Incorporating Well-Being into Mentorship Meetings: A Case Demonstration at Massachusetts General Hospital Department of Surgery a Harvard Medical School Affiliate

Abstract

Surgeons have been under great pressure during the COVID pandemic. Their careers are filled with fast paced decisions, life and death situations, and long hours at work. The COVID pandemic created more tasks and even new responsibilities at times, but when the operating rooms were closed down, there was less work. The COVID experience invited the opportunity to rethink mentoring in the surgery department at the Massachusetts General Hospital. The leadership experimented with a new style of mentoring which involved a team approach. In addition, they tried something else that was new: adding a lifestyle medicine expert and wellness coach to the mentoring team. The program was tested on 13 early stage surgeons who found the experience to be beneficial, and they commented that they wished they had it even earlier in their careers. Including a non-surgeon who was a lifestyle medicine physician and wellness coach added an element of whole person health that was acceptable to the surgeons and even embraced as the majority of them elected to follow up with one on one coaching after the mentoring meeting. This team mentoring program with senior surgeons and a lifestyle medicine expert is one that can be explored by other departments and other hospitals given its success at the department of surgery at Massachusetts General Hospital.

Mentorship has become a universal necessity for a successful career in surgery. ¹ A mentor is defined as a trusted counselor or guide. ² The act of mentoring in an academic institution is one that involves time, and commitment from faculty who are juggling multiple academic roles including clinician, researcher, and educator. Importantly, the role of a mentor frequently requires balancing the desire to teach the mentee possible solutions to their challenges through the mentor’s experiences versus coaching the mentee and allowing them to discover their own passions and paths. One area that has not been conventionally incorporated into mentoring discussions is work-life balance and the personal health of the mentee. The process of coaching for wellness in surgical specialties is not well-studied or utilized.^3,4 Combining mentoring with wellness coaching is a new area of exploration in medicine and surgery.

The Massachusetts General Hospital Department of Surgery (MGH DOS) takes an active role in assessing and promoting the well-being of their faculty by identifying an internal Director of Wellness and a Director of Lifestyle Medicine and Wellness from outside surgery who has expertise in both lifestyle medicine and coaching. The MGH DOS also has a Wellness Committee with representation from the different divisions within the department. Some faculty members in the department have also received training in coaching. The challenges of the recent years have revealed a need to merge these wellness efforts with the Department’s mentorship program.

Surgical training and the early years of independent practice are demanding and difficult times. Elective operations were put on hold during the initial phases of the COVID pandemic and many surgical residents and attendings were asked to work overtime to cover areas of need throughout the hospital, often outside of their specialty. With this chaotic time came an opportunity for many physicians to examine their work, progress, goals, and personal vision. The MGH DOS used that time to reorient their program for mentoring young attendings. Supported and prioritized by Departmental leadership, the Department created a longitudinal mentorship program in 2021 involving faculty members from multiple specialties within and outside the hospital. This team mentoring approach considered each mentee individually and used their input to select mentors that could help them identify, prioritize, and set metrics to achieve their career goals.

All junior faculty surgeons within the MGH Department of Surgery for less than five years were eligible to participate in the program (n = 13). There were 3 to 4 mentors for each mentee for a total of 44 mentors. The mentors were instructed to consider the interests of their mentee at the center of all conversations. One mentor was designated as the lead mentor and facilitated the meetings. Additionally, one of the co-directors of the mentoring program and an administrator attended the one-hour meetings. The administrator took notes to record all the important points, action items for follow-up, and the goals set for the coming months prior to the second round of mentorship meetings. There were three rounds of mentor meetings planned for the academic year 2021–2022 and the meetings were virtual given the COVID pandemic.

A lifestyle medicine provider who was also an experienced wellness coach joined the second set of mentor meetings with dual purpose: 1 to target interventions for mentees that scored on lower end of the spectrum for well-being and 2 to help all mentees enhance their productivity and creativity. During the second round of meetings, the minutes and notes from the first meeting were discussed, the mentor surgeons followed up on the goals and plans of the mentee, and the leader of the meetings opened the discussion to the topic of well-being. This was a team mentoring model.

The lifestyle provider and wellness coach participated in the entire second mentoring session, allowing her to glean the extent of the mentee’s responsibilities and goals. Anecdotally, it was helpful that the lifestyle provider was also a physician in terms of “buy-in” and understanding from the surgeon participants and mentors. During this portion of the mentoring sessions, mentors shared their personal experiences with work-life balance, setting boundaries, declining opportunities that did not fit into their priorities and purpose, handling mishaps, as well as tips to be a productive and well-adjusted physician.

Every well-being conversation was different and unique to the individual mentee’s experiences, needs, and goals. The lifestyle medicine provider did not tell the mentee what to do, but rather guided them to self-reflection, identifying their strengths, sharing their aspirations, and brainstorm strategies around obstacles in the way of progress forward. In many sessions, the lifestyle medicine provider shared research and guidelines from the medical literature about the topics discussed such as growth mindset, purpose, positivity, gratitude, high quality connections, and the power of laughter.

After the second round of mentor meetings, the program administrator distributed anonymous surveys to each mentee. In general, satisfaction with the mentorship sessions was very high with 78% of the mentees being very satisfied and 22% somewhat satisfied. All the mentees felt that the mentorship sessions were of appropriate length and format and indicated a desire to participate in further wellness coaching. Ten of the mentees participated in one hour 1:1 sessions with the lifestyle medicine provider and completed between 2–6 sessions each. Three of the mentees who met with the lifestyle medicine provider during the mentorship meeting but did not participate in one-on-one coaching meetings did have follow-up with the lifestyle medicine provider through follow-up email communications on topics raised during the meeting. One of the two who did not opt for one-on-one sessions, arranged to take care of two items identified at the meeting as being important to improve their well-being and shared the update with the lifestyle medicine provider through email. All the one-on-one sessions were virtual via zoom meetings, and all the mentoring meeting were virtual using the zoom platform

As part of the survey, there was an opportunity to share thoughts and feedback from the mentees. Some of the comments included free form answers about strengths of the program and additional feedback. Overall identified strengths of the program included the wellness coaching, diversity of mentors and advice, the collaborative spirit of the mentorship committee, and the multiple perspectives with constructive feedback. Suggestions for improvement included offering the mentorship session in the first year as an attending surgeon and ensuring that all mentors can attend the sessions.

Incorporating well-being discussions into a team mentorship model was feasible and well accepted by mentees. Recent research on the well-being of surgeons indicates that it is complex and multifactorial including different domains such as professional components, personal components, and the area of work-life balance. ⁵ Businesses have used and explored optimal processes for mentoring for years. Reports reveal that the team approach to mentoring yields good results. ⁶ This team approach worked well for the MGH DOS. Departments of Surgery will need to adapt to the needs of their faculty and include discussions as well as coaching that address these areas. For MGH DOS, the addition of a lifestyle medicine expert who was also an experienced wellness coach created opportunities for mentees to participate in 1:1 coaching as a follow-up to the mentoring meeting. This approach is novel and can likely be replicated at other hospitals and in other departments. This mentoring program is innovative and comprehensive in that it takes the whole surgeon into account: the professional life, the personal life, and the work-life balance.