“In My Experience…Mentorship in Orthopaedic Surgery”

Mentorship is critical. None of us would be anywhere we are, were it not for those who have mentored us. When I think of mentorship and why it’s so powerful and impactful to me, it is ultimately for that simple reason. I am forever grateful to the people before me that paved the way and allowed me to have a platform where I can mentor the next generation. And so, as I think back and pay homage to the people that were influential to me, I always start with Peter Scoles, a Pediatric Orthopedic Surgeon at Case Western Reserve University School of Medicine, where I went to medical school.

If you were a Case Medical Student and you wanted to go into Orthopedics, Dr. Scoles took you under his wings. He would essentially say, “you do your job, and I’ll do my job”. For the students, that meant getting involved with research and making yourself as competitive as possible. Dr. Scoles’s commitment was to do everything possible to help every student match successfully in Orthopedics.

It was a powerful message, and he was an incredible role model. I thought to myself, if I ever get to a similar position, I want to pay that forward, and mentor students in the future. And that’s what I’ve been doing ever since.

We find ourselves in a precarious time in education because there’s been the push to eliminate objective measures – grades, standardized test scores, AOA honors induction, to name a few. But regardless of what your belief system is, there is no question that when you start to remove all those data points, it becomes nearly impossible to differentiate students.

At Columbia, for example, I was able to easily rank order the students based on Step 1 score, Step 2 score, third-year clerkship grades, AOA induction, and scholarly productivity. Those criteria, combined with their acting intern performance, letters of recommendation, and advocacy from mentors helped us to globally evaluate and rank the students.

I could then easily help direct students in the top tier to apply to a small number of residency programs and then add 20 unique programs to each subsequent tier – allowing each cohort to have a minimum of 20 unique programs to which their “higher tier” classmates had not applied. This process contributed to our 97% match success rate over the past 28 years.

Now, fast forward to 2024, and most of those objective measures have been eliminated, and your advocates become much more important and, in fact, impactful. If students don’t have somebody waving the flag for them, they might not get on anybody’s radar. Students from orphan schools (no orthopedic department) are very much in distress about this and I certainly understand why.

One of the key features to becoming a good mentor is being honest and introspective. You will likely get asked by many people to be a mentor. “Dr. Johnson, I understand that you’re interested in total hip replacement from an anterior approach. That is something I’m interested in. I’d love to do research with you. I’d love for you to become my mentor”.

Now, if Dr. Johnson does not have the bandwidth to dedicate the time necessary to becoming a mentor for that student, then that relationship will go sideways in a hurry. And then the question will be, was Dr. Johnson a bad mentor? Was the student a bad mentee? Was it a bad combination, a bad mix? Or was it simply just the fact that Dr. Johnson was too worried about his clinical responsibilities such as building his practice? He’s got a lot of things on his plate. Maybe he’s got a young family.

The most important feature to becoming a mentor, therefore, is to dedicate the time necessary to do so. You must have enough bandwidth and be able to say no to people if you really can’t mentor them. The flip side is also true. You have to be a good mentee. If the potential mentee walks into your office and says with palms up, “Dr. Kirschenbaum, I’m here to be your mentee. What are you going to do for me?”, then we have a problem! That mentor is not going to feel positive and optimistic about the potential relationship. This is a bidirectional relationship. The mentor-mentee relationship is one of the most powerful relationships that we have in life and in work.

The mentee must share what they’re going to bring to the relationship. Then the mentor should set achievable guidelines and a roadmap for what the pathway will look like. If there is uncertainty, and the student doesn’t know what to expect, that leaves a lot of room for potential problems with the relationship. It is perfectly acceptable to acknowledge that this is not a good relationship and divorce early before it’s too acrimonious. Just simply say, I’m going to go in a different direction.

As the mentor, please suggest someone else, if you think another faculty member or another person might be a better fit. But don’t stay in a toxic relationship, if it’s not working well. It’s okay to bail and find a different pathway.

The positive features of being a mentor include having the honor of participating and seeing the mentee succeed. You have the privilege of watching them evolve, grow, and mature. If you’re mentoring a first-year medical student who’s interested in orthopedics, helping them match in orthopedics is incredibly gratifying. But that pales in comparison to watching them complete residency, fellowship, and begin their career as an orthopedic surgeon.

The mentor role is a selfless one. It’s not about you bragging or taking responsibility for the mentee’s accomplishments. It’s about taking pure joy in seeing the mentee succeed. Ultimately, they must do the hard work. But you can certainly help shape them and ensure they understand what it takes to achieve their goals. You help guide them as to which people to get in contact with, and what the pathway looks like. So many students just simply don’t know. And obviously, from a mentee standpoint, the proof is in the pudding. You’re trying to find somebody who is invested in your success and who takes you, your wishes, dreams,and aspirations seriously.

From the mentee standpoint what you get out of it is to achieve your goals and aspirations. And you do so with somebody whom you respect, and someone whom you might emulate. The best-case scenario has the mentor-mentee relationship evolve over time to colleague, to friend, advisor, lifelong friend. I am blessed to have some of those relationships with people who mentored me.

I have a long list of mentors who have helped shape my career personally and professionally. My first mentor, as mentioned above, was Peter Scoles. For residency, it was John Richmond (“JR”) and Tom Thornhill, who were probably the two most influential mentors with respect to helping me in many ways. And then in my first fellowship, it was Louis Bigliani and Evan Flatow, who showed me how to become a leader in shoulder and elbow surgery. I completed a second fellowship at the University of Maryland where Claude “T” Moorman and Leigh Ann Curl taught me the tools necessary to become an outstanding sports medicine surgeon and team physician.

One of the amazing aspects about academics is that I had mentors who had no vested interest in helping me. There was no reason, but either through AOA, ASES, AAOS, or through a variety of different organizations, took interest in me. When I was being recruited for Chair positions, I had 10 different chairs from around the country who were incredibly generous with spending time with me to help unlock some of the mysteries of being a chair. Therefore, mentorship doesn’t have to be local. It can be regional, national, and international.

In summary, mentorship is critical for success. For mentees, choose wisely and do not be afraid to have more than one mentor and to change mentors when necessary. For mentors, lean in and be intentional with your time, advice, and guidance. I hope you find it as rewarding and gratifying as I have over the last nearly 3 decades!

Bill Levine