Mentoring Experience For FITs in West Africa-Musings

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Mentoring has been conceptualized as a process in which one person (the mentor) shares their knowledge, skills and experience with another (the mentee) to advance career and life aspirations. This is an active process that involves the mentor devoting their time to help others learn from their experiences. Trainees are often bewildered at the beginning of their residency training and face enormous work, family and personal challenges. While medical training involves a lot of self-directed learning and skill refining over a long career, this journey can be made easier by having support from senior colleagues and trainers.

This support is especially important for trainees in developing countries where career opportunities may be limited. Having a guide during the training years will help to avert costly mistakes. However, mentoring is a tasking engagement and it can be challenging to find common grounds to relate with if one's choice of a mentor and mentee is not based on shared values and interests. A trainee interested in academia may have a better mentoring experience if their mentor is an academic-clinician rather than a hospital consultant without experience in academics. Likewise, a mentor who has taken on a trainee interested in a heart failure subspecialty may find it more fulfilling if the mentor has considerable background in heart failure care and research.

Structured mentoring programs are not a routine part of the postgraduate medical training in many countries in Africa. Trainees often have to use their initiative to make important career choices. Many mid-career changes would be avoided if trainees had candid advice and directions early in their training years. Some enter the residency programs with little thoughts about their future goals, and such residents often end up not finishing the program. Others become disillusioned by economic realities with attendant negative consequences on their training. Having formally assigned mentors can guide trainees through tough times, and these mentors can serve as tutors and medical educators providing feedback and updates on academic progress of the trainee. This relationship is also important when trainees need recommendations for competitive positions and retaining junior faculty. Mentoring programs can help mentees develop concrete goals, boost self-confidence and solve problems. These programs can include career development, research skills, teaching and clinical practice. They can also further be broken down into monthly meetings, clinical observations, competency assessments, assistance with and feedback on presentations, career development discussions, and coaching sessions.

Characteristics of good mentors include being an avid listener, honest, accessible, approachable and having the best interest of the mentee at heart. Another important quality is having capacity to introduce mentees to professional networks, which may provide a useful fast-track for outstanding mentees. However, a stumbling block is the lack of formal mentoring training to potential mentors, even in places where there are mentoring programs. Oftentimes, mentors and mentees do not have clear directions on the purpose and thrust of the relationship. Some assigned mentors may be too busy to provide the needed mentoring for junior doctors. Having a log where scheduled mentoring meetings, points covered, decisions reached and action plans are documented may put the mentoring experience into better perspective and make it an active two-way process. A good mentoring exercise is an opportunity for the mentor to give back to junior ones, and is a path to academic fulfilment knowing one has positively impacted another human and helped them in areas where they were struggling to navigate. Providing some compensations to mentors for their time may make such schemes more enduring. However, any mentoring scheme incorporated into the residency training should have objective outcomes. These outcomes may include residents' retention rates in the faculty, number of successful residents' research grants, successful nominations to professional networks, academic track of mentees and performance at annual competency reviews.

In our department in Ibadan, Nigeria, we have a mentoring program where trainees can select two official mentors/academic advisors among the consultants, and are expected to meet at least monthly to go over their academic progress and areas where they need academic support and advice. There is an evaluation form to fill out that captures points covered at the meetings and action plans. Each participant provides feedback to the overall residency coordinator about their experience. I have benefited from this mentoring exercise and it is a good template that can be adapted by other institutions. My mentors have been supportive and are always willing to render useful insights and share their experiences, which I have found useful several times when I am faced with challenges. I learned to better define my career plans after fruitful discussions with them. A structured mentoring program in the residency curriculum in West Africa will go a long way to improve the quality of medical training and help career advancements of our trainees.

This article was authored by Ayodipupo Oguntade, MD, Fellow in Training (FIT) at the University College Hospital, Ibadan in Ibadan, Nigeria, and UK FCO Chevening Scholar at the University College in London, UK.