Mentoring and role models in recruitment and retention: A study of junior medical faculty perceptions

Abstract

Purpose: This study explored the views of junior faculty toward informing mentorship program development.

Method: Mixed sampling methodologies including questionnaires (n = 175), focus groups (female, n = 4; male, n = 4), and individual interviews (female n = 10; male, n = 9) of junior faculty were conducted in clinical departments at one academic health sciences center.

Results: Questionnaire results indicated that having role models increased commitment to an academic career; mentorship experience during residency training was a high incentive to pursue an academic career; and junior faculty did have identifiable mentorship experiences. Focus group results revealed that mentoring as well as the presence of role models a few years ahead of the junior faculty would promote career development. Females preferred similar age role models who spoke the same language, particularly in the area of promotion. Females identified several challenges and issues including a lack of researcher role models, a range of perceptions regarding the merits of formal versus informal mentoring, and the idea that mentors should provide advice on promotion and grants. Males valued advice on finances while females wanted advice on work–life balance.

Conclusions: Mentorship emerged as an important factor in academic faculty recruitment and retention, with varying perceptions of how it should be institutionalized. Role models were viewed as important for retention, and a paucity of mid-career, female researcher role models suggests a gap to be filled in future programmatic efforts.

Introduction

Mentoring has been considered a key aspect in recruitment and retention of faculty (Benson et al. 2002; Reck et al. 2006; Weinert et al. 2006; Wingard et al. 2008) and in particular, junior faculty (Taljanovic et al. 2003; Schrubbe 2004; Daley et al. 2006; Kosoko-Lasaki et al. 2006; Thorndyke et al. 2006). Mentoring is a term defined very broadly in the literature (Rose et al. 2005). Mentorship as a construct has been defined by Berk et al. (2005, p. 67) as follows

A mentoring relationship is one that may vary along a continuum from informal/short-term to formal/long-term in which faculty with useful experience, knowledge, skills, and/or wisdom offers advice, information, guidance, support, or opportunity to another faculty member or student for that individual's professional development.”

The relationship between a mentor and mentee is a reciprocal, dynamic, collaborative relationship (Healy & Welchert 1990) where the mentor may act as a facilitator, coach, counselor, sounding board, critical friend, networker or role model. Role model has been defined as “a person whose behavior in a particular role is imitated by others” (Merriam-Webster Dictionary 2012). Whatever the role required by the mentee at a particular time, the essence of mentoring is considered that of a learning relationship (Connor et al. 2000). Teherian & Shekarchian (2008) suggests the benefits of mentoring are three-fold: (1) mentees learn networking, negotiation skills, conflict management, academic writing, and presentation skills, shaping their academic identity and planning their career path; (2) mentors gain satisfaction derived from the mentee's development process as well as sharing of experiences and learning with junior colleagues, as well as becoming part of a support network of senior doctors; and (3) the organization benefits as mentoring can help doctors develop personally and feel valued resulting in physicians providing better patient care.

Table

Practice points

Mentorship in residency training is a strong incentive to pursue an academic career. Mentorship is an important factor in academic faculty recruitment and retention. Role models are important for retention. Implementing both formal and informal mentoring together would be beneficial. Having role models/mentors that are a few years ahead of faculty positively influences retention. Role models/mentors who “speak the same language” may enhance academic faculty retention.

Mentorship can have an important influence on career guidance, career choice, productivity (especially with respect to publications and grant success), and career satisfaction (Gray & Armstrong 2003; DeAngelis 2004; Wasserstein et al. 2007; Mahoney et al. 2008). Several studies have addressed the role of mentoring in improving faculty retention by implementing faculty development mentoring programs. Benson et al. (2002) demonstrated a two-tier program (1 year preceptoring and multi-year mentorship) with voluntary participation and selection of senior faculty members by junior faculty members. There was a trend toward greater retention of participating faculty compared to junior faculty who did not participate. The University of California San Diego (UCSD) developed a structured mentoring program for junior faculty. The retention rate 4 years after the 7 month program at UCSD was 85% of the 67 participants and 93% retention in academic medicine (Wingard et al. 2004). In a Department of Medicine, St. John's University School of Medicine, Baltimore, MD, where there was attrition of women faculty, interventions including mentorship for junior faculty, resulted in an increase in retention and promotion of women faculty by 550% over 5 years (Fried et al. 1996). At UCSD School of Medicine in collaboration with the UCSD Hispanic Center of Excellence, a junior faculty development program that integrated professional skill development and focused academic career advising with mentoring was associated with an increase in the retention of under-represented minority faculty in academic medicine from 75% to 90% (Daley et al. 2006). Creighton University School of Medicine implemented a mentoring program for junior women faculty and for under-represented minorities. The 5 year retention rate for the first year of the mentoring program was 58%, as opposed to 20% prior to implementation of the program (Kosoko-Lasaki et al. 2006).

This study was designed to understand factors that may be barriers to recruitment and retention of academic junior faculty. The target population for the whole study included department/division chairs/chiefs, junior faculty, senior residents, and physician fellows across all clinical departments at the Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Canada. This article will focus on one component of this study, “the views of junior faculty toward informing mentorship program development.”

Method

The study was approved by The Health Sciences Research Ethics Board, The University of Western Ontario, London, Ontario, Canada.

Mixed sampling methodologies (questionnaires, focus groups, and individual interviews) were conducted in 13 clinical departments at the Schulich School of Medicine & Dentistry. Junior clinical academic faculty were defined as “Individuals who joined their respective clinical departments full time within the past 7 years.”

Questionnaire

The questionnaire was designed by the investigators. The questionnaire covered demographic data: birth era; gender; academic rank; area of practice; spousal status; children including number and age; and dependents other than children. Questions using Likert scales (1–5) covered: aspects of mentorship; exposure to role model; quality of work life; importance of personal life; significance of income in career choice; value of parental and maternal benefits in career choice; choice of practice location; and the value of academic promotion. Mentorship and role model were not defined in the survey.

On the questionnaire there were three statements with respect to mentorship: (1) within your area of practice, you have had a clearly identifiable mentorship experience; (2) If you had a mentorship experience your mentor was: same sex, opposite sex, no mentorship; and, (3) A positive mentorship experience during residency training provides incentive to pursuing an academic career. A fourth statement on the questionnaire pertained to role models: (4) within your area of practice you have been exposed to role models that have increased your commitment to an academic position. Participants rated their answers for questions 1, 3, and 4 on a Likert scale (1–5) ranging from 1 being “very much” and 5 being “not at all.”

To maximize response rate, elements of the Dillman (2000) method were used. All invitations to participate in the study were mailed. Statistical Package for the Social Sciences was used for quantitative data by an independent professional.

Focus groups and individual interviews

There were two focus groups: (1) female junior faculty; and (2) male junior faculty. The same interview guide was utilized for both focus groups and individual interviews. The guide consisted of four statements covering the following themes: generational differences; formalized mentoring promoting career development; tensions between the demands of an academic career and the demands of child bearing and child rearing; and shortage of role models contributing to the reluctance toward an academic career. A final question invited other comments. Focus groups and individual interviews were audio taped and transcribed with individual participant's permission, insuring participant anonymity. Data collected for this article came from two statements from the interview guide: “Nurturing formalized mentoring programs in clinical academic departments would promote career development for junior faculty;” and “The shortage of faculty role models with whom junior faculty can relate to and identify with contributes to a reluctance to embark on an academic career.”

Junior clinical academic faculty completing the questionnaire were randomly selected and mailed an invitation to participate in a focus group. An independent professional, not a faculty member or co-investigator, facilitated the focus groups. Participants completing the questionnaire and who did not participate in the focus group were randomly selected and invited by mail to participate in the individual interviews. Individual interviews were conducted by a co-investigator and an assistant; both of them were not faculty members. The terms mentorship and role model were not defined for the participants in the individual interviews or focus groups.

An independent professional, not a faculty member, analyzed the focus group and individual interview data using a content analysis approach. Word frequencies were examined and overall themes among the responses were developed. The format of the focus groups and interviews was geared to elicit agreement or disagreement with the statements provided. The first task was a general count of who agreed versus disagreed with each statement provided. Subsequently, general themes were determined once there was a significant repetition of related words that revealed why a respondent agreed or disagreed. Where a theme did not emerge due to a varied response, a list summarizing the variety of responses was generated.

Results

Questionnaire results

There were 248 mail outs to junior faculty for questionnaire invitation to participate in the study. Out of the 248 mail outs, 7 mail outs were excluded from the study for the following reasons: basic scientist (did not meet criteria); on maternity leave; sabbatical; left program; or out-of-the-country. This reduced the mail-out sample size to 241 (females, 86; males, 155). One hundred and seventy-five participants responded with an overall response rate of 72.62%. For details regarding the response rates, see Table 1.

Table 1  Junior faculty participants versus non-participants

	Number of junior faculty who participated in the survey		Number of junior faculty who did not participate^a in the survey		Number of junior faculty who participated in the focus groups		Number of junior faculty who participated in the individual interviews
Department	M	F	M	F	M	F	M	F
Anesthesia and perioperative medicine	15	3	6	5	1		1
Clinical neurological sciences	6	5	3			1	2	1
Diagnostic radiology and nuclear medicine	7	4	3	3	1	1
Family medicine	3	6	1			1	1	1
Medicine	27	14	17	5	1		1	2
Obstetrics and gynecology	2	5	1				1	1
Oncology	4	4	2	2		1		1
Ophthalmology	2		1	2
Otolaryngology	4		1
Pediatrics	10	3	3	1			1
Pathology	4	1	1	2
Psychiatry	18	7	2				1	1
Surgery	14	7	3	2	1		1	3
Gender total	116	59	44	22	4	4	9	10
Total	n = 175		n = 66		n = 8		n = 19

Notes: M, male and F, female.

Junior clinical academic faculty are defined as those individuals who joined their respective clinical departments full time within the past 7 years.

^aGender information for non-participants was deduced from their “given” names.

Out of the 175 participants, 59 were female and 116 male; 41 junior faculty were born between 1945 and 1962 and 134 in 1963 and later. Overall academic ranks were: 2 Lecturers; 138 Assistant Professors; 32 Associate Professors; and 1 Full Professor (Table 2).

Table 2  Characteristics of junior faculty participants

		Gender		Age range		Academic rank^a
Department	Total	M	F	A	B	L	AP	AsP	FP
Anesthesia and perioperative medicine	18	15	3	6	12		15	3
Clinical neurological sciences	11	6	5	2	9		9	2
Diagnostic radiology and nuclear medicine	11	7	4	4	7		10	1
Family medicine	9	3	6	2	7		8
Medicine	41	27	14	8	33		33	8
Obstetrics and gynecology	7	2	5	2	5	1	3	3
Oncology	8	4	4	1	7		7	1
Ophthalmology	2	2			2		2
Otolaryngology	4	4			4		4
Pediatrics	13	10	3	3	10		10	3
Pathology	5	4	1	2	3		4		1
Psychiatry	25	18	7	9	16		19	6
Surgery	21	14	7	2	19	1	14	5
Total	175	116	59	41	134	2	138	32	1

Notes: M, male; F, female; A, born between 1945 and 1962; B, born from 1963 and later; L, Lecturer; AP, Assistant Professor; AsP, Associate Professor, FP, Full Professor.

Junior clinical academic faculty are defined as those individuals who joined their respective clinical departments full time within the past 7 years.

^aMissing data are not included in the frequencies.

Of the 175 junior faculty respondents the majority of junior faculty had a clearly identifiable mentorship experience. For junior faculty, a positive mentorship experience during residency training provided a high incentive to pursue an academic career. Junior faculty reported that they had a mentor and the majority of junior faculty reported that their mentors were male. A small number of males and females reported that they had mentors of both sexes. Most female faculty reported that they had mentors of the opposite sex and most male faculty reported that their mentors were of the same sex. Most junior faculty reported they were exposed to role models that increased their commitment to an academic position (Table 3).

Table 3  Survey responses pertaining to mentors and role models

Survey statement/question	Responses (n = 175)	Sample comments
Within your area of practice you have been exposed to role models that have increased your commitment to an academic position.	124 junior faculty reported they were exposed to role models that increased their commitment to an academic position.	“Would not have chosen my sub specialty had it not been for my mentor.” “Academic position was mainly chosen because of the influence of role models.”
Within your area of practice, you have had a clearly identifiable mentorship experience.	79 junior faculty had a clearly identifiable mentorship experience.	“Very good clinical & administrative mentorship; poor research mentorship.” “Significant factor is helping to adjust to the responsibilities. A supportive mentorship is essential to junior faculty.” “Do not have formal mentorship; clinician very supportive & Chair gives opportunity if ask for mentorship.”
A positive mentorship experience during residency training provides incentive to pursuing an academic career.	147 junior faculty reported that having a positive mentorship experience during residency training provided a high incentive to pursue an academic career.	“Positive mentorship, academically motivated individual has influence in making a decision to pursue an academic career.” “Yes! I had a much more positive mentorship as a resident than as Junior Staff.”
If you have had a mentorship experience your mentor was: __Same sex __Opposite sex	65 male junior faculty reported that their mentors were of the same sex. 26 female junior faculty reported that their mentors were of the opposite sex.	Male respondents “Minimal mentorship as staff, but several excellent mentorships during residency.” “Two mentors in past; shared common interests in sports and recreation.” Female respondents “Helpful to have same sex mentors (e.g., women – family pressures/parenting & balancing time).” “Several identifiable mentors of both sexes.”

Focus groups

Out of 175 junior faculty completing the questionnaire, 42 randomly selected junior female faculty and 70 randomly selected junior male faculty were mailed invitations to participate in the focus groups. Focus group response rate for junior female faculty was 9.52% (n = 4) and junior male faculty was 5.71% (n = 4).

Both junior male and female faculty were in full agreement that having nurturing formalized mentoring programs in clinical academic departments would promote career development for junior faculty.

Male and female junior faculty had a number of practical suggestions for mentors such as: advising on career goals; assisting with basic essentials; providing practical feedback, orientation; providing information on research issues; and looking out for the mentee. A female faculty member felt that a mentor did not need to be an expert but rather someone to speak their language (respondent: “It doesn’t have to be an expert in the field, just someone who speaks the language.”), and have sufficiently available time for the mentee.

With respect to role models, junior female faculty described a lack of women researchers around their age. Junior male faculty indicated that they would appreciate having a variety of role models. Junior male and female faculty felt there was a shortage of role models a few years ahead of them.

Individual interviews

Out of 167 junior faculty who completed the questionnaire and who did not participate in the focus groups, 28 junior female faculty and 56 junior male faculty were randomly selected and mailed invitations to participate in the individual interviews. Individual interview response rate for junior female faculty was 35.72% (n = 10) and response rate for junior male faculty was 16.7% (n = 9).

Some respondents in each group felt mentoring programs were good in theory but may fail in practice or prove unsustainable. Junior male faculty believed mentors should be compensated for the activity. Junior male and female faculty believed their department needed to formalize mentoring programs. They believed that there were clear roles and expectations for mentors and junior faculty members. Junior male faculty felt mentors should be matched with junior faculty based on mutual interest. Mentees should learn where to focus their energy and learn how to navigate the financial channels of the university. Junior female faculty felt the mentor should be closer in age to them. They felt that mentors could provide advice on the promotion process, show them how to get research grants, and discuss work–life balance. Having more than one mentor serving different mentorship roles, e.g., clinical versus research was suggested. In the case of small departments with a limited mentor pool, mentors outside of the department were proposed.

The majority of junior male faculty agreed or partially agreed (four agreed, three partly agreed, and two disagreed) that the shortage of faculty role models with whom junior faculty can relate to and identify with, contributes to a reluctance to embark on an academic career. The majority of junior female faculty did not believe there was a shortage of role models as they perceived there were more female role models currently. In addition, there were some role models that junior female faculty may not want to emulate. Among junior male faculty, many of them felt they were driven more by internal motivators to pursue research than by a role model. Overall, junior male faculty did not think that gender played a role in mentorship but some felt that generational differences did affect mentorship. Junior female faculty felt they needed more junior role models as well as female role models. Some junior faculty used the term, “mentor” instead of “role model” when commenting on this statement. They would refer to medical students and residents having role models and junior faculty were the role models.

When asked if they had any other comments or perspectives that may help direct departments in their recruitment and retention efforts for junior faculty, junior women faculty added that there was a need for a formal mentoring program. (Table 4: examples of individual interview comments).

Table 4  Emerging themes from individual interviews: Examples of comments from individual interviews

Themes	Sample comments
Incentives for role models and mentors.	“I think that there needs to be support for the mentors. So other than just recruiting someone, mentors, I think, there needs to be some way of rewarding, supporting, and encouraging mentors to do a good job of it.” “For the mentors, there must be some benefit. Having a protégé takes time and space … most don’t have these formal programs … service needs are in conflict with other needs both for mentor and the mentored …”
Miscellaneous: guidelines, procedural issues, generational differences, theory versus practice.	“I think if that person is assigned for me there would have to be some kind of system in place that ensures that, that they are going to meet what my developmental needs are … mentors need guideline to know what they are doing.” “Mandated that every new recruit should be assigned a mentor … a required number of meetings … more formalization of the process.” “In theory mentorship works, but it needs to be truly formalized and truly targeted towards the needs of the employee and not where it's a formality that it needs to be done on paper but where the mentorship is truly not mentoring and not troubleshooting and not there to fix problems or address problems.” “I’ve got a number of different mentors for different reasons and for different aspects of what I do. So I don’t think one person would be able to fill that role.”
Junior faculty as role models for medical students and residents.	“… looking at medical students, they’re exposed to lots of faculty both junior and senior who have very productive academic lives and probably are balanced, but they won’t know that unless it's presented to them that way.”
Role models just a few years ahead.	“I would agree in that I think to try to match as a mentor somebody who's older and more focused on career would be a bad match for somebody who wants to have a better balance of family versus career … it would be better to have somebody who was ten years or less older than the person who needs the mentor.” “… nice to have a mentor a few years ahead to advise more the generation expectations and balance lifestyle.”

Discussion

Mentorship

Mentorship emerged as an important factor in faculty recruitment consistent with other studies (Lynch & Harrell 1971; Bilbey et al. 1992; Sanders et al. 1994; Rubeck et al. 1995; Benson et al. 2002; Feng & Ruzai-Shapiro 2003). Similarly, mentorship proved important for retention, although there were a number of views on the current adequacy of mentorship in departments. A significant majority of junior faculty had experienced a mentor which is in contrast to other studies (Palepu et al. 1998; Freiman et al. 2005; Sambunjak et al. 2006).

Two interesting new findings emerged: a preference for mentors closer in age to the junior faculty member and for mentors who “speak the language.” These comments may speak to intergenerational differences. With younger generations focusing more on work–life balance, they may believe it is important to have mentors who have similar values (Bickel & Brown 2005; Bickel & Rosenthal 2011). This may have indicated some survey bias in those who agreed to participate, but this is less likely in view of the high participation rates of junior faculty.

Recommendations for mentorship committees emerged from individual and focus group interviews. Based on the comments, there was a sentiment that a mentorship committee should be: (1) formalized which is consistent with a study by Leslie et al. (2005) as a possible necessity to ensure equitable access to mentoring for all junior faculty (2005), particularly new recruits; (2) include relevant multidisciplinary members; and (3) be facilitative which is consistent with studies by Straus et al. (2009) and Taherian and Shekarchian (2008).

Participants felt that in addition to a mentorship committee, consideration should be given to informal mentoring. The literature has identified informal mentoring models such as: peer mentoring in which people of similar rank who share interests work together toward common goals (Bussey-Jones et al. 2006; Seritan et al. 2007; Files et al. 2008; Mayer et al. 2008; Moss et al. 2008; Santucci et al. 2008); multiple-mentoring in which the mentee is encouraged to develop a mentoring community consisting of a few mentors who seek to address and support the various aspects and the needs of the mentee (Chesler & Chesler 2002); and a two-tiered program involving 1 year perceptoring and multi-year mentoring (Benson et al. 2002).

Faculty respondents also noted that mentors should be recognized and compensated as they have to take time from their busy academic and clinical schedule to mentor. Ramani et al. (2006) indicated mentoring should be rewarded, and Luckhaupt et al. (2005) survey study found that mentors, who were funded to be mentors, had more mentees than their non-funded colleagues. Schindler et al. (2002) piloted a program that was designed to recognize all aspects of faculty contributions, including serving as a mentor. In Schindler et al.'s study (2002), awards were given to faculty showing outstanding contributions.

Role models

Junior female faculty did not think there was a shortage of female role models, which is in contrast to the literature which indicates there is a lack of role models for women faculty (Swenson et al. 1995). This contrast may be due to the increase in women entering academics.

The terms mentor and role model seemed to be used interchangeably. When asked about role models, some junior faculty referred to the term, “mentor” and not “role model,” and they referred to themselves as the role model to residents and medical students. This may indicate these terms may not be fully understood. The study of Taylor et al. (2009, p. 1131) considered the role model function as one in which the learner is in a purely observational learning role and that mentoring pre-supposes the intentions to offer help or provide guidance.

Lessons learned

Focus groups were planned for the second stage of this study and unfortunately due to the busy and demanding schedules for junior faculty, there were not many faculty available to participate at one specific date/location/time. It was then decided that individual interviews would allow junior faculty to choose a convenient time and place for a member of the research team to interview them. A decrease in the availability of the junior faculty to participate may be an indication that there has been a significant workload increase in academic medical life, along with family responsibility trends for today's junior faculty compared to yesterday's junior faculty. Another possible explanation is that since mentoring is an emotional and personal experience (Chapman & Guay-Woodford 2008; Bickel & Rosenthal 2011), some individuals may be hesitant to discuss their views in a group.

The terms mentorship and role model in the survey and interviews were not clearly defined for the participants so that in future studies the definitions should be clearly articulated for participants.

Conclusions

Mentorship emerged as an important factor in faculty recruitment and retention, with varying perceptions of how it should be institutionalized. Role models were viewed as important for academic junior faculty retention. A key message that arose was the request for closer age mentors who could speak the same language. Although the majority of female junior faculty perceived that there were more female role models currently compared to previously, they did indicate that there appeared to be a paucity of mid-career female researcher role models which suggests a gap to be filled in future programmatic efforts. Finally, there appears to be the need to clearly explain the difference between a role model and a mentor to all faculty, medical students, and residents.

Acknowledgments

The authors thank St. Joseph's Healthcare, Medical Affairs, and the London Health Sciences Centre Opportunity Fund for supporting this study. Dr Richard S. Zayed, for carrying out the quantitative analysis. Dr Zayed is a Psychologist, Child and Parent Resource Institute, Ministry of Children and Youth Services, Assistant Professor, Department of Psychiatry, The University of Western Ontario, London, Ontario. Maria Sánchez-Keane, for facilitating the focus groups, and performing the qualitative analysis for the focus groups and interviews. Ms Sánchez-Keane is the Principal Consultant at the Center for Organizational Effectiveness. This study was conducted at the Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.