Introduction

A mentor serves as guide or trusted advisor to individuals with less experience, and mentorship is an important aspect of residency training. In health care, a mentor is typically a senior clinician in the same specialty area who provides training and advice to someone who is his/her junior.1 Research shows that mentorship leads to improved personal development, career guidance, research productivity, and physician burnout prevention.1–3 Lack of mentorship is associated with lower test scores and reduced psychosocial support.4

Mentorship can be either formal or informal. Formal mentorship involves pairing a mentor and mentee through an established program. Informal mentorship arises organically between a mentor and mentee.5 Both formal and informal mentorship have shown to be successful. However, formal mentorship guarantees established mentor-mentee pairings and well-defined structure and goals throughout the relationship,5,6 which are associated with the increased perception of mentor support by mentees.7 In both types of mentorship, the best relationships occur when the trainee can select his/her mentor.6,8 According to Sinclair et al. additional aspects of the ideal mentorship are likeness in regional location and specialty area, and mentorship training for mentors.8

Established formal mentorship programs (FMP) are associated with greater resident satisfaction in the mentorship process, yet FMPs are not often established in surgery residencies.1–3,9 Despite the benefits, only 54% of general surgery, 58% of urology, and 52% of orthopedic surgery residencies throughout the United States have an established FMP.1–3 Surgical specialties like obstetrics and gynecology (OBGYN) are a highly technical and stressful fields, which require a unique blend of technical and fast decision making, communication, and leadership skills, and a good mentor can help trainees fine tune and grow these skills.10 However, to our knowledge, the structure and prevalence of FMPs in OBGYN residency programs remain unknown. Therefore, this pilot study aims to evaluate the status of mentorship programs in OBGYN residency programs and obtain insights that can help OBGYN residency programs establish structured mentorship programs for their trainees.

Methods

This was a cross-sectional study of OBGYN program directors (PDs) (N=70) from Region 4 of the Council on Resident Education in Obstetrics and Gynecology (CREOG) from July to September 2022. CREOG Region 4 is composed of all OBGYN residencies from Alabama, Arkansas, Illinois, Iowa, Kansas, Louisiana, Manitoba, Minnesota, Mississippi, Missouri, Nebraska, Oklahoma, Tennessee, Texas, and Wisconsin. PDs’ email addresses were obtained from the CREOG directory, which is available online from the American College of Obstetricians and Gynecologists (ACOG). Participation in the survey by PDs was anonymous and voluntary. This study was approved by the Institutional Review Board at the University of Mississippi Medical Center (UMMC) (UMMC-IRB-2022-19). An invitation to participate in the study was sent by email to OBGYN PDs in July 2022. To increase study participation, two additional emails were sent in July and August 2022. Survey emails were sent by Redcap (Vanderbilt University, Nashville, TN), a secure e-mail distribution tool.

The survey contained 26 questions for PDs with an FMP and 10 questions for PDs without an FMP. Questions contained yes or no, multiple-choice, and free-text responses about the presence and structure of FMPs or about the barriers to implementing an FMP. Survey responses were recorded and stored in Redcap, a web-based application for securely building and managing surveys and data. Survey responses were analyzed using descriptive statistics.

Results

The survey response rate for PDs from Region 4 was 30% (N = 21). Fifteen OBGYN programs (71.4%) self-reported having an established FMP, whereas 6 programs (28.6%) reported not having an FMP. Key responses from PDs regarding the format and structure of FMPs are reported in Table 1, respectively. Twelve FMPs (80%) have a set frequency of scheduled meetings between mentors and mentees. Seven FMPs (46.7%) require faculty members to complete an evaluation form of their resident mentee. Nine FMPs (60%) do not have a formal exit strategy in place for failed mentor-mentee relationships. The most common reasons PDs listed for not having an FMP were “not enough time” (33.3%), “not enough faculty interest” (33.3%), “not enough faculty” (16.7%), and “not enough funding” (16.7%). PDs listed “not enough faculty” (50%) and “not enough time” (33.3%) as the two major barriers to implementing an FMP. Two PDs (33.3%) without an FMP reported “no barriers exist” to implementing an FMP into their residency program.

Table 1.Key responses from program directors (PDs) regarding the format of formal mentorship programs (FMPs). Descriptive statistics represented as percent rates of responses per questions.
Survey Questions Responses (N=15)
How long has your FMP been established?
0-5 years 13.3%
5-10 years 60%
10-15 years 26.7%
>15 years 0%
Who is eligible to serve as a mentor?
Full-time Faculty 100%
Part-time Faculty 26.7%
Private Practice Physicians 20%
Which residents participate in the FMP?
Lower-Level Residents Only (PGY-1 and 2) 0%
Upper-Level Residents Only (PGY-3 and 4) 0%
All Residents (PGY-1 through 4) 100%
How are mentors and mentees paired?
Formal (mentee is assigned to mentor) 80%
Informal (mentee chooses mentor) 20%
How many mentors are paired with each mentee? (Mean, SD) 1.4 (0.8) *
Can mentees request a specific mentor?
Yes 100%
No 0%
Can mentors request a specific mentee?
Yes 66.7%
No 33.3%
Do you have an official training course for mentors?
Yes 13.3%
No 86.7%
Do mentors sign a mentor contract about his/her duties and expectations as a mentor?
Yes 40%
No 60%
Do mentees sign a mentee contract about his/her duties and expectations as a mentee?
Yes 20%
No 80%
Do mentees fill out a form stating their short- and long-term goals to establish the FMP relationship?
Yes 60%
No 40%
How frequent are mentors-mentees required to meet?
Every 3 Months 40%
Every 6 Months 40%
No Formal Requirement 20%
Are faculty members required to complete an evaluation form of their resident mentee?
Yes-after every formal meeting 33.3%
Yes-every 6 months 13.3%
No 53.3%
Who reviews the evaluation form completed by the mentor?
Program Director 100%
Mentor and Mentee 28.6%
Clinical Competency Committee 14.3%
Department Mentoring Committee 14.3%
Does the FMP have a formal exit strategy in place for failed mentor-mentee relationships?
Yes 40%
No 60%

* Denotes mean (standard deviation) mentors paired with a mentee.

Discussion

Although there are multiple studies that evaluate the status and importance of mentorship programs for trainees, to our knowledge, this is the first study that explores the status of mentorship programs for OBGYN residents.11,12 In this pilot study, we surveyed PDs from OBGYN residency programs in CREOG Region 4 about the prevalence and structure of FMPs for their respective trainees. The major reported barriers to implementing FMP in OBGYN residency programs are the limited time and interest of faculty for FMPs. A common practice in mentorship is to pair resident mentees with faculty mentors from the same institution or same region.8,12 Pairing within similar regionalities has shown to increase mentorship success. Our survey findings are consistent with this model, as 100% of the OBGYN PDs with an FMP reported that they involve full-time faculty as mentors. Nonetheless, limited time and availability for mentorship impairs the development and implementation of FMPs in OBGYN residency programs, despite impact and need.

Mentorship programs are vital components of residency programs. Mentoring relationships are beneficial to both the mentor and mentee. These relationships expose both individuals to new perspectives, ideas, energy, and diversity. Mentees involved in mentorship programs have shown to have increased research productivity, leadership roles, and career development compared to mentees without an established mentor.1–3,10 Residents from FMPs report high satisfaction with their mentors and increased confidence to achieve their career goals.10 Additionally, a survey study of urology trainees found that structured mentorship programs are associated with lower burnout.12

However, limited time and faculty impair the development of these structured and productive relationships in OBGYN residencies. A possible method to avoid this barrier and develop mentor/mentee relationships is to pair local community-based OBGYN physicians working in private practice with residents, a method utilized by 3 of the PDs (20%) with established FMPs.13 Community-based mentorship is a feasible option to expand mentorship opportunities for OBGYN residents. However, the structure of the FMP should depend on the faculty/senior clinician, resources, and schedule availability of the mentor and mentee, and developing the ideal FMP requires feedback from the faculty/senior clinician and residents about the program design.

The main limitation of this pilot study was our small sample size and mentorship assessment of only PDs from CREOG Region 4. This small sample size may warrant response bias from PDs interested in mentorship programs, which could overstate the prevalence of FMPs in our study population. Our survey did not evaluate formal versus informal mentorship programs or resident participation in mentorship programs. Therefore, further evaluation of OBGYN FMP is warranted.

Conclusions

Our preliminary results suggest that most OBGYN residency programs in CREOG Region 4 have established FMPs, which vary in structure and format. OBGYN residency programs without FMPs lack this beneficial component of training and career development. Therefore, programs should work to develop an FMP or aim to maintain and improve the FMPs that are already established.

Lessons for Practice

  • Mentoring relationships are beneficial to both the mentor and mentee. These relationships create new perspectives, ideas, energy, and diversity. Mentorship programs can improve professional development and prevent burnout.

  • Mentorship programs can be formal or informal. Both types of mentorship programs are effective and improve the training experience of trainees. Thus, mentorship programs should be established for all trainees.

  • Although less organic, formal mentorship programs ensure consistent mentorship is in place. However, implementing formal mentorship programs can be difficult due to time constraints, personnel, and resources. Therefore, residency programs should strive to provide the resources to develop and maintain formal mentorship programs.