Does Promotion Reflect Mentorship at the School of Medicine?

January 1, 2008
SM. ScottLA. Morrison

Abstract

The University of New Mexico School of Medicine started a mentoring program in 1999 after receiving feedback from faculty that mentoring was one of the top responses to the question “What would you have wanted us to provide you when you started your faculty position to assure your success?” As the process continued, a “First mentor” was added to letters of offer for junior faculty hires. Mentoring of faculty was added to the guidelines for promotion to full professor. Although promotion as an outcomes is difficult to delineate as specifically due to mentoring, we have identified correlations between an extension of assigned mentors to new hires at the senior ranks and a tripling of the number of women and minority faculty members who attained the rank of full Professor resulting in an increase from 3 to 14 total minority faculty members and from 14 to 30% of full Professors who are women.

Paper

In 1999, the University of New Mexico School of Medicine started a faculty development program. The choices of the workshops and processes followed upon: 1) faculty interviews, 2) discussions with the Chairs, and a 3) web-based faculty survey. The overall intention for the survey was “what would you have wanted us to provide at the time of your hire that would have enhanced your career success?” Thirty percent of the faculty completed the survey and their top three choices were: a) faculty orientation, b) assistance in understanding the promotion and tenure process and c) provision of  a mentor.

The faculty orientation, called QuickStart (QS), was initiated with a half-day academic orientation separate from the benefits orientation and provided four times a year. We received positive feedback from faculty (both those who attended and those who did not have access because of hire prior to the initiation of the orientation) and a request for more information from the new faculty. As a result,  the School of Medicine increased QS to three days (2 days for basic scientists and 3 days for clinicians) after the first year of the program.

The Senior Associate Dean within each of the four yearly QS sessions provided an introduction to the other workshops (mentoring, annual performance review [called SMART], dossier preparation, leadership course, and negotiation).  Changes (content and number of workshops) have followed feedback from faculty on what they perceive as needed for their career success. A primary driver in assuring that faculty are aware of workshops and promotion was the development of a mentoring program and the provision of mentoring workshops to allow mentors and mentees an avenue to discuss how to improve the mentoring outcomes. Overall, the SOM has 20-25 workshops yearly, open to all faculty in the School of Medicine and to their staff, except for the Leadership course which requires nominations by the Chairs. Most recently, the Leadership courses included primarily women and/or minority faculty identified by their Chairs for leadership development.

Mentoring Proposal

Mentoring was addressed through a series of processes. An initial proposal was made to the leadership recommending a multiple step process with certain expectations:

  • New faculty will be introduced to the mentoring culture at multiple levels: 1) mentor assignment during recruitment, 2) 3-day orientation, 3) interviews of new faculty and mentors to evaluate the effect of mentoring/orientation
  • Short-term mentoring relationship with senior faculty member
  • Two mentors would be assigned: one as a content expert and one outside of the Department to orient to the culture of the University and to allow cross-department interactions to be enhanced
  • An expected outcome was that new faculty will become mentors within first few years of appointment

The mentoring program was proposed to require assignment of mentors during recruitment (attachment A). This was part of the proposal because of the belief that if a mentor could not be identified before offering a position, it enhanced the possibility of the new faculty member being an “only” within their area of expertise and thus, at risk for failure because of isolation and a lack of discipline-specific role models. Further, the question of hiring a faculty member where no mentor could be identified raised the possibility that this SOM may be a poor match for the faculty member. For the School of Medicine, we have a faculty of very diverse skill sets and a large number of areas of practice within which there are few practitioners. The hope was that the mentoring program would allow successful transition of all faculty. In particular,  it would allow the small division areas to retain new faculty members by investing in  the development of their clinical skills but also by recognizing the role of mentoring in balancing the development of an academic career against the pressure of a high volume clinical practice. The assignment of two mentors was proposed to address the need for  a) content expert mentor (within the Department or institution or outside of the institution if none exist at UNM) and b) an institutional mentor from another department. The role of this mentor would be to allow networking outside of the Department and to allow discussions of topics that are more universal for all faculty members.

The proposal also assumed that the initial mentoring assignment would be short term. This mentor was eventually named “First mentor” to acknowledge the role this faculty member would play in the early phases of the faculty member’s career. That would allow an introduction to the institution but without an expectation that the relationship need continue past its usefulness.

Most of the relationships are designed to continue for six months and during that time the conversation is expected to center on a variety of issues as outlined in the checklist (Attachment B) and to help the faculty member transition to the next set of mentors by serving in a triage role. The plan eventually assigned a single mentor so the mentor has knowledge of the institution and may also be a content expertbut need not be. If not , they play an important role in assisting the faculty member in identifying those at UNM or regionally/nationally who can serve as content experts.

Discussions with Leadership to initiate the Mentoring Program

After introduction of the QuickStart orientation and a recognition by attendees that mentoring would be important to their success, a series of discussions occurred with the Committee of Chairs (COC) to discuss the desire to have a formal mentoring program and to design an implememtation strategy . These discussions resulted in acceptance that the SOM would move forward with a mentoring plan despite reluctance having been voiced that a) mentoring is needed only by those who can’t figure it out themselves and b) motivated faculty would find mentors themselves without the need for a formal assignment. Secondly, the Chairs wanted to name the mentor after getting to know the faculty member during the first six months rather than identify a mentor before coming to UNMSOM who could facilitate the transition to a new institution.

Mentoring workshops for mentors and mentees were begun (Appendices B and C). Discussions with COC were followed by some Department-specific discussions and a request from Pathology to provide a checklist of activities that would be discussed with the mentee. Pathology continued to work on the idea of mentoring through a Department-specific process. The checklist was provided to Pathology and incorporated into the ongoing mentoring workshops for the SOM. Mentoring workshops are offered up to four times a year, attended by mentors and mentees alike. A talk is provided followed by a group discussion about the issues.

After one year of post-arrival mentoring assignments by the Chair, a survey was done of faculty who were hired during that year (Attachment F). Essentially none of the hires from that year could identify a mentoring relationship. As we worked with the Committee of Chairs, division chiefs, and other levels of leadership to address the usefulness of mentoring, two chairs who had been reluctant to pursue mentoring in a formal fashion had faculty members fail to attain promotion. With review, the lack of mentoring was identified by the Chairs as a possible causal factor in the failure to be promoted.

Thus, the Committee of Chairs agreed to designate a mentor within the letter of offer (pre-hire) for each new junior faculty member. A series of suggested roles that Chairs could play in mentoring was sent to the COC via e-mail (Appendix E). Over the next few years, we changed the process such that: 1) the letter of offer now identifies a specific mentor’s name rather than just addressing the “promise of mentoring,” 2) the vast majority of all hires now have a mentor named including senior hires who are also in need of an introduction to the culture of the SOM, 3) promotion to Professor requires demonstration of mentorship of faculty, now added to the promotion guidelines for the SOM.

Outcomes

The introduction of mentoring, the provision of faculty development processes and workshops, and yearly discussions with the Chairs centering on the potential promotion of each faculty member are not clearly causally related to the increase in promotion of women and minority faculty members. Given that limitation, the change in the distribution of promotions is as follows:

In 2000, there were 19 women who were full Professors in the School of Medicine (14% of all full Professors). In 2006, there were over sixty women who were now full Professor and by 2008, women were 30% of the full Professors. In addition, the number of under-represented minority faculty members who were full Professor increased from 3 (all men) to 14 (8 men) during the same six year period. During the same period, women and minorities participated proportionately more in the offered workshops.