Surgical Mentors: Confronting Diversity and Generational Change

Surgical mentoring – be it at the level of students, residents, junior faculty, or staff – is at a crossroads, and will require growth and transformation in order to avert a crisis, according to expert analysis presented at the annual meeting of the Society for Vascular Surgery.

The workforce as a whole, and medical practice in its wake, are rapidly moving from a generation of baby boomers who have a relatively homogenous worldview with respect to work, family, and society, to a diverse and fundamentally different group comprising generations X, Y, and Z for whom those values seem quaint, unengaging, or simply wrong.

Does this chasm make the experiences of the older generation moot in the eyes of the younger? Does it undercut the likelihood of successful mentoring? Or can mentors adapt to the needs of the newer generations?

It would not matter so much if surgical mentoring weren’t such a critical part of professional development. But surgeons are trained through an apprentice system whereby technical expertise is passed down from one generation to the next, along with the mores and expectations of the particular group culture.

Surgery requires not only profound functional skill, but astute professional judgment. In principle, those with many years of practical experience are the ideal mentors for the neophyte. But complex lifestyle and demographic issues (such as new resident work-hour restrictions, career paths, governmental and societal mandates, and shifting worldviews) are emerging that will create an experiential gap and alter the previous mentor-mentee relationship.

Generational Crossroads

Sarah Sladek provided some perspective on the increasing diversity between mentors and those who will need to be mentored.

Ms. Sladek is the founder of XYZ University, a marketing and consulting company focused on generational change, especially in membership associations. She sees the passing of the torch from the baby boomers (or the "loyalty generation") to the XYZ generations as the greatest challenge surgeons will face in mentoring.

"Demographic shifts are threatening the stability of most of our industries ... because most of our industries, including yours, are dominated by the baby boomer generation. But just 3 years from now (in 2015), generation Y, the youngest generation in the workforce, will outnumber the baby boomer generation."

If a surgical practice does not currently reflect this shift, it will need to. However, the structural accommodations in workday/workweek hours, office hierarchies and protocols, benefits, and time off that were made to the boomer generation are not at all tailored to the widely differing expectations and attitudes of the younger XYZ generations.

She pointed out that even the 3,500 members of the Society for Vascular Surgery reflect the nature of this change: Some 800 of those members are retired, and although 150 new graduates annually become vascular surgeons, 160 are needed to fill available positions. Thus, it is important to determine how to hire, engage, and mentor the new generations.

An understanding and acceptance of these differences will lead to structural changes in the way businesses – including surgical practices, academic centers, and even hospitals – operate, according to Ms. Sladek.

One of the most obvious differences, she pointed out, is the lack of diversity among the baby boomers vs. the considerable diversity in race, ethnicity, culture, and expectations found in generations X, Y, and Z.

Baby boomers, she said, were raised to recapitulate the workforce and lifestyle patterns of the generations before them. In contrast, the new generations expect a level of flexibility, personal gratification, novelty, and personal and social fulfillment in life and work far beyond that of their parents’ generation. Some people blame the children’s television program "Mister Rogers’ Neighborhood," she said. "All of a sudden, we had a childhood educator telling children, ‘You are special. You are unique. Do what makes you happy.’ And so we saw this move from conformity to individuality, and we also saw a move toward incredible independence, [with their] being the first generation of latchkey children."

Furthermore, she said, the new generations lack a sense of job security: No longer can they expect to get a job after college and stay with the same organization throughout their career. And they are inundated with news, much of it bad, including the fall of politicians and corporations. They have been shaped by greater individuality, suspicion of authority, and a lot more rebellion. The evolution from an era of relatively hands-off parenting to one of extremely hands-on parenting has created XYZ generations with vastly different experiences, sets of expectations, and worldviews, compared with those of their boomer bosses.

And neither the workplace nor the educational system is yet designed to handle this change. Yet change they must, she said, or they will lose out in competing for these workers and keeping them productive once they have them.

Dealing With Diversity

In theory, optimal mentoring should involve mentors’ sharing of knowledge and experience with the like-minded individuals who can be most receptive. In practice, there may be no choice but to accommodate a seeming mismatch between mentor and student. Today’s mentors – whether program directors, senior surgeons, senior faculty members, or even a senior residents – may need to step outside of their own comfort zone in life experiences, interests, and worldviews.

Perhaps a key indicator of the rapidly developing need to manage workforce change was the fact that the SVS mentorship session was sponsored jointly by the SVS Women’s Leadership Committee and the SVS Diversity and Inclusion Committee. Indeed, Dr. Julie Freischlag, surgeon-in-chief and chair of the department of surgery at Johns Hopkins University, Baltimore, who was one of the key speakers, represented a major facet of this shift: Next year, Dr. Freischlag will be the first female SVS president.

Dr. Freischlag pointed out that mentoring is, first and foremost, a relationship between two people, and not a set of teaching rules. A key aspect of mentoring, therefore, is trust. A coach is there just to get you through your job, she said, whereas a mentor will stick by you and continue to help even when you decide not to follow in the mentor’s footsteps.

A good mentor is one who has authentic guidelines; who promotes mature, self-governing work teams; and who walks the walk. "You need to have sound judgment, independent thinking, a tendency to think divergently, and a good sense of humor so that they want to come see you," she noted. The mentees "are not going to look like you. They may not be from the same background as you. They are going to have different aspirations."

She emphasized the importance of helping people to grow, to learn how to decide what is best for them, and to identify their real interests – not what the mentor would do in their position. "When you hear what they need, you need to have other people talk to them, pointing them to sources of information and other colleagues, all the while being supportive and enthusiastic about the choices made, even if they are not the ones that you yourself would have chosen."

To be in the top 10 among surgical mentors, she gave this advice:

• Let go of your expectations; look at their expectations, not yours.

• Put things into perspective for them and set a good example.

• Agree to disagree on certain things.

• Make light of being overwhelmed yourself, and do not belittle their feelings of being overwhelmed by their number of choices, activities, and so on.

As for identity, sex, race, specialty, family issues, or other areas upon which a mentor may not feel able to advise, she said that it is the mentor’s job to find appropriate additional mentors. "As you mentor people who are not like you, you may need to ask a lot more questions about how they are feeling or what they want, because you really don’t know. And saying to someone else that you ‘know what they are going through’ isn’t true, because you really don’t. So ‘tell me more what it’s like to be a student from Nigeria; tell me more what it’s like to be the only woman in this training program; tell me more what it’s like to be a single mother in this situation’ – those are the questions you need to use."

Dr. Fredrick P. Beavers of the Washington Hospital Center in Washington, D.C., spoke to his own experiences as an African American and to those of minorities in the past who did not have demographically similar mentors. He pointed to the success of these pioneers as evidence that mentorship does not require having identical sex, race, nationality, or other characteristics, but rather an ability to transcend such differences in terms of the values, respect, and true concern for the development and well-being of the mentored.

However, that is not to say that there is not a problem in the pipeline from medical school to the workforce. He cited statistics showing that the percentage of minorities drops dramatically at every step upward in the medical workforce. The percentage of minority individuals decreases from medical school to the level of junior faculty and staff, and further decreases from the junior to senior level and beyond. "The impact a positive mentoring relationship can have on a junior faculty member is immeasurable. The impact that a negative mentoring relationship can have has been measured, and is reflected in these statistics," he concluded.

Collectively, the speakers agreed that not only are true mentors capable of mentoring outside their demographics, but perhaps they also must be prepared to mentor outside of their interests, experience, and even their worldviews. This is a change in perspective that must happen if the surgical professions are to thrive.

None of the speakers had any disclosures relevant to their talk other than Ms. Sladek, who consulted on the issue of generational change.

Surgical mentoring – be it at the level of students, residents, junior faculty, or staff – is at a crossroads, and will require growth and transformation in order to avert a crisis, according to expert analysis presented at the annual meeting of the Society for Vascular Surgery.

The workforce as a whole, and medical practice in its wake, are rapidly moving from a generation of baby boomers who have a relatively homogenous worldview with respect to work, family, and society, to a diverse and fundamentally different group comprising generations X, Y, and Z for whom those values seem quaint, unengaging, or simply wrong.

Does this chasm make the experiences of the older generation moot in the eyes of the younger? Does it undercut the likelihood of successful mentoring? Or can mentors adapt to the needs of the newer generations?

It would not matter so much if surgical mentoring weren’t such a critical part of professional development. But surgeons are trained through an apprentice system whereby technical expertise is passed down from one generation to the next, along with the mores and expectations of the particular group culture.

Surgery requires not only profound functional skill, but astute professional judgment. In principle, those with many years of practical experience are the ideal mentors for the neophyte. But complex lifestyle and demographic issues (such as new resident work-hour restrictions, career paths, governmental and societal mandates, and shifting worldviews) are emerging that will create an experiential gap and alter the previous mentor-mentee relationship.

Generational Crossroads

Sarah Sladek provided some perspective on the increasing diversity between mentors and those who will need to be mentored.

Ms. Sladek is the founder of XYZ University, a marketing and consulting company focused on generational change, especially in membership associations. She sees the passing of the torch from the baby boomers (or the "loyalty generation") to the XYZ generations as the greatest challenge surgeons will face in mentoring.

"Demographic shifts are threatening the stability of most of our industries ... because most of our industries, including yours, are dominated by the baby boomer generation. But just 3 years from now (in 2015), generation Y, the youngest generation in the workforce, will outnumber the baby boomer generation."

If a surgical practice does not currently reflect this shift, it will need to. However, the structural accommodations in workday/workweek hours, office hierarchies and protocols, benefits, and time off that were made to the boomer generation are not at all tailored to the widely differing expectations and attitudes of the younger XYZ generations.

She pointed out that even the 3,500 members of the Society for Vascular Surgery reflect the nature of this change: Some 800 of those members are retired, and although 150 new graduates annually become vascular surgeons, 160 are needed to fill available positions. Thus, it is important to determine how to hire, engage, and mentor the new generations.

An understanding and acceptance of these differences will lead to structural changes in the way businesses – including surgical practices, academic centers, and even hospitals – operate, according to Ms. Sladek.

One of the most obvious differences, she pointed out, is the lack of diversity among the baby boomers vs. the considerable diversity in race, ethnicity, culture, and expectations found in generations X, Y, and Z.

Baby boomers, she said, were raised to recapitulate the workforce and lifestyle patterns of the generations before them. In contrast, the new generations expect a level of flexibility, personal gratification, novelty, and personal and social fulfillment in life and work far beyond that of their parents’ generation. Some people blame the children’s television program "Mister Rogers’ Neighborhood," she said. "All of a sudden, we had a childhood educator telling children, ‘You are special. You are unique. Do what makes you happy.’ And so we saw this move from conformity to individuality, and we also saw a move toward incredible independence, [with their] being the first generation of latchkey children."

Furthermore, she said, the new generations lack a sense of job security: No longer can they expect to get a job after college and stay with the same organization throughout their career. And they are inundated with news, much of it bad, including the fall of politicians and corporations. They have been shaped by greater individuality, suspicion of authority, and a lot more rebellion. The evolution from an era of relatively hands-off parenting to one of extremely hands-on parenting has created XYZ generations with vastly different experiences, sets of expectations, and worldviews, compared with those of their boomer bosses.

And neither the workplace nor the educational system is yet designed to handle this change. Yet change they must, she said, or they will lose out in competing for these workers and keeping them productive once they have them.

Dealing With Diversity

In theory, optimal mentoring should involve mentors’ sharing of knowledge and experience with the like-minded individuals who can be most receptive. In practice, there may be no choice but to accommodate a seeming mismatch between mentor and student. Today’s mentors – whether program directors, senior surgeons, senior faculty members, or even a senior residents – may need to step outside of their own comfort zone in life experiences, interests, and worldviews.

Perhaps a key indicator of the rapidly developing need to manage workforce change was the fact that the SVS mentorship session was sponsored jointly by the SVS Women’s Leadership Committee and the SVS Diversity and Inclusion Committee. Indeed, Dr. Julie Freischlag, surgeon-in-chief and chair of the department of surgery at Johns Hopkins University, Baltimore, who was one of the key speakers, represented a major facet of this shift: Next year, Dr. Freischlag will be the first female SVS president.

Dr. Freischlag pointed out that mentoring is, first and foremost, a relationship between two people, and not a set of teaching rules. A key aspect of mentoring, therefore, is trust. A coach is there just to get you through your job, she said, whereas a mentor will stick by you and continue to help even when you decide not to follow in the mentor’s footsteps.

A good mentor is one who has authentic guidelines; who promotes mature, self-governing work teams; and who walks the walk. "You need to have sound judgment, independent thinking, a tendency to think divergently, and a good sense of humor so that they want to come see you," she noted. The mentees "are not going to look like you. They may not be from the same background as you. They are going to have different aspirations."

She emphasized the importance of helping people to grow, to learn how to decide what is best for them, and to identify their real interests – not what the mentor would do in their position. "When you hear what they need, you need to have other people talk to them, pointing them to sources of information and other colleagues, all the while being supportive and enthusiastic about the choices made, even if they are not the ones that you yourself would have chosen."

To be in the top 10 among surgical mentors, she gave this advice:

• Let go of your expectations; look at their expectations, not yours.

• Put things into perspective for them and set a good example.

• Agree to disagree on certain things.

• Make light of being overwhelmed yourself, and do not belittle their feelings of being overwhelmed by their number of choices, activities, and so on.

As for identity, sex, race, specialty, family issues, or other areas upon which a mentor may not feel able to advise, she said that it is the mentor’s job to find appropriate additional mentors. "As you mentor people who are not like you, you may need to ask a lot more questions about how they are feeling or what they want, because you really don’t know. And saying to someone else that you ‘know what they are going through’ isn’t true, because you really don’t. So ‘tell me more what it’s like to be a student from Nigeria; tell me more what it’s like to be the only woman in this training program; tell me more what it’s like to be a single mother in this situation’ – those are the questions you need to use."

Dr. Fredrick P. Beavers of the Washington Hospital Center in Washington, D.C., spoke to his own experiences as an African American and to those of minorities in the past who did not have demographically similar mentors. He pointed to the success of these pioneers as evidence that mentorship does not require having identical sex, race, nationality, or other characteristics, but rather an ability to transcend such differences in terms of the values, respect, and true concern for the development and well-being of the mentored.

However, that is not to say that there is not a problem in the pipeline from medical school to the workforce. He cited statistics showing that the percentage of minorities drops dramatically at every step upward in the medical workforce. The percentage of minority individuals decreases from medical school to the level of junior faculty and staff, and further decreases from the junior to senior level and beyond. "The impact a positive mentoring relationship can have on a junior faculty member is immeasurable. The impact that a negative mentoring relationship can have has been measured, and is reflected in these statistics," he concluded.

Collectively, the speakers agreed that not only are true mentors capable of mentoring outside their demographics, but perhaps they also must be prepared to mentor outside of their interests, experience, and even their worldviews. This is a change in perspective that must happen if the surgical professions are to thrive.

None of the speakers had any disclosures relevant to their talk other than Ms. Sladek, who consulted on the issue of generational change.

Surgical mentoring – be it at the level of students, residents, junior faculty, or staff – is at a crossroads, and will require growth and transformation in order to avert a crisis, according to expert analysis presented at the annual meeting of the Society for Vascular Surgery.

The workforce as a whole, and medical practice in its wake, are rapidly moving from a generation of baby boomers who have a relatively homogenous worldview with respect to work, family, and society, to a diverse and fundamentally different group comprising generations X, Y, and Z for whom those values seem quaint, unengaging, or simply wrong.

Does this chasm make the experiences of the older generation moot in the eyes of the younger? Does it undercut the likelihood of successful mentoring? Or can mentors adapt to the needs of the newer generations?

It would not matter so much if surgical mentoring weren’t such a critical part of professional development. But surgeons are trained through an apprentice system whereby technical expertise is passed down from one generation to the next, along with the mores and expectations of the particular group culture.

Surgery requires not only profound functional skill, but astute professional judgment. In principle, those with many years of practical experience are the ideal mentors for the neophyte. But complex lifestyle and demographic issues (such as new resident work-hour restrictions, career paths, governmental and societal mandates, and shifting worldviews) are emerging that will create an experiential gap and alter the previous mentor-mentee relationship.

Generational Crossroads

Sarah Sladek provided some perspective on the increasing diversity between mentors and those who will need to be mentored.

Ms. Sladek is the founder of XYZ University, a marketing and consulting company focused on generational change, especially in membership associations. She sees the passing of the torch from the baby boomers (or the "loyalty generation") to the XYZ generations as the greatest challenge surgeons will face in mentoring.

"Demographic shifts are threatening the stability of most of our industries ... because most of our industries, including yours, are dominated by the baby boomer generation. But just 3 years from now (in 2015), generation Y, the youngest generation in the workforce, will outnumber the baby boomer generation."

If a surgical practice does not currently reflect this shift, it will need to. However, the structural accommodations in workday/workweek hours, office hierarchies and protocols, benefits, and time off that were made to the boomer generation are not at all tailored to the widely differing expectations and attitudes of the younger XYZ generations.

She pointed out that even the 3,500 members of the Society for Vascular Surgery reflect the nature of this change: Some 800 of those members are retired, and although 150 new graduates annually become vascular surgeons, 160 are needed to fill available positions. Thus, it is important to determine how to hire, engage, and mentor the new generations.

An understanding and acceptance of these differences will lead to structural changes in the way businesses – including surgical practices, academic centers, and even hospitals – operate, according to Ms. Sladek.

One of the most obvious differences, she pointed out, is the lack of diversity among the baby boomers vs. the considerable diversity in race, ethnicity, culture, and expectations found in generations X, Y, and Z.

Baby boomers, she said, were raised to recapitulate the workforce and lifestyle patterns of the generations before them. In contrast, the new generations expect a level of flexibility, personal gratification, novelty, and personal and social fulfillment in life and work far beyond that of their parents’ generation. Some people blame the children’s television program "Mister Rogers’ Neighborhood," she said. "All of a sudden, we had a childhood educator telling children, ‘You are special. You are unique. Do what makes you happy.’ And so we saw this move from conformity to individuality, and we also saw a move toward incredible independence, [with their] being the first generation of latchkey children."

Furthermore, she said, the new generations lack a sense of job security: No longer can they expect to get a job after college and stay with the same organization throughout their career. And they are inundated with news, much of it bad, including the fall of politicians and corporations. They have been shaped by greater individuality, suspicion of authority, and a lot more rebellion. The evolution from an era of relatively hands-off parenting to one of extremely hands-on parenting has created XYZ generations with vastly different experiences, sets of expectations, and worldviews, compared with those of their boomer bosses.

And neither the workplace nor the educational system is yet designed to handle this change. Yet change they must, she said, or they will lose out in competing for these workers and keeping them productive once they have them.

Dealing With Diversity

In theory, optimal mentoring should involve mentors’ sharing of knowledge and experience with the like-minded individuals who can be most receptive. In practice, there may be no choice but to accommodate a seeming mismatch between mentor and student. Today’s mentors – whether program directors, senior surgeons, senior faculty members, or even a senior residents – may need to step outside of their own comfort zone in life experiences, interests, and worldviews.

Perhaps a key indicator of the rapidly developing need to manage workforce change was the fact that the SVS mentorship session was sponsored jointly by the SVS Women’s Leadership Committee and the SVS Diversity and Inclusion Committee. Indeed, Dr. Julie Freischlag, surgeon-in-chief and chair of the department of surgery at Johns Hopkins University, Baltimore, who was one of the key speakers, represented a major facet of this shift: Next year, Dr. Freischlag will be the first female SVS president.

Dr. Freischlag pointed out that mentoring is, first and foremost, a relationship between two people, and not a set of teaching rules. A key aspect of mentoring, therefore, is trust. A coach is there just to get you through your job, she said, whereas a mentor will stick by you and continue to help even when you decide not to follow in the mentor’s footsteps.

A good mentor is one who has authentic guidelines; who promotes mature, self-governing work teams; and who walks the walk. "You need to have sound judgment, independent thinking, a tendency to think divergently, and a good sense of humor so that they want to come see you," she noted. The mentees "are not going to look like you. They may not be from the same background as you. They are going to have different aspirations."

She emphasized the importance of helping people to grow, to learn how to decide what is best for them, and to identify their real interests – not what the mentor would do in their position. "When you hear what they need, you need to have other people talk to them, pointing them to sources of information and other colleagues, all the while being supportive and enthusiastic about the choices made, even if they are not the ones that you yourself would have chosen."

To be in the top 10 among surgical mentors, she gave this advice:

• Let go of your expectations; look at their expectations, not yours.

• Put things into perspective for them and set a good example.

• Agree to disagree on certain things.

• Make light of being overwhelmed yourself, and do not belittle their feelings of being overwhelmed by their number of choices, activities, and so on.

As for identity, sex, race, specialty, family issues, or other areas upon which a mentor may not feel able to advise, she said that it is the mentor’s job to find appropriate additional mentors. "As you mentor people who are not like you, you may need to ask a lot more questions about how they are feeling or what they want, because you really don’t know. And saying to someone else that you ‘know what they are going through’ isn’t true, because you really don’t. So ‘tell me more what it’s like to be a student from Nigeria; tell me more what it’s like to be the only woman in this training program; tell me more what it’s like to be a single mother in this situation’ – those are the questions you need to use."

Dr. Fredrick P. Beavers of the Washington Hospital Center in Washington, D.C., spoke to his own experiences as an African American and to those of minorities in the past who did not have demographically similar mentors. He pointed to the success of these pioneers as evidence that mentorship does not require having identical sex, race, nationality, or other characteristics, but rather an ability to transcend such differences in terms of the values, respect, and true concern for the development and well-being of the mentored.

However, that is not to say that there is not a problem in the pipeline from medical school to the workforce. He cited statistics showing that the percentage of minorities drops dramatically at every step upward in the medical workforce. The percentage of minority individuals decreases from medical school to the level of junior faculty and staff, and further decreases from the junior to senior level and beyond. "The impact a positive mentoring relationship can have on a junior faculty member is immeasurable. The impact that a negative mentoring relationship can have has been measured, and is reflected in these statistics," he concluded.

Collectively, the speakers agreed that not only are true mentors capable of mentoring outside their demographics, but perhaps they also must be prepared to mentor outside of their interests, experience, and even their worldviews. This is a change in perspective that must happen if the surgical professions are to thrive.

None of the speakers had any disclosures relevant to their talk other than Ms. Sladek, who consulted on the issue of generational change.