President’s Column: Some Thoughts on Mentorship

Published Thursday, June 21, 2012
AAGP President Paul D.S. Kirwin, MD

With July 1st around the corner, we have the opportunity to rekindle our commitment to mentoring new fellows, residents, medical students and trainees from diverse disciplines. We have vested interests in cultivating an interest in geriatric psychiatry, yet the privilege and impact of mentoring is far broader than the specific concerns of our discipline. 

A wise person once said, "A lot of people have gone farther than they thought they could— because someone else thought they could." 

Mentors in my life have helped create a vision for my career and grounded me in times of uncertainty. In my mid-twenties I worked as a research assistant at the National Institute of Mental Health, where I met my wife Barbara. A psychiatrist, David Pickar, headed the research and clinical efforts on a unit working to understand the etiology and treatments for schizophrenia. He once said to me, “What are you doing with your life? Let’s talk about how you can go to medical school.” As I began my science pre-requisites he asked routinely, “When is your next exam? Take the day and study. You have to get A’s in these courses.” My father, my wife’s father, friends at Rochester, Yale, Penn—the places where I trained— and many individuals in this organization have served as my mentors. They led by example, by their creative vigor and commitment to excellence, by their thoughtful attention, by making time in their demanding schedules to meet and to listen to whatever was on my mind.  They led by their wise perspective often with a turn of phrase that gave clarity to ambiguity. 

Mentorship is one of the most profound things we can do for another, the most lasting influence; it shapes one’s character and becomes the emotional resonance that remains part of one’s inner compass—propelling you to push further than you imagined you could. 

Residents and medical students in our Scholars Program have consistently rated mentorship as one of the best components of the AAGP, commenting on the mentors’ warmth, availability, and enthusiasm. Find ways to mentor medical students, residents, fellows and trainees from our allied professions. Many of you are in private practice—see how you might volunteer and have a trainee accompany you or mentor a junior staff member. Your example will inspire and create a lifelong impression.

The AAGP membership has a special track record of promoting training, with organized mentorship underpinning these efforts. The Stepping Stones Program, the Scholars Program, the Summer Research Institute, and the M-STREAM program at UCSD—all endeavors that expose the best and brightest to our field: educational and research efforts begun by our members who continue to push these creative engines forward.

From 1997 to 2007 the Stepping Stones Program brought 50-60 trainees a year to our Annual Meeting—or approximately 500 trainees over 10 years. We stressed the importance of a national representation with residents coming from all over the country—big and small programs, urban and more rural. In 2007 we conducted a survey of these trainees with about 40 percent responding. Of the responders:

  • 72 percent completed a fellowship in geriatric psychiatry.
  • 73 percent spend over half of their time in clinical practice with a focus on geriatrics.
  • 76 percent reported they were currently AAGP members.

With the help and support of the Geriatric Mental Health Foundation and the AAGP, we moved on to develop the Open Doors Program, which grew into our current Scholars Program. Our membership contributed $19,000 in 2010, $38,000 in 2011, and $52,000 in 2012.  

The number of applications continues to grow as word of the Scholars Program disseminates around the country. We continue to attract talent with diverse interests, from programs big and small. We began with 7 Honors Scholars in 2010, and have 16 this year. Honors Scholars have a full ride to the meeting, are assigned an academic mentor, and are expected to produce a scholarly work in the subsequent year. This year we have 16 additional bright minds contributing to our field of knowledge. General Scholars are a mix of residents and medical students, given partial support to the meeting, and also assigned a mentor and encouraged to work on a scholarly project. In 2010, 6 of the 7 Honors Scholars entered a geriatric psychiatry fellowship, with one entering an addictions fellowship, but whose Scholars project focused on geriatric mental health.

Fifteen percent of geriatric psychiatry fellows training in our nation today are Honors Scholars with several General Scholars also in geriatric psychiatry fellowship programs—all with mentored academic projects that advance the margins of our knowledge.    

The Scholars Program exemplifies the best and the brightest of the next generation of geriatric psychiatrists. They are vital to the future of our field; they are essential to the life blood of the AAGP.  Details of their scholarly work are expanded on in an additional article in this issue of Geriatric Psychiatry News. Just a note to highlight a few projects over the past two years: The Size of the Amygdala and its relation to Late Life Depression; Candidate Genes in Alzheimer's Disease; Diffusion Tensor Imaging Correlates of Neuropsychiatric Symptoms in MCI and Alzheimer’s Disease; Community Integration and Successful Aging in Schizophrenia; C-reactive Protein and Geriatric Depression; Prescribing Psychotropic Medications in the Absence of Psychiatric Diagnosis—and many more.

Oliver Wendell Holmes once wrote that "One’s mind, once stretched by a new idea never regains its original dimensions."  The pluripotential of our trainees and the thoughtful mentorship by our members exemplify the spirit his words. 

But our successes are not always linear. Several years ago I mentored a Yale medical student in the precursor to the current M-STREAM program. She helped found and led the medical student geriatric interest group for four years; she generated years of enthusiasm and leadership and a legacy of an interest group that persists today. She then went into anesthesia. One could see this as a failure in outcome—but in keeping with the spirit of the 2008 IOM report we work to infuse and invest in medical student education with the hopes of attracting bright young minds to our field. We now have a colleague in anesthesia who will see countless older patients and is educated and sensitized the needs of the elderly. A success!

In a recent article published in Academic Emergency Medicine, “Being a Mentor: What’s in It for Me?” Wendy C. Coates, MD, explores models of mentorship from business, organizational psychology, and education and relates discoveries from these disciplines to medical education and practice. She breaks her findings into advantages for both mentor and institution. Advantages for the mentor include: becoming part of and establishing a network; developing a base of support from mentees and building legacy, enhanced with years of mentor/mentee relationships; pride in nurturing the next generation; increased salary and promotion potential with recognition of superiors; increased personal satisfaction and mitigation against burn-out; increased perception of career success; and a renewed sense of purpose. Dr. Coates goes on to outline benefits to the work group, specialty or institution:  enhanced network development and national collaborations, enhanced productivity and efficiency, external recognition and improved morale, enhanced skill of members, advantages in recruitment and enhanced satisfaction, and retention of senior members (Coates, WC. “Being a Mentor: What’s in It for Me?” ACADEMIC EMERGENCY MEDICINE 2012; 19:92–97).

Mentorship is at the heart of AAGP’s success and underpins our optimistic prospects. It gives purpose and meaning to our professional lives and infuses our daily work with hope for the future. We are sowing seeds, and over the years have the wonderful satisfaction of seeing our mentees make their own significant contributions and begin mentoring their next generation.  

Back to May/June 2012 Geriatric Psychiatry News