Surgical career choices: the vital impact of mentoring.

ABSTRACT

OBJECTIVE: Few studies have analyzed the impact of mentoring on general surgical graduates' future career choices. We attempted to characterize the impact mentoring had on choices made by graduates from our residency program regarding surgical subspecialty training. METHODS: A 32 item web survey was sent to 99 graduates of a university general surgery program, who matriculated between 1985 and 2007. The intent of the questionnaire was to evaluate influences on future subspecialty choice. Focusing on the influence of mentoring, we compared graduates who indicated that an influential mentor was an important factor in their decision (MENTOR) to those respondents who ranked this factor as unimportant (OTHER). Results were analyzed using Fisher's exact test with significance determined at p < or = 0.05. RESULTS: A total of 83 respondents (84%) answered the questionnaire (61 men, 18 women, 4 not indicated). Of these respondents, 61 (75%) indicated that an influential mentor was important or very important in choosing their specialty field (MENTOR). The most common fields of the mentors were general surgery (22%), surgical oncology (15%), and plastic surgery (13%). Protégés indicated that their decision to pursue a subspecialty was most influenced by the following mentor characteristics demonstrating expertise (77%), being a role model (72%), and practicing professional integrity (70%). In the MENTOR group, the vast majority of respondents [72% (43/60)] were in the same field as their mentor (P = <0.0001). Protégés also tended to practice in the same setting as their mentor All (8/8) of those who identified a mentor in a non-academic practice were also currently in a non-academic practice (P = 0.002). Respondents in a non-academic practice were more likely than those in academic practice to have identified their mentor before or during medical school [59% (20/34) versus 8% (2/26)]. Alternatively, 62% (16/26) of academic practitioners identified their mentor during their PGY 2 or 3 y compared to only 21% (7/34) of those in a non-academic practice (P = 0.003). CONCLUSION: Mentored surgical residency graduates were likely to enter the same specialty and practice type as their mentor. Also, the timing of identifying a mentor was strongly correlated with future practice type. With increasing concerns about "the impending disappearance of the general surgeon" along with increasing growth in surgical sub-specialization, it is essential that all types of surgeons provide early and sustained mentorship to medical students and residents to help shape the future of surgery.