Mara B. Antonoff, MD

In 2011, an article titled "Building a Successful Career: Advice From Leaders in Thoracic Surgery" was published in Thoracic Surgical Clinics of North America.¹ In developing this paper, Dr. Sean Grondin states, "I have been fortunate to have had mentors who have guided me through my surgical training and early years of practice," and he continues, "I realize how much I have learned from and been influenced by the experience and guidance of other surgeons."

Based on his experiences, Dr. Grondin selected a group of 20 outstanding leaders in thoracic surgery, and asked them to each write a short summary of what they deemed to be key elements for developing a successful thoracic surgical career. The inspiration for the paper was an appreciation for mentorship and a desire to further disseminate the influences of the greats in our field; it is both revealing and remarkably appropriate that, in their responses, the majority of the recognized leaders discussed the importance of cultivating strong mentorship relationships, with the word "mentor" mentioned 34 times in the article. The importance of having strong mentors to guide oneself in career development is highlighted over and over again.

In his comments, Dr. Douglas Mathisen states, "Residency training usually introduces you to the most important mentors in your life. They will be the ones who nurture you, educate you, and point you in the right direction. They are likely to bring out the desire in you to become an academic surgeon and educator."

Advice for success from Dr. Valerie Rusch included eight key points, one of which focused on mentorship: "Peer review and senior advice are frequently helpful, and most senior academic physicians are delighted to provide this. Mentors may be surgeons but are also often found in other specialties or even nonclinical settings." And, from the mentors’ perspective, Dr. F.G. Pearson remarks, "In a residency training program, the opportunity to act as a meaningful mentor is a gift and a rewarding opportunity."

For a cardiothoracic surgeon’s individual success, it is clear that having (and utilizing) the right mentors can make a significant impact. Further, when one considers the success of a group of individuals, it is equally important that mentorship relationships are present and strong. In the summer of 2011, the Senior Tour (a group of retired cardiothoracic surgeons committed to education and service for their profession) was asked by the Joint Council on Thoracic Surgery Education to visit 10 thoracic surgical training programs that were considered above average according to a poll taken of thoracic surgical residents in the fall of 2010 by the Thoracic Surgery Residents Association.²

As they summarized their findings, they noted that the top programs possessed many common features leading to superior training in cardiac and general thoracic surgery. The authors specifically noted seven key factors, and, among them, was "a significant emphasis on mentorship, with the program director playing the primary roles and with voluntary relationships between residents and other faculty and with mentorship also including involvement in job finding."

If mentorship is so important to success in this career path, exactly what opportunities exist for trainees seeking mentorship? A Google search for ["mentor" AND "thoracic surgery"] yields a number of results, with ultimate direction leading to essentially two organizations: the AATS and Women in Thoracic Surgery (WTS).

From the AATS website, there is a list of names and contact information for mentors who have been selected or self-nominated for prospective candidates for thoracic surgery residency. These mentors are available to offer guidance, recommendations, and research opportunities, as well as clinical rotations in cardiothoracic surgery (http://aats.org/TSR/contactsMentors.cgi).

A number of opportunities for mentorship are also available through WTS. There is a formal mentoring program, aiming to pair women interested in cardiothoracic surgical careers with established WTS members. Dr. Shanda Blackmon, the Mentoring Chair for the WTS, reflects on the program, stating, "Many surgeons think that mentorship has to be a formal relationship at the same institution. What we have learned at WTS is that mentorship relationships can be equally effective even when they are not formal and the mentor is not from the same institution." She continues, reporting that, "in the survey we conducted through WTS, we discovered that mentorship was one of the most important factors to young surgeons aspiring to start a career in thoracic surgery." It is for this reason that WTS places such emphasis on helping trainees find and sustain mentorship opportunities.

WTS specifically offers scholarships to the Society of Thoracic Surgeons meeting, the Scanlan/WTS Traveling Mentorship, the Carolyn Reed Award, a list of mentors online, and resident mentors. (Further details of all of these programs can be found at www.wtsnet.org.) WTS provides a number of opportunities for female trainees to connect with female mentors. But is it absolutely necessary to find mentors who are "like you"?

Dr. Jennifer Lawton, president of WTS, acknowledges that everyone needs mentoring, but urges that "mentoring of women and minorities is particularly important in order to take advantage of the vast array of benefits to be gained by ethnic, racial, and gender diversity in the workplace."

She continues: "If we don’t see others successful in a chosen field, we do not perceive the goal attainable for ourselves. I have seen this many times in cardiothoracic surgery and women. Women who are not exposed to female mentors have expressed concern that practice in the field is not possible for women (especially those who aspire to have a family)." And, further, she explains that "we are typically more comfortable in mentoring situations with others like ourselves (similar challenges, needs, concerns). Surveys demonstrate that medical students often choose fields of interest because of mentors. For these reasons, it is important for individuals to find mentors who are similar to themselves."

Additional formal mentoring programs exist, and include the Brooks Scholarship through the Southern Thoracic Surgical Association (STSA), the Society of Thoracic Surgeons Looking to the Future scholarship program, the AATS Member for a Day program, and more.

Exactly what should one hope to get out of a mentorship relationship? The truth is, it really depends on the stage of career and the specific needs of the mentee. Mentorship needs change over time, and even well-established mentoring relationships will evolve and adjust along with participants in the interaction.

Sarah Schubert is a fourth-year medical student at Penn State, who has matched into the I-6 program at the University of Virginia and is the current recipient of the Scanlan/WTS scholarship. This award provides trainees with an opportunity to gain exposure to women cardiothoracic surgeon mentors by visiting a WTS member for an elective period. Ms. Schubert reports that she applied for the scholarship because she "wanted to work with and learn from a highly successful female cardiac surgeon in hopes of initiating and developing a professional relationship with a woman in the field."

As a medical student, she has fairly basic mentorship needs. She tells us that "right now, I need mentors who can serve as good role models – in the OR, with patients, with colleagues and trainees, and in their personal lives outside the hospital. As I prepare to enter residency, I anticipate that I will need to further develop my patient care skills and operative techniques, as well as skills to manage time and obligations. Knowing and working with people who have already figured out how to juggle those different obligations will be immensely helpful." Other medical students may be looking for advice on interviewing and ranking residency programs, and, like Ms. Schubert, may be interested in tips on how to get a great start in internship.

For individuals deep in the throes of cardiothoracic training, the needs are clearly different. Dr. Ryan Shelstad, a first-year fellow at the University of Colorado, states: "In my mind, the primary objective of clinical fellowship is acquisition of technical skills and clinical decision making in CT surgery. Thus, mentorship at this stage follows this objective." He continues, "CT fellowship is a relatively short time to achieve this goal as well as position oneself to successfully transition to a faculty position or private practice, which is the second objective—and area for mentoring."

Dr. Shelstad acknowledges and explains the transition in his mentorship needs, "I think earlier in training, mentorship focused on career choice, research, and transition to a fellowship. Much was focused on getting to the next step. While that is still important, now is the time to focus on the clinical aspects of CT surgery that I will use the rest of my career." And, certainly, the specific mentoring needs will continue to change with time.

Dr. Lawton, who holds the rank of professor at Washington University, St. Louis, states that, "after reaching full professor, surgeons need mentoring and sponsoring to reach goals such as dean positions, leadership positions, national organization officer positions, etc. We also all continually need mosaic mentoring that evolves over time (someone to mentor for research career aspects, managing work-life balance issues, family issues, teaching issues, financial issues, etc.). As we progress in our careers, we have the opportunity to also be mentored in other areas by younger generations."

Wait, did she just say that progressing surgeons can be mentored by younger generations? Yes, she did. And not only can seasoned surgeons be mentored by younger surgeons, they also stand to gain considerably from their own mentees. Dr. Lawton further states, "There is always reciprocal gain in a mentoring relationship for the mentor. There is no better joy than to see a mentee succeed and be fulfilled and happy in her chosen field. For some, this provides a rich legacy of trainees and mentees to provide continued enrichment, excitement, and a source of tremendous pride in later years." In the previously mentioned article by Grondin, Dr. Gail Darling states, "Academic careers are usually measured in papers published, grants awarded, invited lectures, and academic standing. Equally important are the students we teach and motivate toward careers in surgery, residents and fellows we have taught and mentored who will provide care to patients and who will go out and teach new generations of surgeons who will in turn provide care."

Once mentorship bonds have been established, it is critical to cultivate these relationships and to gain the most possible from these interactions. When asked how he has achieved these ends, Dr. Shelstad replies, "You and your mentors have the same goal: mutual success. Work hard for your mentors, and they will work hard for you. I would encourage explicit discussion of goals and expectations to ensure you and a potential mentor are on the same page. Mentorship is essential to success in cardiothoracic surgery."

Without a doubt, participation in mentorship relationships is a key element of success at every stage of the career and development of a cardiothoracic surgeon. Outstanding programs already exist to support modern trainees, and further efforts will certainly be met with great enthusiasm. Also apparent is the need for ongoing, career-long mentorship – and the paucity of formal programs to support it. This need may be a great opportunity for the establishment of future programming.

On a personal note, when reflecting on mentorship, I think of a statement made by Benjamin Franklin: "Tell me and I forget, teach me and I may remember, involve me and I learn." To those incredible individuals who have taken the time, effort, and interest to truly involve me, I have immense gratitude. I will aim for the rest of my career to make it worth your while, with hopes to bring you pride and inspire others as you have inspired me. To all who have taken time to truly involve any student, resident, or junior colleague – you have motivated us and given strength to the ongoing legacy of our amazing field.

Citations

1. Grondin SC. Building a Successful Career: Advice From Leaders in Thoracic Surgery. Thorac. Surg. Clin. 2011;21(3):395-415.

2. J. Thorac. Cardiovasc. Surg. 2014;147(1):15-17.

In 2011, an article titled "Building a Successful Career: Advice From Leaders in Thoracic Surgery" was published in Thoracic Surgical Clinics of North America.¹ In developing this paper, Dr. Sean Grondin states, "I have been fortunate to have had mentors who have guided me through my surgical training and early years of practice," and he continues, "I realize how much I have learned from and been influenced by the experience and guidance of other surgeons."

Based on his experiences, Dr. Grondin selected a group of 20 outstanding leaders in thoracic surgery, and asked them to each write a short summary of what they deemed to be key elements for developing a successful thoracic surgical career. The inspiration for the paper was an appreciation for mentorship and a desire to further disseminate the influences of the greats in our field; it is both revealing and remarkably appropriate that, in their responses, the majority of the recognized leaders discussed the importance of cultivating strong mentorship relationships, with the word "mentor" mentioned 34 times in the article. The importance of having strong mentors to guide oneself in career development is highlighted over and over again.

In his comments, Dr. Douglas Mathisen states, "Residency training usually introduces you to the most important mentors in your life. They will be the ones who nurture you, educate you, and point you in the right direction. They are likely to bring out the desire in you to become an academic surgeon and educator."

Advice for success from Dr. Valerie Rusch included eight key points, one of which focused on mentorship: "Peer review and senior advice are frequently helpful, and most senior academic physicians are delighted to provide this. Mentors may be surgeons but are also often found in other specialties or even nonclinical settings." And, from the mentors’ perspective, Dr. F.G. Pearson remarks, "In a residency training program, the opportunity to act as a meaningful mentor is a gift and a rewarding opportunity."

For a cardiothoracic surgeon’s individual success, it is clear that having (and utilizing) the right mentors can make a significant impact. Further, when one considers the success of a group of individuals, it is equally important that mentorship relationships are present and strong. In the summer of 2011, the Senior Tour (a group of retired cardiothoracic surgeons committed to education and service for their profession) was asked by the Joint Council on Thoracic Surgery Education to visit 10 thoracic surgical training programs that were considered above average according to a poll taken of thoracic surgical residents in the fall of 2010 by the Thoracic Surgery Residents Association.²

As they summarized their findings, they noted that the top programs possessed many common features leading to superior training in cardiac and general thoracic surgery. The authors specifically noted seven key factors, and, among them, was "a significant emphasis on mentorship, with the program director playing the primary roles and with voluntary relationships between residents and other faculty and with mentorship also including involvement in job finding."

If mentorship is so important to success in this career path, exactly what opportunities exist for trainees seeking mentorship? A Google search for ["mentor" AND "thoracic surgery"] yields a number of results, with ultimate direction leading to essentially two organizations: the AATS and Women in Thoracic Surgery (WTS).

From the AATS website, there is a list of names and contact information for mentors who have been selected or self-nominated for prospective candidates for thoracic surgery residency. These mentors are available to offer guidance, recommendations, and research opportunities, as well as clinical rotations in cardiothoracic surgery (http://aats.org/TSR/contactsMentors.cgi).

A number of opportunities for mentorship are also available through WTS. There is a formal mentoring program, aiming to pair women interested in cardiothoracic surgical careers with established WTS members. Dr. Shanda Blackmon, the Mentoring Chair for the WTS, reflects on the program, stating, "Many surgeons think that mentorship has to be a formal relationship at the same institution. What we have learned at WTS is that mentorship relationships can be equally effective even when they are not formal and the mentor is not from the same institution." She continues, reporting that, "in the survey we conducted through WTS, we discovered that mentorship was one of the most important factors to young surgeons aspiring to start a career in thoracic surgery." It is for this reason that WTS places such emphasis on helping trainees find and sustain mentorship opportunities.

WTS specifically offers scholarships to the Society of Thoracic Surgeons meeting, the Scanlan/WTS Traveling Mentorship, the Carolyn Reed Award, a list of mentors online, and resident mentors. (Further details of all of these programs can be found at www.wtsnet.org.) WTS provides a number of opportunities for female trainees to connect with female mentors. But is it absolutely necessary to find mentors who are "like you"?

Dr. Jennifer Lawton, president of WTS, acknowledges that everyone needs mentoring, but urges that "mentoring of women and minorities is particularly important in order to take advantage of the vast array of benefits to be gained by ethnic, racial, and gender diversity in the workplace."

She continues: "If we don’t see others successful in a chosen field, we do not perceive the goal attainable for ourselves. I have seen this many times in cardiothoracic surgery and women. Women who are not exposed to female mentors have expressed concern that practice in the field is not possible for women (especially those who aspire to have a family)." And, further, she explains that "we are typically more comfortable in mentoring situations with others like ourselves (similar challenges, needs, concerns). Surveys demonstrate that medical students often choose fields of interest because of mentors. For these reasons, it is important for individuals to find mentors who are similar to themselves."

Additional formal mentoring programs exist, and include the Brooks Scholarship through the Southern Thoracic Surgical Association (STSA), the Society of Thoracic Surgeons Looking to the Future scholarship program, the AATS Member for a Day program, and more.

Exactly what should one hope to get out of a mentorship relationship? The truth is, it really depends on the stage of career and the specific needs of the mentee. Mentorship needs change over time, and even well-established mentoring relationships will evolve and adjust along with participants in the interaction.

Sarah Schubert is a fourth-year medical student at Penn State, who has matched into the I-6 program at the University of Virginia and is the current recipient of the Scanlan/WTS scholarship. This award provides trainees with an opportunity to gain exposure to women cardiothoracic surgeon mentors by visiting a WTS member for an elective period. Ms. Schubert reports that she applied for the scholarship because she "wanted to work with and learn from a highly successful female cardiac surgeon in hopes of initiating and developing a professional relationship with a woman in the field."

As a medical student, she has fairly basic mentorship needs. She tells us that "right now, I need mentors who can serve as good role models – in the OR, with patients, with colleagues and trainees, and in their personal lives outside the hospital. As I prepare to enter residency, I anticipate that I will need to further develop my patient care skills and operative techniques, as well as skills to manage time and obligations. Knowing and working with people who have already figured out how to juggle those different obligations will be immensely helpful." Other medical students may be looking for advice on interviewing and ranking residency programs, and, like Ms. Schubert, may be interested in tips on how to get a great start in internship.

For individuals deep in the throes of cardiothoracic training, the needs are clearly different. Dr. Ryan Shelstad, a first-year fellow at the University of Colorado, states: "In my mind, the primary objective of clinical fellowship is acquisition of technical skills and clinical decision making in CT surgery. Thus, mentorship at this stage follows this objective." He continues, "CT fellowship is a relatively short time to achieve this goal as well as position oneself to successfully transition to a faculty position or private practice, which is the second objective—and area for mentoring."

Dr. Shelstad acknowledges and explains the transition in his mentorship needs, "I think earlier in training, mentorship focused on career choice, research, and transition to a fellowship. Much was focused on getting to the next step. While that is still important, now is the time to focus on the clinical aspects of CT surgery that I will use the rest of my career." And, certainly, the specific mentoring needs will continue to change with time.

Dr. Lawton, who holds the rank of professor at Washington University, St. Louis, states that, "after reaching full professor, surgeons need mentoring and sponsoring to reach goals such as dean positions, leadership positions, national organization officer positions, etc. We also all continually need mosaic mentoring that evolves over time (someone to mentor for research career aspects, managing work-life balance issues, family issues, teaching issues, financial issues, etc.). As we progress in our careers, we have the opportunity to also be mentored in other areas by younger generations."

Wait, did she just say that progressing surgeons can be mentored by younger generations? Yes, she did. And not only can seasoned surgeons be mentored by younger surgeons, they also stand to gain considerably from their own mentees. Dr. Lawton further states, "There is always reciprocal gain in a mentoring relationship for the mentor. There is no better joy than to see a mentee succeed and be fulfilled and happy in her chosen field. For some, this provides a rich legacy of trainees and mentees to provide continued enrichment, excitement, and a source of tremendous pride in later years." In the previously mentioned article by Grondin, Dr. Gail Darling states, "Academic careers are usually measured in papers published, grants awarded, invited lectures, and academic standing. Equally important are the students we teach and motivate toward careers in surgery, residents and fellows we have taught and mentored who will provide care to patients and who will go out and teach new generations of surgeons who will in turn provide care."

Once mentorship bonds have been established, it is critical to cultivate these relationships and to gain the most possible from these interactions. When asked how he has achieved these ends, Dr. Shelstad replies, "You and your mentors have the same goal: mutual success. Work hard for your mentors, and they will work hard for you. I would encourage explicit discussion of goals and expectations to ensure you and a potential mentor are on the same page. Mentorship is essential to success in cardiothoracic surgery."

Without a doubt, participation in mentorship relationships is a key element of success at every stage of the career and development of a cardiothoracic surgeon. Outstanding programs already exist to support modern trainees, and further efforts will certainly be met with great enthusiasm. Also apparent is the need for ongoing, career-long mentorship – and the paucity of formal programs to support it. This need may be a great opportunity for the establishment of future programming.

On a personal note, when reflecting on mentorship, I think of a statement made by Benjamin Franklin: "Tell me and I forget, teach me and I may remember, involve me and I learn." To those incredible individuals who have taken the time, effort, and interest to truly involve me, I have immense gratitude. I will aim for the rest of my career to make it worth your while, with hopes to bring you pride and inspire others as you have inspired me. To all who have taken time to truly involve any student, resident, or junior colleague – you have motivated us and given strength to the ongoing legacy of our amazing field.

Citations

1. Grondin SC. Building a Successful Career: Advice From Leaders in Thoracic Surgery. Thorac. Surg. Clin. 2011;21(3):395-415.

2. J. Thorac. Cardiovasc. Surg. 2014;147(1):15-17.

In 2011, an article titled "Building a Successful Career: Advice From Leaders in Thoracic Surgery" was published in Thoracic Surgical Clinics of North America.¹ In developing this paper, Dr. Sean Grondin states, "I have been fortunate to have had mentors who have guided me through my surgical training and early years of practice," and he continues, "I realize how much I have learned from and been influenced by the experience and guidance of other surgeons."

Based on his experiences, Dr. Grondin selected a group of 20 outstanding leaders in thoracic surgery, and asked them to each write a short summary of what they deemed to be key elements for developing a successful thoracic surgical career. The inspiration for the paper was an appreciation for mentorship and a desire to further disseminate the influences of the greats in our field; it is both revealing and remarkably appropriate that, in their responses, the majority of the recognized leaders discussed the importance of cultivating strong mentorship relationships, with the word "mentor" mentioned 34 times in the article. The importance of having strong mentors to guide oneself in career development is highlighted over and over again.

In his comments, Dr. Douglas Mathisen states, "Residency training usually introduces you to the most important mentors in your life. They will be the ones who nurture you, educate you, and point you in the right direction. They are likely to bring out the desire in you to become an academic surgeon and educator."

Advice for success from Dr. Valerie Rusch included eight key points, one of which focused on mentorship: "Peer review and senior advice are frequently helpful, and most senior academic physicians are delighted to provide this. Mentors may be surgeons but are also often found in other specialties or even nonclinical settings." And, from the mentors’ perspective, Dr. F.G. Pearson remarks, "In a residency training program, the opportunity to act as a meaningful mentor is a gift and a rewarding opportunity."

For a cardiothoracic surgeon’s individual success, it is clear that having (and utilizing) the right mentors can make a significant impact. Further, when one considers the success of a group of individuals, it is equally important that mentorship relationships are present and strong. In the summer of 2011, the Senior Tour (a group of retired cardiothoracic surgeons committed to education and service for their profession) was asked by the Joint Council on Thoracic Surgery Education to visit 10 thoracic surgical training programs that were considered above average according to a poll taken of thoracic surgical residents in the fall of 2010 by the Thoracic Surgery Residents Association.²

As they summarized their findings, they noted that the top programs possessed many common features leading to superior training in cardiac and general thoracic surgery. The authors specifically noted seven key factors, and, among them, was "a significant emphasis on mentorship, with the program director playing the primary roles and with voluntary relationships between residents and other faculty and with mentorship also including involvement in job finding."

If mentorship is so important to success in this career path, exactly what opportunities exist for trainees seeking mentorship? A Google search for ["mentor" AND "thoracic surgery"] yields a number of results, with ultimate direction leading to essentially two organizations: the AATS and Women in Thoracic Surgery (WTS).

From the AATS website, there is a list of names and contact information for mentors who have been selected or self-nominated for prospective candidates for thoracic surgery residency. These mentors are available to offer guidance, recommendations, and research opportunities, as well as clinical rotations in cardiothoracic surgery (http://aats.org/TSR/contactsMentors.cgi).

A number of opportunities for mentorship are also available through WTS. There is a formal mentoring program, aiming to pair women interested in cardiothoracic surgical careers with established WTS members. Dr. Shanda Blackmon, the Mentoring Chair for the WTS, reflects on the program, stating, "Many surgeons think that mentorship has to be a formal relationship at the same institution. What we have learned at WTS is that mentorship relationships can be equally effective even when they are not formal and the mentor is not from the same institution." She continues, reporting that, "in the survey we conducted through WTS, we discovered that mentorship was one of the most important factors to young surgeons aspiring to start a career in thoracic surgery." It is for this reason that WTS places such emphasis on helping trainees find and sustain mentorship opportunities.

WTS specifically offers scholarships to the Society of Thoracic Surgeons meeting, the Scanlan/WTS Traveling Mentorship, the Carolyn Reed Award, a list of mentors online, and resident mentors. (Further details of all of these programs can be found at www.wtsnet.org.) WTS provides a number of opportunities for female trainees to connect with female mentors. But is it absolutely necessary to find mentors who are "like you"?

Dr. Jennifer Lawton, president of WTS, acknowledges that everyone needs mentoring, but urges that "mentoring of women and minorities is particularly important in order to take advantage of the vast array of benefits to be gained by ethnic, racial, and gender diversity in the workplace."

She continues: "If we don’t see others successful in a chosen field, we do not perceive the goal attainable for ourselves. I have seen this many times in cardiothoracic surgery and women. Women who are not exposed to female mentors have expressed concern that practice in the field is not possible for women (especially those who aspire to have a family)." And, further, she explains that "we are typically more comfortable in mentoring situations with others like ourselves (similar challenges, needs, concerns). Surveys demonstrate that medical students often choose fields of interest because of mentors. For these reasons, it is important for individuals to find mentors who are similar to themselves."

Additional formal mentoring programs exist, and include the Brooks Scholarship through the Southern Thoracic Surgical Association (STSA), the Society of Thoracic Surgeons Looking to the Future scholarship program, the AATS Member for a Day program, and more.

Exactly what should one hope to get out of a mentorship relationship? The truth is, it really depends on the stage of career and the specific needs of the mentee. Mentorship needs change over time, and even well-established mentoring relationships will evolve and adjust along with participants in the interaction.

Sarah Schubert is a fourth-year medical student at Penn State, who has matched into the I-6 program at the University of Virginia and is the current recipient of the Scanlan/WTS scholarship. This award provides trainees with an opportunity to gain exposure to women cardiothoracic surgeon mentors by visiting a WTS member for an elective period. Ms. Schubert reports that she applied for the scholarship because she "wanted to work with and learn from a highly successful female cardiac surgeon in hopes of initiating and developing a professional relationship with a woman in the field."

As a medical student, she has fairly basic mentorship needs. She tells us that "right now, I need mentors who can serve as good role models – in the OR, with patients, with colleagues and trainees, and in their personal lives outside the hospital. As I prepare to enter residency, I anticipate that I will need to further develop my patient care skills and operative techniques, as well as skills to manage time and obligations. Knowing and working with people who have already figured out how to juggle those different obligations will be immensely helpful." Other medical students may be looking for advice on interviewing and ranking residency programs, and, like Ms. Schubert, may be interested in tips on how to get a great start in internship.

For individuals deep in the throes of cardiothoracic training, the needs are clearly different. Dr. Ryan Shelstad, a first-year fellow at the University of Colorado, states: "In my mind, the primary objective of clinical fellowship is acquisition of technical skills and clinical decision making in CT surgery. Thus, mentorship at this stage follows this objective." He continues, "CT fellowship is a relatively short time to achieve this goal as well as position oneself to successfully transition to a faculty position or private practice, which is the second objective—and area for mentoring."

Dr. Shelstad acknowledges and explains the transition in his mentorship needs, "I think earlier in training, mentorship focused on career choice, research, and transition to a fellowship. Much was focused on getting to the next step. While that is still important, now is the time to focus on the clinical aspects of CT surgery that I will use the rest of my career." And, certainly, the specific mentoring needs will continue to change with time.

Dr. Lawton, who holds the rank of professor at Washington University, St. Louis, states that, "after reaching full professor, surgeons need mentoring and sponsoring to reach goals such as dean positions, leadership positions, national organization officer positions, etc. We also all continually need mosaic mentoring that evolves over time (someone to mentor for research career aspects, managing work-life balance issues, family issues, teaching issues, financial issues, etc.). As we progress in our careers, we have the opportunity to also be mentored in other areas by younger generations."

Wait, did she just say that progressing surgeons can be mentored by younger generations? Yes, she did. And not only can seasoned surgeons be mentored by younger surgeons, they also stand to gain considerably from their own mentees. Dr. Lawton further states, "There is always reciprocal gain in a mentoring relationship for the mentor. There is no better joy than to see a mentee succeed and be fulfilled and happy in her chosen field. For some, this provides a rich legacy of trainees and mentees to provide continued enrichment, excitement, and a source of tremendous pride in later years." In the previously mentioned article by Grondin, Dr. Gail Darling states, "Academic careers are usually measured in papers published, grants awarded, invited lectures, and academic standing. Equally important are the students we teach and motivate toward careers in surgery, residents and fellows we have taught and mentored who will provide care to patients and who will go out and teach new generations of surgeons who will in turn provide care."

Once mentorship bonds have been established, it is critical to cultivate these relationships and to gain the most possible from these interactions. When asked how he has achieved these ends, Dr. Shelstad replies, "You and your mentors have the same goal: mutual success. Work hard for your mentors, and they will work hard for you. I would encourage explicit discussion of goals and expectations to ensure you and a potential mentor are on the same page. Mentorship is essential to success in cardiothoracic surgery."

Without a doubt, participation in mentorship relationships is a key element of success at every stage of the career and development of a cardiothoracic surgeon. Outstanding programs already exist to support modern trainees, and further efforts will certainly be met with great enthusiasm. Also apparent is the need for ongoing, career-long mentorship – and the paucity of formal programs to support it. This need may be a great opportunity for the establishment of future programming.

On a personal note, when reflecting on mentorship, I think of a statement made by Benjamin Franklin: "Tell me and I forget, teach me and I may remember, involve me and I learn." To those incredible individuals who have taken the time, effort, and interest to truly involve me, I have immense gratitude. I will aim for the rest of my career to make it worth your while, with hopes to bring you pride and inspire others as you have inspired me. To all who have taken time to truly involve any student, resident, or junior colleague – you have motivated us and given strength to the ongoing legacy of our amazing field.

Citations

1. Grondin SC. Building a Successful Career: Advice From Leaders in Thoracic Surgery. Thorac. Surg. Clin. 2011;21(3):395-415.

2. J. Thorac. Cardiovasc. Surg. 2014;147(1):15-17.