Mentorship is defined as a professional partnership in which knowledge, skills, and wisdom are imparted between individuals for the purpose of career development and advancement. Substantial research has demonstrated the positive effect of successful mentoring relationships on professional achievement and satisfaction in many occupational sectors.^1,2 In medical and surgical disciplines, ensuring a strong and vibrant physician workforce is paramount, given the projected shortages in upcoming years among the physician workforce in the United States. For example, recent reports from the American Association of Medical Colleges suggest a lack of over 120,000 physicians within 20 years, with notable and rising differences in supply and demand for surgical specialties.^3,4 Moreover, the projected gaps in the physician workforce may be even more pronounced for individuals entering academic practice.^5,6 As such, mentorship remains the cornerstone of ensuring a vibrant, diverse, successful, and engaged workforce in academic medicine and surgery.⁷

Mentorship has been consistently cited as a successful strategy to increase the pipeline of individuals entering careers as physician scientists, as well as reducing attrition from the academic community. Successful mentorship models have been shown to enhance the professional advancement of women and underrepresented minorities, for whom substantial gaps in achievement persist and attrition is high.^{8,9,10,11,12,13} For example, studies examining the career aspirations of underrepresented minority high-school, college, and medical school students reveal that few have mentorship from physician scientists, but early exposure to mentors and role models is correlated with a student’s decision to pursue a career as a physician scientist.^5,8,14 In addition, studies of early career faculty members consistently demonstrate that faculty with successful mentoring relationships are more likely to have successful research portfolios and academic clinical practices.^15,16,17 Faculty development initiatives that explicitly emphasize mentoring have been shown to be of the most effective strategies to recruit, promote, and retain academic faculty in underrepresented minority groups.¹⁸ Nonetheless, the penetration of structured mentorship models into academic specialties remains variable, and understanding the mentorship archetypes and challenges is important to identify best practices for achieving successful mentoring relationships.¹⁹

A mentor is distinct from a teacher or role model. In their roles, mentors impart not only knowledge, as an educator would, but also wisdom regarding the expectations, opportunities, and norms of an academic career. Unlike role models who passively demonstrate behavioral norms, mentors actively invest in their mentees.²⁰ Numerous mentorship models have been described, including dyad mentoring pairs, peer mentoring, speed/micromentoring, reverse mentoring, distance mentoring, and team mentoring.²¹ These mentoring paradigms are not mutually exclusive, and the needs of mentors and mentees are dynamic and fluid across the trajectory of a career. No single mentoring model has been identified as superior over another. Instead, the attributes of successful mentoring relationships are dependent on the context and individuals in the relationship, the organization, and professional development goals.

Dyad mentoring remains the most common model of mentorship.²¹ Most traditionally, dyad mentorship appears in the form of a one-on-one relationship in which a more senior individual guides a junior individual along their career path. The mentor and mentee typically meet individually for periodic meetings at a cadence set by both.^22,23 The mentor provides feedback regarding aspects of professional life, such as academic productivity, clinical care, educator roles, and administrative service (Figure 6.1). Mentees will often present progress on projects, such as a manuscript for publication or a grant application to be reviewed. Other dyad models include coaching mentorship. In contrast to a traditional mentor who provides a holistic approach to professional growth, a coach is focused on helping the mentee acquire a specific skill or highly targeted areas of professional growth.^22,24 Coaching models often have meetings that occur in briefer intervals, as the guidance is tailored to focused topics, such as methodological techniques, writing, or oral presentations.

Peer mentoring models have been most commonly used for youth and education programs and involve joining mentors and mentees of similar age or level in an organization.^25,26,27 Peer mentors are well suited to guiding an individual, given their proximity in experiences, such as assembling a research grant or beginning as a faculty member in practice. Peer mentoring models have distinct advantages for both the mentor and mentee, as mentees may feel empowered to be candid regarding specific elements of support that are needed that they may not be comfortable asking of
more senior mentors. In addition, peer mentorship offers an opportunity for shared resources and learning.²⁸ In return, peer mentors also reap tangible rewards, such as demonstrating mentorship capability that will allow them to advance for additional leadership opportunities (e.g., residency program director or medical student clerkship director), or grant programs (e.g., federally funded research mentoring awards).

Speed mentoring or micromentoring is described as mentorship that occurs in brief intervals regarding a focused topic and is often less formal than more traditional mentoring relationships.^29,30 Micromentoring models are designed for maximum efficiency and can often provide an ideal structure for mentors who have limited capacity for more in-depth mentoring relationships. Micromentoring models are best suited to specific topics, such as reviewing a curriculum vitae or personal statement, that yield tangible and pragmatic support. Micromentoring also can provide an opportunity to test out a potential mentoring relationship to determine if individuals are compatible to work together in longer-term partnerships (Figure 6.2).³¹ Given the brevity of a micromentoring relationship, it is critical that both the mentor and mentee adhere to clear communication regarding goals, time commitment, deliverables, and expectations from the outset.

Reverse mentoring describes the process by which mentoring occurs in a bidirectional manner between the mentor and mentee and provides the mentee specific opportunities to “mentor-up.”^32,33 In reverse mentoring models, mentees take ownership of learning goals to impart to a more senior mentor, which can include new techniques, methodologies, or strategies for dissemination of work (Figure 6.3). Reverse mentoring is advantageous in that it can allow for greater engagement of mentees in an organization. Reverse mentoring can also bridge generational gaps across mentoring relationships and provide more senior mentors unique and innovative perspectives from established norms within an organization.²²

Although mentorship traditionally occurs in face-to-face meetings, the expansion of technology in recent decades has allowed for the evolution of distance or remote mentoring models.^34,35 These relationships can be particularly useful for mentees to

connect with mentors with distinct skill sets who may not be present at their institution and foster collaboration across centers. Distance mentoring is also helpful for situations in which a mentor or mentee unexpectedly transitions to a different institution, but the collaboration is expected to continue. As with other mentoring relationships, distance mentoring models function well with clear communication regarding goals and expectations and often with more regular reevaluation of progress. Explicit timelines, assigned tasks, and scheduled meetings are essential to overcome barriers due to lack of colocation.

Finally, team-based mentorship model approaches have become increasingly popular, given their ability to increase the capacity of mentorship for an individual and bring synergy across multiple phenotypes of mentors, such as traditional mentors, coaches, sponsors, and peer mentors.^28,36 Team-based models also have the advantage of engaging individuals with different areas of expertise, leveraging the power of cognitive diversity, and can allow for shared responsibility of the mentorship tasks across multiple mentors. Although mentorship teams can be challenging to coordinate logistically, they are one of the most critical strategies to provide support for individuals facing difficulty in their mentoring relationships.³⁶