A mentor is someone who takes a special interest in the professional development of a less experienced colleague [1]. This individual (the mentor) provides guidance and support to another individual (the mentee), with the desired goal of improving that individual’s development. Dictionary definitions of a mentor vary, but they essentially describe an experienced and trusted advisor, counselor, guide, tutor, or coach, often in an organization or institution, who trains and counsels new employees or students. Contemporary definitions include “a trusted and experienced advisor who has a direct interest in the development and education of another individual” and “an artist of enlightenment” [2].

The term mentor dates back to Homer’s Odyssey from ancient Greek literature. Odysseus leaves his son Telemachus in the care of a trusted friend (Mentor) when he leaves for the Trojan War. Mentor served as Telemachus’ loyal guardian and wise advisor and later helped Telemachus find his father when Odysseus did not return. Under Mentor’s guidance, Telemachus matured and developed his own identity. Athena, the goddess of wisdom, intermittently took the form of Mentor, imparting advice and wisdom of a personal nature. In Greek, mentoring has become synonymous with the term enduring. Ancient Chinese kings used a form of mentoring called Shan Jang (to cede or yield) to pass the crown to a successor. The literal translation is “the enlightened stepping aside to create room  …  for the next deserving person to step in and take charge.”

Despite the importance of mentoring for physicians and the medical profession, neither mentor nor mentoring appears in Dorland’s Illustrated Medical Dictionary, 31st edition. Mentoring is an intentional process of interaction between two individuals, which includes nurturing to promote growth and development of the mentee (or protégé). It is an insightful process in which the mentor’s wisdom is acquired by the mentee and modified as needed, as well as a process that is supportive and often protective. The successful mentor–mentee relationship therefore requires active participation of both parties [3, 4].

The mentoring relationship can be structured or loose. It can be a relatively short process or an ongoing (enduring) one. There are often breaks in the relationship, which can be reestablished in the future. Both individuals should be enriched by this relationship, although the gains of the mentee initially appear far greater than those of the mentor. In that sense, altruism and volunteerism toward a junior professional colleague serve as the foundation of every mentor–mentee relationship.

The surgeon Harvey Cushing had as his mentor internist Sir William Osler. Such a relationship between specialists would be uncommon today because physicians with different backgrounds collaborate infrequently. For whatever reasons, many physicians are “encouraged” to be skeptical of physicians from other disciplines. However, individuals with dissimilar backgrounds in different specialties often have tremendous insight to offer those willing to learn and unafraid to benefit from others. Research mentoring commonly involves relationships between individuals with different backgrounds and research interests yet having a shared goal of producing meaningful evidence that advances scientific knowledge. In international settings, faculty mentors who teach and practice emergency medicine (EM) are often specialists trained in other disciplines, which creates further important collaboration between specialties.

The literature consistently reports that professionals with strong mentors are more productive and have greater career satisfaction, both in the short and long term [5–11]. Research suggests that academic physicians with mentors publish more articles in peer-reviewed journals and are more confident in their abilities than their peers without mentors [12]. Individuals describing positive mentoring relationships, as well as those with any mentoring, report greater perceived success. One study, despite its selection bias, found that professionals without mentors reported lower salaries than their peers with mentors [13]. Furthermore, strong mentoring relationships have the most influence on a mentee’s ultimate career selection [14, 15]. The advantages of mentoring hold especially true for women; unfortunately, they report that mentoring is less available to them than to their male colleagues [12]. A large proportion of students, residents, and even junior faculty never experience a true mentor relationship and identify this as one of the most important factors hindering their career progression [15, 16]. Mentors do not have to be similar in gender, age, clinical interests, or personality, yet many mentees (and mentors) believe this to be necessary. Professional societies recognize the importance of mentoring; many have established formal mentoring programs offering potential mentors and mentoring resources. Several EM organizations, including those committed to international EM, have also developed formalized mentoring programs. Faculty development workshops and committees have become increasingly common in EM and other specialties, resulting in improved mentoring relationships throughout all medical disciplines. Educational sessions related to mentoring occur with increased frequency at local, state, national, and international meetings. These venues provide excellent networking opportunities to exchange ideas during roundtable discussions, question-and-answer sessions, and small-group forums, resulting in improved mentoring at all levels.

Mentoring is a special form of educational and professional service that is highly personal. It must be individualized to meet the needs of the mentee. The mentoring relationship is dynamic. It evolves over time, during which both parties continually define and redefine their roles [20]. Mentoring should be considered a process, not a product. This is often difficult for physicians, who naturally tend to be goal oriented. Because the results of mentoring are not always seen immediately, this activity becomes even more challenging for emergency physicians who prefer immediate results from their actions. Mentoring relationships must remain noncompetitive and confidential. Mentors may see qualities in or opportunities for their mentee that their mentee does not see. Mentors should attempt to foster successes in areas their mentee did not think possible.

Mentoring can occur in person, over the telephone, electronically (via email or video conferencing), and through general mail. These options make long-distance or even international mentoring possible. Articles or references can be exchanged, describing specific research or research-related challenges, topics discussed during previous interactions, information that might benefit the mentee, areas of specific interest (even if these are not mutual), information published by key individuals in a certain area, and subjects of general interest. Appointments to meet can be scheduled at international, national, state, regional, or local meetings. Although it is much less likely for international mentors and mentees to meet, it does occur. With more US medical schools and EM training programs becoming involved in EM education and systems development at the international level, opportunities for international mentorship will increase. If a meeting is planned, a preestablished agenda maximizes the value of this interaction and may help the mentor meet his or her mentee’s needs. Both parties will be better prepared for a meeting if an agenda is set in advance. This agenda should have a time limit established to make sure there is time to cover what the mentee needs during the meeting and to prevent the mentor from being overwhelmed. Unquestionably, time efficiency and sensitivity are critical to the mentor and the mentee; availability is rarely a perfect match between these two parties.

The hierarchical nature of the mentor–mentee relationship may complicate this experience. Because of their advanced knowledge and seniority, mentors are typically more powerful than their mentees. Mentors must use caution if they suggest shortcuts or behaviors privileged by experience, such as those related to direct patient care, research, authorship, committee work, or interpersonal interactions. They must be careful not to exert undue pressure on their mentee’s decisions with respect to patient care, scheduling, project selection, committee participation, or career direction. Most mentees will have more than one mentor, which should not be interpreted as a mentor’s failure. The nonexclusive nature of the mentoring relationship is healthy and appropriate. Having more than one mentor offers mentees the opportunity to gain knowledge from more than one authority (and more than one perspective).

Individuals desiring mentorship should be encouraged to seek mentors from faculty committed to their personal and professional growth and to their success within EM, the hospital environment, and the academic milieu. In general, a successful mentor should be dedicated to their mentee’s well-being. Despite this, mentors should allow mentees to make their own decisions, even if they disagree or know these decisions might not result in favorable outcomes. Mentees must be allowed to make mistakes and learn from them. A fine line exists between being appropriately attentive (sharing observations), overprotective (not allowing missteps, which can provide tremendous learning), and smothering (dominance or control). Mentors should remain toward the left of this “scale.” It is appropriate for mentors to be protective of their mentees, but it is necessary that this be done in a skillful manner that allows mentees to identify for themselves the need to redirect or reframe whatever challenge(s) they face.

Selecting a faculty mentor, especially the “best” or “right” one, is difficult on many levels. First, there is unlikely one best or right mentor for each mentee. Second, relationships are challenging—personalities and ideas of even the most successful “partners” often clash. Exposure to a broad selection of EM faculty may be limited early in a mentee’s career. Faculty biographies of those interested in mentoring, including professional and personal interests, research activities, and previous mentoring experiences, should be made available on websites, on faculty home pages, or through the division or department, the graduate medical education office, or the dean’s office in the medical school. Verbal recommendations (from administrators, faculty at any level, residents, or other students) and EM interest groups are also good places to meet possible mentors and learn about their interests [21, 22]. Mentees must be made comfortable with the knowledge that they can change mentors, for any reason, without concern of retribution to themselves or their mentor. Changing mentors is common throughout one’s career, particularly at the beginning of the mentoring process, when this relationship is especially dynamic and often includes intense personal interactions.

Experienced individuals with stellar reputations for honesty, integrity, and insight generally make ideal mentors. Good listening skills are important for this relationship to work. Administrators (including departmental chairs, chiefs, assistant chiefs, medical directors, hospital executives, managers, senior researchers, and experienced clinicians) who have an interest in actively participating in mentoring may also provide invaluable mentoring to interested parties [23]. Faculty members closer in age and experience to mentees should be encouraged to participate in this noble responsibility, despite not having long histories of mentoring, advanced positions, or tenure. Often, these individuals serve as the most dedicated mentors, given that they are not too far removed from their mentee’s current position and may have greater availability. “Face time” with prospective mentors (staff meetings, lectures, shadowing, medical school courses, interest groups, disaster exercises, emergency medical services [EMS] activities, or formal mentoring programs) offers opportunities for mentees to connect with mentors. This may also occur during meals, sporting events, social activities, and required hospital gatherings. Mentors who make themselves available provide exposure that helps establish relationships with prospective mentees around common interests. Sometimes, presence and enthusiasm are enough to initiate a mentoring relationship, during which both parties can meet, learn from each other, and benefit. Mentors were not born mentors; there is a learning curve and skill development necessary to this process. Hosting or attending events directed at individuals interested in or beginning EM careers provides a wonderful opportunity to interact with colleagues outside the hospital or emergency department setting.

In the past decade, medical education has changed. Bedside skills and behavior modeling have assumed much greater roles for junior faculty, residents, and students. Simulation is one opportunity during which faculty members observe and critique interactions with “patients,” colleagues, and simulated scenarios [24–26]. Many hospitals have integrated simulation exercises to better prepare their medical staff for rare or important (or both) medical conditions. Most medical schools have modified their curricula to get students out of the classroom and into the examination room earlier. Increasing numbers of introduction to clinical medicine courses illustrate this trend, many with EM faculty as instructors. As a result, students and trainees model their professional behaviors after clinicians earlier in their careers. A positive attitude, compassion for patients, and personal integrity are qualities they respect and emulate. According to surveys of students and young physicians, enthusiasm for the specialty and the practice of medicine are critical characteristics of role models and mentors. Although role models do not play as active a role in career development as mentors, they share an equally important role. In fact, many students and residents select mentors on the basis of personal qualities rather than academic accomplishments. Many mentors began as role models for students, only to be asked to serve as mentors at a later time. Direct clinical observation of students, residents, and even junior faculty provides an excellent opportunity to offer feedback and demonstrate skilled patient care interactions. Clearly, today’s medical students and residents place tremendous emphasis on doctor–patient relationships and the psychosocial aspects of medicine. Younger health care professionals are more likely to discuss personal issues with peers and supervisors than in the past, perhaps in part due to generational issues or parental relationships. These are all reasons why meaningful mentoring relationships should be encouraged at all levels of training.

A paucity of mentors exists for several reasons. The literature confirms that there are fewer effective mentors for women and underrepresented minorities in academic medicine [13, 27–29]. Although increasing, a smaller percentage of women have extended careers and an advanced academic rank in EM [30–34]. This is also true of minority faculty in EM and other specialties. The number of female medical students has only recently equaled the number of male medical students; therefore, it will take some time before a sufficient number of experienced female faculty become available to all of the female students who prefer a female mentor. Inherent gender differences in styles of communication, interaction, and competition have been clearly described, which may influence academic promotion [27]. Confidence, stress, and conflict resolution are perceived and handled differently by students, residents, and physicians according to gender [35–37]. It is important that our specialty’s future physicians receive mentoring that accommodates differences in gender, culture, and professional satisfaction inherent in women and minority candidates. Some institutions lack minority EM faculty or have too few faculty members prepared to advise on minority issues. Several recommendations of the Underrepresented Minority Research/Mentorship Task Force of the Society for Academic Emergency Medicine (SAEM) include targeting underrepresented minority medical students through early mentorship and clinical opportunities, in addition to encouraging the involvement of EM faculty at minority organizations [38].

There is also a shortage of mentors in EM internationally. In many countries, EM education and EM systems are in the early stages of development, so experienced emergency physicians who might provide mentorship do not exist. Furthermore, international faculty dedicated to EM may not have received mentoring during their training and therefore may not possess adequate mentoring skills. Finding mentors may be challenging for individuals developing education or EM systems within their own geographic locale, especially if establishing these de novo. Furthermore, clinical, economic, and cultural pressures are likely to interfere with establishing and nurturing traditional mentor–mentee relationships.

Despite the positive experience that comes from having a mentor, not all individuals enter a mentoring relationship. Many students, residents, and junior faculty are not aware that a mentoring relationship assumes such importance. Potential mentees may feel they are bothering a busy faculty member, so they do not pursue these relationships. Faculty members may feel that the commitment of time, energy, and resources to a potential mentee distracts them from more important academic and personal responsibilities [39, 40]. They may also feel unprepared or lack the skills needed for success. Nevertheless, academic faculty should be encouraged to serve as mentors for our specialty’s future physicians whenever possible, especially when common interests exist inside medicine (e.g., business, risk management, health policy, research, teaching, operations, administration, clinical interests) or outside (e.g., sports, hobbies, literature, history, music, food). It is important to make time for this growth experience once it is initiated, which includes being approachable, available, and enthusiastic about this role. Exposure to prospective mentees remains an important aspect of this process. Offering preclinical students or residents the opportunity to shadow in the emergency department or spend time together outside the hospital is an effective way to share enthusiasm our specialty and be available to prospective mentees.

Students at medical schools without EM residency programs, international students, house staff in foreign countries, and residents practicing in non-EM settings have several opportunities for exposure to EM faculty and mentoring. Advising may occur by offering information and resources related to career selection in, transition to, entry into, or success in EM [41].