Thanks very much. So let me set my timer here, so I don't run over. Here we go. Well, thanks very much to the Congress organizers for inviting me to talk about this topic, Strategies for Successful Mentorship of Female and Underrepresented in Medicine Critical Care Trainees. I'm Assistant Professor of Medicine at Baylor College of Medicine in Houston, Texas. I'm also the Associate Program Director for the Critical Care Medicine Fellowship Program there. I went to medical school in Heidelberg, Germany, board-certified in internal medicine, nephrology, and critical care practice, exclusively critical care now. And I'm really passionate about medical education, also passionate about mentoring trainees and increasing the number of female and underrepresented minority trainees. I have no disclosures. The learning objectives of the talk are that, at the end, I hope that you'll be able to define the terms and distinguish between mentorship, sponsorship, coaching, role models, because a lot of people use these terms in different ways. And then describe what are the benefits of the mentorship to women and underrepresented in medicine trainees. Does it matter if you have a mentor? And then identify what are the barriers to successful mentorship for these groups and what are potential strategies to overcome those barriers. And at the end, we'll talk a little bit about how to establish a more formal program in your fellowship program to help these groups thrive in mentor relations. And just to make sure that everyone is on the same page, URM, Underrepresented in Medicine, is considered African American or African heritage. It's associated with Hispanic, Native American, American Indian, and Alaskan, Hawaiian, Pacific Islander. Why do mentors matter? Well, mentors matter because you can impress from a distance, but you impact up close. So we have tremendous opportunities as mentors to our trainees or even junior faculty to make a difference in their lives and in their careers. So the term mentor goes back, as probably most of you are aware, to Greek mythology, to Odysseus. His son, Telemachus, was taught by a guy named Mentor. It was basically his teacher and tutor and so on. So a mentor is a trusted counselor or guide. And mentorship is a dynamic relationship. It's reciprocal. Both sides get something out of it in a work environment. It can also be in a personal environment, of course, but we're focused on the work environment here. Between an advanced career incumbent, a mentor, and a beginner, a mentee, aimed at promoting the development of both. A sponsor, on the other hand, is someone that makes connections for you, introduces you to opportunities, and puts your name forward. So, for example, here are two of my former fellows, and so I suggested that they could be moderators for this session. That's kind of what a sponsor does. A coach, now this term is used in different ways. And the way I'm using it, as someone who's taken a couple of coaching courses as well, is a coach is basically someone who takes you from one place to another. But the coach doesn't tell you the direction you need to go, where you're going, how you get there. So a coach is someone who really asks questions and help people find the answers to their own questions and doesn't give them advice. A consultant is someone who tells people what to do and then watches them not do it, as a typical experience. And a role model is someone who models a certain behavior or professional role, and others can emulate them. And I think being a mentor, in some way, encompasses all these things. But it's important to be aware of these differences, and what I like is something called mentoring with a coach approach, where you work as a more traditional mentor or function as a more traditional mentor. You give advice and kind of tell their mentees things to do. But as a coach, you also ask a lot of questions to try to figure out what does the mentee actually want. What are their career goals? You don't tell them what to do, but you help them tease out what is already in them and what they really are passionate about and want to do. There's multiple types of mentorship. I think the most common one we're familiar with is the one mentor to one mentee. There's also something called peer mentorship, which can be very successful, especially if you're a woman or underrepresented in medicine and you don't have a lot of more senior women or URM in your faculty group, so people that help each other. You can have facilitated peer mentoring. It can be limited to just one setting for one research project. People can have more than one mentor, one personal mentor, one professional mentor, one research mentor, maybe one mentor for QI. And it doesn't have to be in the same institution. The functions of a mentor are you teach a mentee. Now, I said sponsoring is slightly different, but it's part of it. You're putting mentees' names out there. You give them guidance. You socialize them into the profession. The personal aspect is very important as well, and that's something we do for our fellows. The fellows that I mentor, if there's conflict, they come to me. They know they can talk to me. I will advocate for them. I will listen to them. They can cry if they're upset. I'm not going to judge them. I'm going to be there and support them. I'm still going to give them feedback that might be critical, but I'm on their side as a mentor. So does mentorship make a difference? And Dr. Gershengorn alluded a little bit to that. And there's a lot of studies that actually show that if you have a mentor, you earn more. You're more likely to go into academics. Now, that means you might earn less, but it certainly helps get people into research careers. If you're a researcher, you publish more. You get more grants. Your teaching quality as junior faculty is better. You get promoted faster if you have a mentor. Having a mentor influences what specialty you pick. I mean, I know some residents that have told me afterwards, you know, that I really influenced their choice of going into pulmonary care medicine because they saw a woman that was able to work in the ICU. They have mentees that have good mentors. They have higher levels of being satisfied with their career. They're more confident in themselves, have higher self-esteem, and feel that they're more efficient. And both career and personal development are improved. And actually, mentorship also improves well-being. So both trainees and physicians in general that have mentors have less burnout and have improved well-being and quality of life. And having a mentor also contributes to faculty retention and having less turnover. So I think these last points are something that you can go to your institution with and say it's actually a monetary benefit for you to support a mentorship program for the fellows. So are there differences in the mentorship experience based on your gender? And yes, there are on all levels, for med students, for residents, fellows, and faculty physicians. So men are much more likely to have mentors, basically. And women also report that they have fewer mentors and that it's a bad thing, basically, and that it's been negative for their career. So there was one paper that I would encourage everyone interested in mentoring to go to from Academic Medicine published last year. It's a systematic review of 91 studies about mentorship in medicine, both quantitative and qualitative. And they asked about the impact of mentoring on academic career success for women in medicine. So it was physicians, residents, and students. And they found that mentoring was associated with objective and subjective measures of career success. Some of the things I already talked about. So basically, yes, mentoring helps your career. It's effective, and it might help get people into critical care. Obviously not everyone, but someone who's already maybe inclined to thinking about critical care versus cardiology or something, it might make the difference there. The group that experiences the least mentoring is African-American women. So among white physicians and trainees, men are more likely to have mentors than among African-Americans. Again, the women have much fewer mentors. The mentors are mainly white men, which is just the demographics that we're still faced with. But one in four women have a female mentor. So what are the challenges that female mentees face? So women have much more difficulty finding mentors. Women experience less mentoring, even though they realize it's actually really important and it's something I want. If they have a mentor, it's less effective. So they're maybe not directed towards all this soft information that you get about opportunities in your institution. They might not hear about that. And then if female physicians have a male mentor, they get professional advice, but the whole personal mentorship and personal advice part, which is important for mentorship, is just not there or to a lesser degree. So what do women say they desire in a mentor? So women in general do prefer having female mentors. If it's underrepresented in medicine trainees, they also prefer to have a mentor who's of the same ethnicity because you have more in common. I think it's pretty natural. You share experiences that just someone from another ethnicity or another gender doesn't share. And then especially for women, they can be role models, how to manage having kids and having a family and still being in critical care or being a doctor. And two skills are crucial. It's effective communication and active listening. So a mentor who just talks the whole one-hour meeting to the mentee is not going to be very effective. So mentors help mentees develop the necessary skills for an academic career. They can give them feedback. They can promote them, give them networking opportunities, advise them what steps to take. Like I was talking to Orlando earlier about maybe getting involved in some QI, starting a QI committee in his ICU or getting on some other institutional committees, getting involved in maybe some research projects so he can stay connected to academics. So once his waiver is done, he can hopefully come back to academics. So that's something that's helpful and that I try to do for our current and former fellows. So what are the barriers to successful mentoring that women and URM mention? So often they don't have time and they feel like the mentors aren't really accessible and don't have an interest. The third point is very interesting. Our female mentees, they think that potential mentors are being overextended. So they're kind of taking into consideration the mentors' needs and I wonder how much that is being done by male mentees. They don't have as many strategies of finding a mentor than men have. They maybe don't go out at conferences like this to network and their own insecurities can be barriers as well. They can be reluctant to initiate contact. They may be concerned about discussing some career goals with their supervisor because they might think it will reflect negatively on them or impact their career negatively. And if there's no established mentorship program, they might think if I ask for mentorship and for help, then people will see me as weak, especially in a traditional male specialty as Dr. Gershengorn was talking about, like critical care. There are personal barriers. We talked about some of them already. One thing that's important in mentorship is you need to kind of jive with the personality. On the institutional level, mentorship is an unfunded mandate for academic faculty and that's very true. So institutions could put some weight behind that and just find ways to reward those women and men that are mentors to others. And lack of structured mentoring programs might be another issue. So just a show of hands, in your institutions, who has a structured mentoring program for their trainees or for junior faculty? Yeah, I would say less than half, maybe a third. And then the culture of the institution might just be that mentors aren't valued. So what are some of the strategies that work according to these papers that I refer to that have studied this? It doesn't need to be... As broken directors, for example, we can be proactive in assisting the mentees finding mentors. So we have a structured mentorship program and so we leave it to the mentee to find a mentor that they kind of feel they could get along with and talk about stuff with. And we give them suggestions and if they're not able to come up with someone that they've worked with and that they like, then we assign them a mentor. And we have expectations of regular meetings once a month. There's some institutional strategies I already talked about. Let's go through that. So it was an interesting study that I just want to briefly talk about before we come to the end, about URM physicians. The last study was focused on women, though much of that is applicable to URM physicians as well. So it was a really interesting study. And I think it's really important though much of that is applicable to URM physicians as well. So this was basically a survey of programs focused on recruiting underrepresented minority physicians. And they said bias and discrimination. It's pretty obvious that that's an issue. The personal wealth differential, I wouldn't have thought of that as much, but especially among African Americans and other minorities, they just don't have as much wealth in their families. And so financial issues are much bigger in their lives. And so we as mentors and as institutions can actually help by giving them guidance, helping them with financial planning and so on, providing childcare. They often have more elder care, childcare responsibilities. Minority tax, I think you all are familiar with that, that if you're a minority, you get invited to every committee and every conference and you're kind of the token spokesperson for that minority. That can be very exhausting, and it can be isolating too. And then mentorship training, that's something we definitely can fix, right? We can train our docs to be better mentees. And then this paper is actually very interesting. I would encourage anyone interested in mentorship to look at that, what you can do, what the mentees experience, what a mentor can do to counter that, what institutions can do to counter that. I don't want to go through all of that, but there's a lot of helpful ideas. How you can actually make the mentorship work better. So some best practices for successful mentorship program. Make sure you include all the key stakeholders, mentor, mentee, the diversity, equity, inclusion offices, whoever is the leadership in your institution. Develop some policies. Ask what their concerns are. Address those concerns. Make sure that there's goals established in the mentoring relationship, that there's regular meetings, regular evaluations. Does the mentorship actually work? Let the mentee choose their mentors. Give them an option to... Basically, give them access to outside institution mentors. I mean, obviously, if they just find a mentor outside institution, that's not going to work. You have to facilitate that as faculty. And then as an institution, and Baylor actually does a really good job of that. Mentorship goes into our academic promotion portfolio. I don't think we have mentorship awards, and there's certainly no financial recognition, but at least it helps with your promotion. And then I think this is my final slide. So as a mentor, find out more about your mentee. What are their struggles? What are their experiences? Especially if you're maybe a man or white, what are the experiences that you maybe have no idea about? Like being a woman in the ICU, a physician, and patients and families and other physicians constantly think that you're the nurse, right? That is an experience that men typically don't have, but probably every woman in this room has had. And then just show empathy, understanding. Don't invalidate what they're going through, their concerns. And then institutions, and also we as individuals, need to create a climate free of discrimination. So the first couple of papers here, if anyone is interested in that and wants to take a screenshot of that, some that I got a lot of the information and the ideas from, how to improve mentorship programs. There's a lot more references, and I'm happy to share with anyone interested. There's actually quite a bit of literature out there about mentorship. All right.

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successful mentorship