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In December 1992 I was in the third year of my residency at Los Angeles County General Medical Center. Everything was copacetic until the assistant director, Dr. William Arroyo, asked me if I would consider running for one of the APA Assembly’s member-in-training (MIT) representative positions. At that time, I had been an APA member for five years, and other than knowing that I was an MIT and regularly received the green journal, I knew essentially nothing about APA.
Dr. Arroyo took the time to educate me about APA and explain how to become more involved. As it turned out, I lost the election, but more on that later.
The concept of mentoring is an old one to be sure, but until recently it has not been actively pursued in organized medicine. The essence of the relationship is that an experienced practitioner interacts with a neophyte to impart knowledge and wisdom and provide guidance. In practical terms, this can be as little or as much as the mentor and mentee wish to make it. For example, a large number of early career psychiatrists (ECP’s) may want some guidance in starting or developing a private practice. Most residencies do not teach the fundamentals of starting a private practice, and even fewer impart basic knowledge about fundamentals such as billing procedures, malpractice issues, or obtaining a consultation with a lawyer. A mentor has the ability to fill the gaps.
For other ECP’s, a mentor may be able to open the doors to a network of peers. Perhaps the mentor has expertise in forming a journal club or providing "curbside consults" for challenging cases. Still others may benefit from the collegiality a mentor/mentee relationship can foster or from advice on how to become more involved in the political process, where an experienced mentor may be able to help open a legislator’s door. Clearly, both the interests of the mentor and mentee must match, along with the "chemistry" of the two people.
At the Northern California Psychiatric Society (NCPS), where mentoring receives considerable attention, I have had the opportunity to work with Dr. Richard Shadoan on our mentoring program. We usually hold three or four dinner gatherings a year in Dr. Shadoan’s home. We have found that senior residents, fellows, and ECP’s just out of residency tend to be the most interested, so we have focused on outreach to these groups. In addition, all previous attendees are invited to each dinner. We have relied on NCPS council members as mentoring resources, but are making efforts to expand this pool into general membership.
The biggest challenge has been how to help ECP’s identify what their needs are and what they seek in a mentor, and then to identify an appropriate mentor for them. One way that is being developed is to form a "data-base" of available mentors, which lists geographic locations, demographic information, areas of expertise, and availability. One option we are considering is to keep the database in the graduate education offices of local residencies to provide easy access to mentor lists by fourth-year residents and fellows.
One final benefit for members of our district branch is a new psychotherapy mentoring program in which an ECP mentee can receive time-limited supervision from an experienced psychotherapist in the community.
The concept of mentorship has proved to be an excellent way for experienced psychiatrists to foster the professional growth and development of the men and women who are entering the field. As health care in America, and the world, changes, older methods of "on the job training" are becoming inadequate for the new challenges. It is the hope of many of us that mentoring will become a more prominent method of fostering the professional development of ECP’s. In addition, mentoring may bring back a sense of collegiality that is in danger of becoming lost as the increasing demands of the health care system whittle away opportunities to learn from our elders and to teach those new to the specialty.
And the ending of my election story? It turned out that the person who was elected was unable to complete the term, and I was asked to fill in. From the experiences I gained serving in the Assembly, I have been able to learn more about organized medicine and develop my interests in the legislative process. I am now the Area 6 ECP representative to the Assembly, an Assembly liaison to the Joint Commission on Government Relations, and also a member of several DB, Area 6, and APA committees.
Through my participation in organized medicine, I am able to make my voice heard on critical issues concerning the practice of medicine and how it affects my patients. All this because a mentor took an interest in me.
Dr. Fouras is medical director of the foster care mental health program of the city and county of San Francisco.