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Medical mentoring fosters retention, improved health care delivery

Two medical military personnel in an operating room Navy Cmdr. (Dr.) Shawn Belverud, a neurosurgeon (left), and Lt. Cmdr. (Dr.) Scott Donoughe, a neurology resident, perform a herniated disk repair procedure using a 3D surgical microscope at Naval Medical Center San Diego last month. Mentoring continues throughout a naval medical officer’s career, including while in residency. (Photo by Navy Petty Officer 3rd Class Jake Greenberg.)

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There are a variety of formal and informal methods used to help medical officers advance throughout their careers, and some, of course, are better than others.

But Navy Capt. Barry Adams, commanding officer, Navy Medical Leader & Professional Development Command (NML&PDC), said “none of the new models adequately replace the ability to identify someone within your organization and just spontaneously ask them important career questions – ‘What should I do about this or that.’”

NML&PDC, based in Bethesda, Maryland, is responsible for professional development and training programs affecting more than 3,000 students annually through a portfolio of residence courses, professional workshops, distance education and administrative management of multiple pipeline talent management programs.

There is a sophisticated and complicated algorithm within some iterations of formal Navy website mentoring programs for assigning junior service members to senior members and allowing potential mentors and mentees to choose and contact each other; however, “such an official mentoring program could not be as effective as desired because it ceases to be the spontaneous and organic relationship we want in mentoring, “Adams said.

The next iteration of Navy mentoring is often framed as a personal coaching tool, which Adams said is more of what medical personnel are looking for throughout their careers.

“This coaching paradigm is the evolving state of the art,” he noted.

Borrowing a page from a corporate playbook, each member would have some form of a Plan of Action & Management document that identifies tasks to be accomplished. It details resources required to accomplish the elements of the plan, any milestones in meeting the tasks and scheduled completion dates.

Many coaching efforts within Navy medicine start with, or include, a standardized personality assessment, such as the Predictive Index, Meyers-Briggs, or Emotional Intelligence (EQI). It then becomes a suite of assessments staggered across a career. “You need someone certified or licensed in each of those assessment tools to conduct the assessment and then coach you,” said Adams, himself a licensed professional coach.

But this mode has its own issues, he suggested. “The problem is this system is astronomically expensive in resources, time and manpower…and doesn’t necessarily cover what people go to a mentor for.”

There are also Career Development Boards (CDBs). “Career Development Boards are a very formal process tasked across Navy medicine by the surgeon general that is fairly consistent across Navy medicine. During your career, everyone is required to do one. It’s a thorough scrub and review of records and performance and your life,” Adams said.

CDBs are a fully functional system across the enterprise now, and the NML&PDC is actively pursuing a contract to fully automate the CDB process for officers as currently already happens for enlisted sailors. This automation should help maximize consistency and reporting across the enterprise.

“CDBs are a bit closer to mentoring,” Adams said. “It’s a very fixed process, talking to your peers and supervisors, and getting good, solid and assistive scrutiny – not one-on-one mentoring, but a strong mentoring teamwork.”

“CDBs are very labor intensive, but we’re very proud of the program, which is pretty robust,” Adams said. “It comes as close as we’ve been in getting every single Navy medical service member through an effective career development event…but it’s not the same as that personalized sage advice from a mentor chosen by the member.”

At the Uniformed Services University (USU) in Bethesda, Maryland, mentorship is an integral part of all students’ learning and their development into full-fledged medical doctors.

“We look to have a variety of informal and formal opportunities for students from different services to have exposure to individuals who are clinical experts across their careers,” said Air Force Maj. Ryan Landoll, a clinical psychologist and the USU assistant dean for preclinical sciences. “We think these mentors provide inspiration, knowledge, perspective and support.”

Entering students are assigned an officer sponsor for peer mentoring. They are also divided into “fire teams,” groups of four students that intentionally balance diversity in thought, background, experience and service, Landoll explained. These sponsorships and fire teams last through the full 18 months of preclinical studies and through the full course of study at USU. Additionally, students are supported in academics, career and well-being by the Office of Student Affairs.

With the class of 2021, USU is piloting an academic coaching model where there will be regular meetings with faculty who are outside the student’s evaluation system.

Once students are at Military Medical Training Facilities, they are mentored by preceptors on the wards, Landoll said, adding: “We really support our national faculty though a highly robust faculty development program.”

Because military doctors are relocated so often, Landoll said he “encourages ‘aggressive mentorship’ in the sense that mentees should be active seekers of mentorship with specific physicians in their fields of specialty.”

Mentoring, in its broadest sense, creates prolonged and proven positives that help with officer careers in a high-reliability organization such as Navy medicine.

“Mentorship is not only beneficial for knowledge transfer within Navy medicine, but it also fosters other positive factors such as retention, improved health care delivery and innovation, all the while building better leaders for the future operating environment,” said Navy Rear Adm. Gail Shaffer, deputy chief, Bureau of Medicine and Surgery, and surgery/deputy surgeon general of the Navy.

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