the mentee, right? You have to kind of see what they want to do and what they want to pursue in their career. You don't want to take someone just because it's going to enhance the diversity pool and put them in a situation that they're not going to succeed. So there's certainly a lot of balancing or juggling and a lot of soul searching going on with that. I think that's a fair point that a lot of it does fall on, I mean, I'm primarily in the mentee position at this point, but I think don't be afraid to reach out to somebody that's not like you, that's not like your interests, that doesn't look like you, that doesn't have the background you have. You're going to get more out of that relationship because they've had different experiences. Chances are you already have mentors in your life that do look like you. So some of it's on the mentee as well. Yeah, I think you're right. I think it's, you almost have to look for like this spark beneath the surface, you know, what do you have in common? And for all of us, you know, it's a love of the field or a passion for education, you know, you look for those things that you do have in common, even though on the surface, you might say, well, I don't know if I have much in common with this person, but you really do have the essential things that are important. I'd like to switch gears just a little bit, because so many of our members are not in academic medical centers. And that's why I'm so happy to have Dr. Christopher to talk to us about his perspective and how he's been able to integrate his being a mentor and the mentoring needs he's had in a non academic health center employment. Yeah, so I'm currently in private practice. I've been in private practice since I graduated fellowship. So I'll touch on this in two different ways from the private practice perspective, the need for mentorship, and the need to need for mentorship. Private practice is unlike anything you've done in residency and fellowship, you're as best they try to prepare you for this, there's no way to really know this. And it is really critical to have a good mentor to whatever private practice you join. Little things like, you know, you don't have the same infrastructure you have in a big hospital system. So for instance, how do you turn on the EMG machine? How do you fill out a billing sheet, little things that you're not taught? Where does the where's the fluoroscopy suite? How do you turn that on? You know, what insurance companies should you be taking payer mixes, all these things you really don't know until you're in private practice. So I would have hated to have tried to start my own practice, going into a practice with somebody who had already started in, who was willing to sort of show you the ropes, the business side of medicine, I think was very important. So having good mentorship is incredibly important in private practice. And then I truly think it's important to become a mentor in private practice. The world of private practice can become a very lonely place, it can become a very money-driven place, and you can sort of lose the things you really enjoy doing. And so having a relationship with the university, getting to still train residents, getting to still mentor people, has actually been really good and keeping me out of that sort of dark, lonely place. Also when you're in private practice, you're kind of like an island away from the academic world. So having residents and students and more recent trainees is actually really helpful to sort of staying up to date on things. I've really enjoyed getting to sort of walk, teach people about private practice. You know, when you're in private practice, there's a tendency to think if you're training somebody, are you training your competition, right? But I look at it as I'm trying to train whoever I need to replace me later on. So I'm not going to do this forever. More and more physiatrists are not going into private practice. Things are going into these big academic centers, and part of that is because people aren't comfortable. So I really, when I see residents, I really want to sort of make them feel comfortable. I really like to try and mentor people in this because there's also that aspect of paying it forward. The other final thing I really like about mentoring people is I kind of then get to take credit for whatever they do. So whatever great things Felicia ends up accomplishing in life, I'm going to take partial credit for. There's only so much you can do in one life, but all these people I train, I get to be like, oh, I trained Felicia. I'm the reason she's so great right now. So I think these are the, you know, for private practice, I think all that's important. What advice do you give for people that aren't in an academic center and they want to be a mentor? Like how should they start? Well for me, having my association with the University of Washington is key. I get a lot of residents and stuff like that. One of the things I actually started in my own program was a pre-medical externship program. So it allowed me to hire pre-medical students, and I will tell you that has been the best decision I ever made. They work for you. They can basically function as your medical assistants. You can pay them less. They're harder working. They're smarter. They're just really good. That's one of the best things I ever did. So having that sort of young energy also keeps you sort of young, and it keeps you grounded. Like in private practice, the world just sort of beats you down slowly to the point you lose focus on why did I go into medicine in the first place. But when you have these sort of young enthusiastic people coming through, it really sort of energizes you and reminds you this is why I went into medicine. And you know teaching residents procedures, teaching younger people procedures actually keeps me more up-to-date on you know the latest techniques and how to do it, and it makes me more energetic about a procedure that I would otherwise be super bored with. So for me, having the affiliation with the university is good, but you know if you don't have that, you know you can find mentorship in other ways like pre-medical students. Dr. Singh, how many senior residents, when I've asked them what they're going to do next year, and I said you're going in academics, and the response is no way I'm going into academics. I couldn't possibly handle the politics, as if private practice doesn't have substantial politics as well. Who mentored you through the political aspects of a private practice? So my boss who started my practice was my primary mentor. His name's Richard Cerusi. The biggest key is I get to not make the same mistakes he made. He can say listen I made these 10 mistakes, don't make the same mistake. I'll give you an example. I wanted to put my, I wanted to be that doctor who was really in touch with his patients. I put my email address on my business card so that my patients could contact me. I was going to be the most you know in touch. He said do not do that, and he said I did that bad mistake. And then in terms of which payers you take, the politics of private practice is very different than the politics of the university system. It's more dealing with payers in a way that you guys in academics don't really have to. I mean, you have that to some extent, but in private practice, a lot of your time is doing peer-to-peer calls and fighting for every little cent. In the big institutions, you don't have to deal with that as much. So it's a different type of politics, but it is very political in and of its own way. That's a really interesting question, Dr. O'Dell. And I would just add on to that if you do go into academics, which is, again, I think very rewarding and can be very rewarding. Have a mentor outside of your primary academic appointment. I cannot stress enough how important that is because they are not in the fray of the same politics that you're in, and you can kind of have them run interference for you when you're negotiating things about protected time and space and funding and all this other good stuff. I cannot stress enough how helpful that can be. As a researcher, it's been gold, and even as a clinician, I think that's really important. I keep hearing the same theme of this mentoring team. I think it's so interesting because people tend to think I'm looking for a mentor, but really, you're looking for a mentoring team, right? And your different team members are going to step up and be more important at different times and are going to have different roles, and they're going to connect with you in different ways. And it's so valuable to have that. Let's see if there's any questions from the audience. We have about 10 more minutes in our session today. And keep on that. I haven't had a chance to glance at the chat, but keep on the chat. Shout out to your mentors. Are there any comments on the chat so that you can feel that you're interacting? If you have any questions, go ahead and submit them. Karen, I see a question in the chat box. Oh, good. Go ahead and read it out. So it's asking, how do you manage when people you admire as mentors see you as competition and not as part of their legacy? Great question. So this actually happened to my research mentor. It was unfortunate, but I think that's also one of those things where you, again, if the mentoring relationship was going well and now that seems to be happening, it's probably a good sign that you've outgrown that mentoring relationship and that there could be a failure to launch to a certain extent and that you really need to kind of be differentiating yourself from that clinician or from that person because that really just shouldn't be. That's a scarcity mindset, and I believe in abundance. There's more than enough out there for all of us to do as Puman R clinicians, as Puman R educators, definitely as Puman R researchers. And so that mindset is not helpful and probably means that that relationship has run its course. And that's OK. That's OK. Like I said, that's a natural progression of any mentorship relationship. Unfortunately, sometimes you get there sooner rather than later, but I think that's a good indicator that that relationship probably needs to end. I think that's a struggle, perhaps not a struggle, but a consideration for many department chairs. I mentioned what a time-consuming and difficult process recruitment is, and yet when you have junior faculty that come to you with a great opportunity that's going to take their career forward and is going to be the right move for their development, how difficult it is for a chair to be honest and say, you know what? I'm going to get hurt by this because I'm going to have to recruit somebody to take your place. But boy, this is a great opportunity for you. Is there anything that I can do to help you pursue this opportunity? Man, hearing that from a chair, which we hear all the time from Joel Stein just because of the quality of person that he is, when you hear it from a chair, I think that's a great reflection of the value system and the quality. Hello? Let's see. If you can see other questions, Mike, go ahead and shout out some other ones. Oh, here's one that makes me sad. How do you find mentors if you don't know any physiatrist? Oh. I know. So I think one of the ways might be through the Academy. So AAPMNR has a virtual mentoring system. It's under the early career part of the website. But if you just Google AAPMNR virtual mentor, there is a system there that you can put in your information. And the same for people that want to mentor someone, they can put in their information, and then the Academy makes that virtual match. I can read off another tough one. When you work with mentors who are of different culture, gender, racial backgrounds than yourself, and they do have something valuable to teach you, but they do hold stereotypical thoughts and display microaggressions, how do you deal with that? I think that's a really, again, I'm going to sound a little bit one note, but that's really where it's nice. If you have a mentoring team, you can go to one of your other mentors and bounce things off of them. I do that all the time. I'm just kind of like, am I being too sensitive about that? Did I take that wrong? Am I reading more into this than that needed to be? And they're like, no, no, that was a microaggression, or that was not OK, that was not cool, and this is how we're going to rectify it. And so I think if you don't feel comfortable doing that yourself, that's where that mentor, hopefully someone that's maybe a more senior person, can help have that discussion or at least facilitate that discussion. But I also believe, I still believe that a lot of people are good at baseline. I say that generally because of the day and time that we're in, but I do believe most people are good people in general, and they just haven't had that brought to their attention. I do still think that there's a lot of ignorance out there. And so sometimes, just very gently, but directly and succinctly bringing that to someone's attention and telling them that, hey, that, and be specific, I statements. If anybody's ever said that, I don't like the way that this makes me feel because X, Y, Z. And I felt like most people are very responsive to that. They just don't realize that A, B, or C as a microaggression is making you feel uncomfortable, hopefully. Felicia, I think you're right. Sometimes I think back at some of the things I've said, I just cringe. Everybody said things that they didn't, that was ungraceful, or that they didn't put it well, or they didn't mean it. And so I think you're right. If you give someone the benefit of the doubt, and then I think it's your personal choice, how many benefits of a doubt do you give someone? Or do you just say, that's the person that was helpful in telling me this little piece that I needed, but I'm certainly not going to use them as a role model. In fact, I'm going to learn what not to do, and see if you can value a specific aspect of the relationship, even though there are other parts of them that you don't admire at all. We learn so much from conflict. And I would echo what Felicia says. It helps to have multiple mentors that you can bounce ideas off of. That's one of my roles is mentoring someone in their other mentor-mentee relationship. How do I navigate some of those sticky conversations or sticky personality issues? It helps to get a variety of different opinions sometimes. I don't know how many times I've talked to medical students and heard just horror stories of the things that they have observed attendings do. And I point out to them, if you ask me who the 10 most influential physicians during my medical school years were, seven of them were just absolutely dreadful human beings. I mean, just awful. And I committed to myself at that time right there, there is no way that I will ever treat my patients, treat my staff, be dishonest, throw a temper tantrum in the OR. As painful as that was, they were great role models in terms of teaching me what I absolutely do not want to be when I grow up. Amen to that. Go ahead. Max is a first-year medical student. He's asking, as a first-year medical student determined to match into PM&R, when do you think is an appropriate time to look for a mentor? Today. I think right away, yeah. I've never heard anyone tell me they were over-mentored. I don't think that's a risk. What do you guys think? It's never too early, never too late to find a mentor. I think for me, mentorship happens organically. The next question in the chat is, how do you facilitate the mentor and mentee relationships as part of a required mentorship program for a residency program, as some faculty or some residents don't seem engaged? So we've toyed with assigned research mentors and assigned mentors. For me, that's where I had one of my most dramatic failures of mentorship, because I was assigned to be a research mentor at my institution. And I'll be the first one to admit research is not my strong point. So I felt a little fish out of water in doing that. And I think it showed. And it certainly, unfortunately, gave my mentee a bad taste of research in general. The mentee eventually recovered from that, because we have other faculty that are much stronger in that area than I am. So at least I was able to direct my mentee in the right direction. But I think that's part of it. Sometimes, it can be challenging when you're assigned a mentor right off the bat. And it's kind of like a blind date. I had an interesting job when I was at UW. And I was the assigned mentor for medical students. So I would get six a year. And I would mentor them through med school. And I think through that process, I learned you're going to be a mentor for a specific thing. So for example, I felt like I was their mentor that was their guide of how to get through med school. But obviously, I couldn't be their mentor of how to match in emergency medicine. But I could be their bridge, because I knew a lot of emergency medicine doctors. And so I could be a bridge for them or an introduction for them. But my role was more like, how do you be a physician? I could mentor on that. How do you become a physician? Or how do you navigate the OSCEs or something like that? And so I think for the assigned mentor relationships, maybe it's best if they can be defined. Like, what is the role? If the role is institutional guide, then maybe the match doesn't have to be quite as close compared to if your goal is research or clinical mentorship. Have you guys had experiences with assigned mentors, other people on the panel? Ours at NYP is a little different. So we do have, for our residency program, we have assigned mentors that are faculty. But it is kind of introduced as, this is a random assignment. If you find someone else that you find that you click with better or as your interests evolve, we're totally open to adapting this. We also have a formal peer mentorship program where a PGY 2, 3, and 4 are paired together. And that is extremely valuable in itself for providing peer mentorship. But it also guides you towards a better faculty mentor because a PGY 4 may be able to add the insight to a 2 and say, hey, I think this person might give you what you need. I think this person might help you decide between these two subspecialties, et cetera. So having that flexibility and having that set as a baseline is a lot more comfortable than saying, oh, I don't know if I click with this person. I really like that you brought up the idea of peer mentors because that's been mentioned by several panelists today. And I am such a fan of that. You don't always have to look for the most senior or the most successful person and think, well, they're the only one that could mentor me. Often, I've had people that I would consider mentors that are more junior than me, but they're very skillful or something that I'm not. And they're very helpful to me in that specific area, even though there might be something else they wouldn't be able to help with at all. I mentioned Gary Clark. I kind of think of him as a trampoline. Even though we're about the same age, Gary has very much the same value system that I do, the very same priorities that I do. And so it's been great when career decisions have come up or difficult, sticky political situations at work. This is somebody that I can call and kind of run something by, bounce ideas off of. And I know that those questions are going to be answered by somebody who's in the same space as I am and just have found him incredibly helpful through my career. I think that's such a rich thing about residency, too. You make friends during residency. You connect in ways you might never connect with people again. And a lot of those can be lifelong peer mentors. Do any of the panelists see other questions on the chat they wanted to tackle? I was typing it in the chat, because I think Marenza Viscosi said, how do you show appreciations for your mentor? And the first thing that came to mind is, I saw this. Talk with. That never works. That never goes bad. But it's like, researchers don't say, I love you. They say, I saw this article, and it made me feel good. And so like, because what's more pure than that, than to say, hey, the stuff that we do and we breathe, eat, and sleep every day that made me think of you. So that always makes me feel really, really happy. Absolutely, I love that. I think for medical students at graduation, having them introduce me to their parents is probably one of the most honor, just so honored to do that. It's just wonderful. Almost brings tears to your eyes. I think even just getting feedback from them. If they have a goal, and you help them, guide them in that direction, and they come back to you saying, I accomplished it, and this is how I did it, this is what I encountered, just reliving that story, that is enriching for me. So getting that kind of feedback and knowing that you did something. Absolutely. Well, as we wrap things up, I thought I'd give all the panelists one more chance if they want to throw out a last pearl, something they heard today that really resonated with them, something they really wanted to make sure they got across to those that are still with us. So Dr. Adele, you go ahead and go first. Something that I just want to mention for residents who are looking for research mentors, often you think about, oh, I'm interested in sports medicine. I want to go to a sports person. Or I'm interested in neurorehab. Go to the rehab. If you're truly interested in an academic research career, go to who the best researcher is, regardless of what their specialty is and what their clinical interest is. Good advice. Dr. Kastaria? Yeah, I actually want to touch on something that Dr. Singh said. Working with mentees, it keeps them fresh. It keeps them young. It prevents burnout. I think it does help us to somewhat live vicariously through our mentees and seeing them succeed. And if you want to consider us giants, them standing on the shoulders of giants, that's how I kind of view that mentor-mentee relationship. I want them to extend beyond what I've accomplished. Absolutely. I can go so far. I want them to go farther. Absolutely, yeah. Dr. Reif? Yes, I wanted to kind of echo what Dr. Skelton had said. I think you're never going to be ready, so just jump in. I think the uphill side of the learning curve is the most fun, in my opinion. So be a mentor, be a mentee, and enjoy the ride. Absolutely. Dr. Skelton? I want to echo something that Dr. O'Dell said in that I hope all the chairs and academic leaders on the call invest in mentorship, because happy, engaged faculty make happy, engaged trainees, which take care of happy patients. And so it's an investment, and it's a win-win-win for everybody involved. Absolutely. Dr. Singh? I'll just offer two thoughts. One, I heard Dr. Reif talk about the upside of the learning curve. I don't know that there is a downside with some private practice. I don't think I've gotten to that peak yet. And out there in the world, if anybody needs to contact me or a virtual mentor, especially in the private practice world or for paying people out there, I'm more than happy to be available. I don't know if you guys have some way of giving my email address out, or I can say right now, it's vsingh at seattlespine.com. But I'm more than happy to help anybody in the world out there that needs help. I think we're all on. I think I saw floating through the chat a way to contact us. I think we're all on the APMNR membership site. You can look for members, because I think I contacted all of you. So I think we're all on there with some emails, and so that's a good way to contact us. And I've learned so much. I've had the best time working with this panel. Thank you all so much for volunteering. I've learned so much. I think my pearl is somebody I saw floating through the chat that we all look so happy. And I thought, we've accomplished our goal, right? Because it's showing the upside of being a mentor. It is a very joyful pursuit. It's a lot of work, and it's a time commitment, and it has its frustrations and that sort of thing. But what a life-affirming role to take, and so I'm glad that we were able to show that to those participating today. We'll do a last quick shout-out. Thank you to Brian, who did our tech work today, to the AAPMNR Med Ed Committee, and Dr. Sianca, who came up with the idea of National Grand Rounds and supported this endeavor. So thank you so much. Thank you for everybody who stuck with us today. It was really fun to talk and to see your questions on the chat, and we look forward to speaking with you again soon. And remember, the next National Grand Round in December. So we're November, AAPMNR Annual Assembly. I think we'll probably all be there virtually, and then December, the next National Grand Rounds. Thank you very much. Terrific. Thanks, everybody. Thank you.

mentoring

importance of mentoring

benefits of mentoring

finding a mentor

building a mentoring team

qualities of a mentor

diversity in mentorship

sponsorship in mentorship

challenges in mentoring

feedback in mentoring