How does the mentoring process work in medicine, whether on the research side or clinical/treatment side?
It’s an apprenticeship. You’re working side-by-side with people who have experience in a field, observing and working in parallel with them. In clinical medicine, you are applying what you have learned in the classroom. In the lab, its similar – you are getting hands-on experience designing, performing, and interpreting experiments. But the mentorship goes much further than just the hands-on and technical aspects of doing research or clinical work. It involves critical thinking and continued education. Some of this is provided directly by the mentor, but the environment that the trainees is exposed to is also critical. The mentor has to provide an environment that is conducive to intellectual growth. This involves ample opportunity to critically review the literature in journal clubs and conferences, as well as attending and presenting at meetings, and publishing to disseminate your results to the research community – there are numerous components that go into mentoring and creating an environment that fosters trainees.
Does mentorship have defined goals or objectives, or is it just expected there will be a general benefit gained from working under a more highly experienced professional?
To be successful, the mentee really has to emerge a step closer to be being a dedicated professional. Establishing goals and a formulating a plan to achieve those goals is a better option than just hoping things are going to happen through passive observation. Each trainee is unique with their individual goals. As a mentor, I try and facilitate a trainee’s transition to independence through my interactions with them and placing them into an environment that helps them achieve their goals. It is an active process that involves the commitment of both the mentor and mentee.
Are there ever cases where young researchers have multiple mentors in their early training?
Yes, multiple mentors are common for physician-scientists. The clearest example we have is when the scientific questions originate from problems faced by patients -- trying to improve their outcomes or symptoms they experience. So there often is a clinical mentor and basic science mentor. There are times when I can provide mentorship for both clinical and basic science because our research program spans these areas. But there some questions that arise that require a specific area of expertise, for example clinical trial
design. We arrange to have a clinical mentor and a basic science mentor for the trainee. Having access to experts in different disciplines is an advantage for mentees at a large medical center. Another typical arrangement where mentoring by more than one person occurs, is an advisory committee. A trainee will meet with their mentor and a committee comprised of several senior investigators with a track record of mentoring on a regular basis to review their progress and discuss career goals. This allows the trainee to have access to other established mentors and get feedback on their work, as well as get career advice.
Does mentorship ever cross areas of occupation, for example a young professional training in clinical hematology to be mentored by an established researcher?
Yes, this is common in academic centers. A typical physician-scientist will participate in three to five years of basic research
while also maintaining clinical duties. While we think of the passage of knowledge and experience going from the mentor to the mentee, learning also goes from the mentee to the mentor. As an example, a physician-scientist trainee can introduce clinically-relevant questions to a basic science laboratory or group that requires a collaborative group to answer. By applying the research expertise in the laboratory, this collaboration between the mentee and the mentor can benefit patients.
Mentoring is a life-long process. Even the established investigator has mentors. I have mentors that I interact with every week and I still go to them for advice and specific input. These relationships continue for a long time and are built on the back-and-forth dialog between mentor and mentee.
Tell us about your current mentorship project with the AA&MDSIF Summer Fellowship winner.
This summer I am mentoring Rigoberto De Jesus. Rigo is from Puerto Rico and has completed one year of medical school there. He’s coming for the summer to investigate why some MDS patients respond to a specific treatment and others do not. Dr. Jacoby in our group is treating MDS patients with a combination of drugs, vosaroxin and azacitidine
. Vosaroxin has a different mechanism of action than azacitidine. It can cause DNA damage to MDS cells. We will determine whether a test can be used to predict who will respond to the combination therapy. We will also measure the DNA damage in the blood cells of MDS patients after they receive treatment.
Rigo will be developing an assay to look at the patient samples before and after they get this combination therapy, to look at the DNA damage in the MDS cells. We want to understand the difference between the DNA damage occurring in the MDS cells versus the normal cells. This is a great opportunity to experience different aspects of a project – from clinical trial is design to correlative science using patient samples. Ultimately we want to see if we can predict treatment response and see if we can understand the mechanism of how and why some patients respond to this treatment.
Rigoberto is interested in clinically-oriented research and selected this project because of its direct relevance to patient care in the short-term.