How I Teach
TRAINING and EDUCATION
“ How I Teach ” is ASH Clinical News ’ forum for sharing best practices in teaching hematology to medical students , residents , and fellows . We invite essays providing insight into teaching and modeling clinical practice ( historytaking , the physical exam , informed consent , giving bad news ), successful research mentoring , disease-specific tips , or more general advice .
In this edition , we hear from the winners of the 2016 ASH Mentor Awards : Ralph Nachman , MD , and Laurence Boxer , MD .
PASSING THE BATON
With Ralph Nachman , MD
Dr . Nachman talks about mentoring as an integral part of being a physician – scientist . Dr . Nachman is professor emeritus of medicine at Weill Cornell Medicine in New York , New York , and the winner of the 2016 ASH Basic Science Mentor Award .
Is there a path to becoming a mentor ? I don ’ t believe anyone sets out to become a mentor , rather , it grows naturally out of one ’ s work as a scientist . I became a mentor through the discussions with my institution ’ s housestaff about clinical problems ; as these problems became part of my scientific interest , I started tackling some of them in the laboratory – working with students , housestaff , and , of course , fellows . Solving clinical problems becomes a joint enterprise , and communication between participants is a vital part of what we do as scientists . And , as I continued throughout my career , I worked with more young people so , for me , taking up more mentoring responsibilities seemed to be a natural progression .
I see mentoring as intrinsic to being a biomedical scientist who is interested in patient care . It ’ s part and parcel of the entire scientific and clinical problem-solving process .
What qualities make a great mentor ? Honesty , integrity , and , perhaps most importantly , trust in the people you work with .
A great mentor should also have what I like to call “ generosity of spirit ,” or the ability to take enjoyment in watching the people you work with grow and develop and to share the accolades of recognition – whether that ’ s through publications or achievements at the bedside and the bench . Much of that depends on the personality of the mentor , and it is sometimes difficult for people to learn . But I ’ ve found that you can enjoy the recognition and success of people you work with almost as much as your own . Being a mentor doubles your successes and joys , as well as your frustrations .
As a mentor , you are living through your mentees ’ experiences . For instance , one of the earliest joys of being a biomedical scientist is seeing your name on the author list of a journal article for the first time , and that is equaled by seeing the people you ’ ve trained – your friends and your colleagues – do the same thing . The pride and accomplishment is immense . It ’ s a measure of knowing that what you ’ ve done has significant benefit .
How has your approach to mentoring changed over the years ? We all come across teachers , physicians , and scientists whom we model because we admire who they are , how they accomplish things , and we see ourselves having the same accomplishments . Then , as your career progresses , you become aware that what you do influences the behavior and careers of others – particularly young trainees – and you start to form your own approach .
Becoming a role model isn ’ t something we are consciously aware of ; it ’ s a way of doing business as a biomedical physician – scientist – a part of the system we belong to .
In turn , the people you interacted with and helped train begin to act as mentors . I like to think of mentoring as running a relay race and “ handing off the baton ” to younger colleagues so they can keep running the race . When I was younger , I was very active in track , and the most interesting race was the one-mile relay . There were four runners , and , after running their quarter-mile leg of the race , each runner hands off the baton to the next . There ’ s nothing more satisfying than handing off the baton cleanly and crisply and perfectly synchronizing the motion between the runner coming and the runner leaving . Doing that in a smooth , almost ballet-like fashion requires great trust . I feel that same satisfaction when I can help a trainee at the bedside or the bench , and when he or she continues running his or her own race .
When you reach that point when your actions start to influence others who , in turn , influence others , you become more aware of what you do . It might not change your approach , but you recognize that your actions have reverberations . There ’ s no greater sense of accomplishment than seeing how some of the people you interacted with in their earlier years have gone on to make significant contributions .
What are the most challenging aspects of mentoring ? Mentoring means living through your mentees ’ experiences – and that includes their disappointments .
Dealing with success is easy ; dealing with failures is something that often needs to be taught or learned through experience . To some extent , you can help trainees learn how to deal with some of these circumstances , but I think the role of the mentor at that point is to sit down , be quiet , and let people vent their frustrations over not accomplishing what they wanted . There are times to preach and there are times to listen – this is one of those times to listen , and then listen some more . And then keep listening .
What other advice would you give colleagues about mentorship ? When I was chairman of the Department of Medicine at Weill Cornell Medical College , I once described mentorship this way : “ When you train a lot of young people , you look at your career in retrospect , as almost a polymerase chain reaction ( PCR ).” What I mean by this is , as a mentor , a small number of things can become tremendously magnified . Small efforts can have a huge impact on a large number of trainees . It ’ s what I call the PCR of leadership . Someone once asked me if he should seriously consider becoming a chair or head of a division , and I said , “ If you look at your career in terms of the PCR , I would say do it .”
What has mentoring taught you in your life ? It ’ s taught me how important it is to relate to people in a meaningful way . There are formal aspects of mentoring we adhere to , but much of it is based on interpersonal relationships – who you are , how you relate to people , and your enjoyment in watching people grow and succeed .
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