Last updated December 2010.
by Lois T. Flaherty, M.D.1
I had lunch recently with a young colleague who is engaged in solo private practice, teaches residents 3 hours a week, participates in a peer supervision group, and is trying to figure out how to keep up scholarly activity. She is enjoying her work but talked about how she missed the informal contacts with colleagues in work settings-in the hallways, and in each others' offices in between patients. This brought back memories of my apprehensiveness as I approached the end of my child and adolescent psychiatry training and faced the prospect of separating from the safety and security of structured workdays, abundant supervision, a continuous flow of patients, a regular salary, and the camaraderie of colleagues and staff. I ate lunch nearly every day with a group of residents in the doctors' dining room at Johns Hopkins.
One the ways I coped with leaving the cocoon of residency was by joining every professional organization I knew about and attending all of their local meetings. I quickly got appointed to committees (discovering the truth of Woody Allen's aphorism that 80 percent of success is showing up2). It was my good fortune that the Maryland Regional Council of Child Psychiatry (its name at that time) was being formed the same year I completed my residency, and a young, energetic and full of ideas Ginger Bausch (the future Ginger Anthony) was instrumental in our getting off the ground and provided a crucial link for us to what was then called the American Academy of Child Psychiatry. I became the program chair, and one of my self-imposed duties was picking up guest speakers at the airport or train station, giving me an opportunity to get to know various luminaries in our field. The Regional Council had monthly scientific meetings (as did the Maryland Psychiatric Society, the Maryland Society for Adolescent Psychiatry, and the Medical and Chirurgical Society of Maryland) plus they all had governing board meetings and committee meetings. Going to all these meetings led to being on more committees, and eventually leadership in the local and national organizations. But these activities did not provide day to day support for career development.
These experiences didn't really involve mentoring. The term networking was not in use then but that's what it was. There was also the opportunity to observe how organizations and leadership worked. I also learned things by going to the scientific meetings. The contacts I made were certainly valuable and in fact led to a faculty position at the University of Maryland, where I spent most of my professional career.
My first experience with mentoring in a professional organization came when I attended meetings of the Academy's Committee on Community Child Psychiatry, led at that time by Alberto Serrano and later by Perry Bach. In the 1970s psychiatrists had largely left community mental health centers, disillusioned by their failure to live up to their promises or pushed out by non-medical administrators. But here were child psychiatrists who were actually working in these centers, and in fact had had long careers in them, and actually had meaningful roles in them. Both Drs. Serrano and Bach thoroughly understood the challenges and opportunities involved and were eager to share their experiences and knowledge. They encouraged me and other members of the committee to put together a symposium at the Annual Meeting, one of my first presentations at a national meeting. They were mentors in the best sense of the word. Eventually I became chair of this committee. This and serving in the Assembly led to other leadership positions in the Academy.
So mentorship can happen in professional organizations. In those days, still fairly early in the history of AACAP, there were no formal programs to encourage residents to attend or to mentor them. However, the membership was much smaller than it is today. The attendance at the first meeting I went to was about 800. There was a sit-down dinner on Saturday evening for everyone who attended. I remember being introduced by an older colleague to a lot of people. The APA was a different story - so much larger and more bewildering to a newcomer. I remember attending a meeting of a committee to which I had been asked to serve as a liaison from the AACP committee on community psychiatry. Lunch was served at the meeting - but not to me, as there had been only enough lunches ordered for the regular committee members.
But the APA has changed. This organization now has many fellowships for residents, and members-in-training even have their own journal. The Shire fellowship began under my tenure as chair of the Council on Children, Adolescents and Their Families, and was the brainchild of Catherine Galanter. It has flourished under her leadership (and with the financial support of Shire Pharmaceuticals)3. Shire fellows are each paired with a mentor based on their interests. They are expected to make a presentation during their second APA Annual Meeting. The presentations usually take the form of Component Workshops or Issue Workshops, which have different criteria for acceptance from that of regular submissions.
The Group for the Advancement of Psychiatry has the most intensively mentored fellowships (and possibly the oldest, dating to the Ginsburg Fellowships which were begun in 1955). Fellows, all psychiatry residents, are assigned to committees consisting of 8-10 members, and work with their committee on a project, usually a publication. Both of these involve a two year commitment to support for the fellows (residents) to attend the organization's Annual (in the case of GAP, semi-annual) meetings, integration of the fellows into the committee structure of the organization, and an expectation that the fellows help to produce a work product by the end of the second year. The fellows also make a group presentation on a topic of their choosing at the end of their second year. GAP fellows do not have formally assigned individual mentors but are mentored by the GAP member in charge of the fellowship and by the committees to which they are assigned. They are expected to contribute to whatever project(s) the committee is working on. One of the fellows on my committee, Adolescence, was the lead author on an article published in JAACAP4.
AACAP's Mentoring Programs
AACAP has provided mentorship programs for medical students and general psychiatry or other residents interested in child and adolescent psychiatry. In one of the programs, sponsored by the Committee on Training and Education, in conjunction with the Committee on Medical Students and Residents, medical students, residents, and fellows meet in groups of 8 to 10 with two or three mentors, three to four times during the annual meeting. Discussing his involvement in this program over the past 3 years, Perry Bach commented,
I notice that many of the mentors are early or in the middle of their own careers, and I think it would be great if we can get more "lifers" involved. While I doubt whether many medical students, residents, or fellows would write to the Academy asking for mentors, I believe we could build on those annual meeting Mentorship sessions by identifying "mentees" attending those sessions who would be interested in corresponding with mentors based on their specific interests or locations (personal communication, November 15, 2010).
In addition, the Campaign for America's Kids provides funding for a summer fellowship program for medical students interested in child and adolescent psychiatry. The medical students receive fellowships to gain valuable work experience and meet leaders in the field. Each student receives a stipend of up to $3,500 for 12 weeks of clinical or research training under a child and adolescent psychiatrist mentor. They also receive travel support to attend the Annual Meeting.
What do all these experiences have in common? All involve sustained relationships over time, supported by an institutional framework, between younger and older colleagues who have shared interests. The mentors serve as guides, encouraging the mentees to develop and use their talents and skills. Through their experiences of being mentored, young professionals develop an attachment not only to their mentors, but to the organization that supports mentoring. The experiences I have described do not all involve mentoring for academic careers.
Greatly increased pressures in professional life have made it unlikely that people actually eat lunch, much less share experiences with their colleagues during free time. Instead, they check e-mail and text messages on their smartphones while grabbing a quick bite from their desk drawer, the hospital snack shop, or a street vendor. Furthermore, as noted in a recent AACAP News article from the ECP Committee, many ECPs are located in settings where they are far from the academic and urban centers that nourished them as residents. 5Young psychiatrists still need support and help in developing their clinical skills and ability to work in a variety of environments, whether they are public sector, research or private practice. Enter the Life Members-who have lots of experience and time to share it (and even to eat lunch). There has been considerable enthusiasm among this group for serving as mentors. Life Members have shown their support by contributing to the Life Members fund, which had raised over $20,000 by the Annual Meeting. We are still in the process of figuring out the logistics, but we did make a start this year by supporting travel awards for two young residents, Dawn Brown, from Baylor, and Chia Grande, from Brown University, to help them attend the Annual Meeting. Both attended the Life Members dinner and gave very positive feedback about their experiences at the meeting. So please stay tuned as we work out the plans for next year's Annual Meeting, Go on-line to the Life Members forum and share your thoughts about mentoring, and consider contributing to the Life Members fund, which you can do on-line as well. Go Life Members!
1Lois Flaherty Chairs the AACAP Committee on Adolescent Psychiatry and is a member of the Life Members Subcommittee. She lives in Cambridge, MA and is editor of Adolescent Psychiatry, the journal of the American Society for Adolescent Psychiatry. Dr. Flaherty may be contacted at Lflaher770@aol.com.
2Woody Allen is reported to have said this in the context of an interview in which the topic was advice to young writers and later told it to William Safire. Fred Shapiro citing his book The Yale Book of Quotations, (2006, Yale University Press) in his July 15, 2010 blog, records the source as The New York Times, Aug. 21, 1977. Retrieved from http://freakonomics.blogs.nytimes.com.
3My husband, John T. Flaherty, MD, worked for Shire from 2005-2007.
4Daley ML, Becker DF, Flaherty LT, Harper G, King RA, Lester P, Milosavljevic, N, Onesti SJ, Rappaport N, Schwab-Stone M. Case study: the internet as a developmental tool in an adolescent boy with psychosis. J Am Acad Child Adolesc Psychiatry. 2005 Feb;44(2):187-90.
5Miller, S. M. (2010) Early career psychiatrists connect: AACAP launches program promoting regional organization outreach to new colleagues. AACAP News. Nov-Dec, 275