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The Fellow on Call: The Heme/Onc Podcast
Episode 146: Career Development Series-Choosing Your Ideal Mentor
Ronak Mistry, Vivek Patel, Dan Hausrath
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- [00:00]
A
Hey, friends. This episode of the Fellow on Call is not meant to be used for medical advice and is intended for educational purposes only. Patient information has been modified to ensure privacy. The views expressed in this episode do not necessarily reflect the views of our employers. Enjoy. Welcome to another episode of the Fellow on Call, the hemonk podcast. We're actually coming at you this time from somewhere different. We're actually at the American Society of Hematology headquarters in Washington D.C. instead of Rolo University Medical center. And that's because we've got a really special episode lined up for you today. For years, guys, you've been emailing us, messaging us, asking all about advice about how to be a good mentee, career advice, how to get ready for fellowship, and we never really had the ability to do that. But we're really excited that today we kick off our first of our partnership episodes with hematopoiesis and the American Society of Hematology. And through this series that will come out over the next year in small pieces, we're going to cover a lot of these questions that you guys have been asking. We're so excited about this.
- [01:04]
B
It's a new frontier here at the Fellow on Call. We're getting a little bit away from just straight content for how to diagnose and treat cancers and benign classical hematology disorders, and really excited about this partnership. And today we're joined by two members of the ASH Trainee Council, Nick and Claire, who will be providing the trainee perspective. Can you guys introduce yourselves and let everyone know where you are in your training and also tell us one fun fact about yourself. And so let's kick it off to Claire.
- [01:34]
C
Hi everyone, my name is Claire Drysdale. I am a 6th year Maryland PhD student at the University of Michigan, currently doing my PhD on sickle cell disease and a fun fact about myself. I am currently helping to produce the musical that our med school puts on every year. So I have been spending a lot of my evenings this month doing set design, painting and sewing costumes and all of that jazz. So it's been super fun. Our theme is into the Wards this year and if you're in the Ann Arbor area, please come see our show at the end of February.
- [02:09]
B
A woman of many talents. That's pretty awesome. I do, I love myself some musical theater. I was huge part of it in college. So 10 out of 10. That's amazing. Let's kick it off to you, Nick.
- [02:18]
D
Hey everyone, I'm Nick Lee. I'm a joint MedPeads ad hemonk fellow at the NIH and Johns Hopkins. My fun fact is mostly because I'm from Virginia, so I haven't dealt with this much snow for this long. So I got to use a snowblower for the first time, which was fun. What was less fun was breaking up all the ice so I could use my snowblower. But, oh, well, driveway's clear, and I still have all ten of my fingers.
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B
That's solid. And just for everybody to know, Nick is going to be all of our bosses one day. I mean, this whole combined thing at NIH and Hopkins, not too shabby.
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A
Not too shabby at all. Guys, thanks again for being here. It's so nice to have some guest hosts joining us as well. So without further ado, let's roll that show. All right, everybody. So we're so excited to jump into our first episode in collaboration with hematopoiesis and the American Society of Hematology for Focus on Mentorship this time. And we are so excited to have a phenomenal pair of guests joining us today. We're going to welcome Drs. Hetty Caraway and Dr. Alfred Lee, and I'm going to turn over to them to introduce themselves.
- [03:24]
E
Hi, everybody. My name is Dr. Hetty Caraway. I'm the director of the leukemia program at the Cleveland Clinic, and I also serve as the vice chair of strategy and enterprise development for the Tausig Cancer center here at Cleveland. And just to give you a background, I've been here about 10 years, and I focus predominantly on the care of patients that have myeloid malignancies and also acute leukemias.
- [03:46]
F
Hey, everybody. My name is Alfred Lee. I'm a hematologist at Yale, and my specialty is classical hematology. So the study of hematology that is largely not cancer. For five years, I was the fellowship director for the hematology and medical oncology fellowship at Yale. And then I retired from that role this past summer, or I guess last summer, and now am the chief of Classical hematology at Yale Cancer Center.
- [04:09]
B
I mean, this is great. We have a malignant hematologist. We got a classical hematologist. This is going to be a great conversation as we talk about mentorship today. So, Nick, do you want to kick us off with the episode?
- [04:18]
D
Yeah, I'd love to. First, the goal of this episode is to really discuss aspects of mentorship that trainees like myself or Claire might not be able to do with their own mentors. Could you? The two of you start off by describing an experience you've had that could fit this bill and what you learned from that and what our listeners could take away from.
- [04:37]
F
I did my MD PhD at Yale. This is from 1995 until 2004. And so when I was towards the end of my PhD, which was what I hoped would be the final year of my PhD, I had a dissertation committee meeting, which, again, I thought was going to be my final one, where I would get the green light and then be able to defend my PhD dissertation. Truthfully, things hadn't gone exactly as I had planned in my lab work. I didn't make quite the progress that I wanted to. I worked on projects that failed and tried many, many other things and had a number of false starts. But I still was kind of expecting that this would be my final dissertation committee meeting before getting the green light to be able to defend my thesis. As it turned out, after I presented my work, the committee asked me to leave the room. They debated a bit, and when they brought me back in, they basically told me that I didn't have enough to graduate and I'd have to spend another year. And that didn't go over well at all. We actually got in a bit of a fight, even an argument about it, as much as one can in the setting of an academic dissertation committee meeting. And so in that setting here I was a PhD student with five other very senior experienced mentors. I just felt like, oh, my gosh, there's not a single person here who are like my mentors that I could possibly turn to at all. No one, I think, prepares you for failure. And I would say that I learned a lot from failure. In fact, like, I think one of the biggest lessons I learned in my own life is that sometimes you learn more from failure than you learn from anything else. I also learned a lot about resilience and determination and about seeking advice and comfort and camaraderie from other people. So I think that was like, my big defining experience. I had to rely on people who were not necessarily my mentors and had to seek mentorship from people who weren't my primary mentors.
- [06:22]
B
That's a really great story that happens to all of us as we progress through our training. Failure is part of research. You know, you can't be a scientist without having some failure, and it's very challenging to navigate. How do you process that? Who do you go to that may be outside of your direct mentorship? So can you tell us a little bit about who you went to and how you went about doing that?
- [06:42]
F
The first thing I did after walking out of the room and from that meeting with My head hung down and my tail between my legs, was to go back to my then partner, now husband, and just vent. And he did probably the single best thing anyone can do when you feel like your security blanket and your roots are being taken away from you, which is that he just listened to and was a listening ear. Through that conversation, I learned a few things. One was that it's okay to fail. And secondly, when you fail, you can only go up. So there was some sort of odd hope that came from that. The second thing I did was to start to talk about it with other colleagues, in this case, you know, my other fellow graduate students. There's a certain shame when you fail. You know, I think in academic medicine, we all are striving to be perfect. We all want to portray an image of perfection, and yet we're all struggling with the same feelings of imposter phenomenon and risk of failure and real fail. And it's hard to sometimes talk about failure with other colleagues. But when I started to tell other people in the lab about what had happened, it felt surprisingly liberating. I didn't feel ashamed at all. If anything, I heard a lot of similar comments of support in terms of the emotional state of other people in the lab and other people I was doing graduate school with. And then the third was that I started realizing in a few of these conversations that I really needed somebody who was senior, who had a bigger picture of things, who was further along in life, and who would give me some balance and some hope that things would work out okay, and also help me to lay some goalposts so that I could objectively transition out of this state of abject failure and turn it into something successful. And so in the PhD world, everything is kind of siloed into your own PhD and the people who are helping you with that. I actually turned over to my medical school advisors, our dean of students. And I found that they, number one, had a really great perspective about this in the big picture. And the second was that because they were rooted in the clinical world, they sort of helped me to see that there was more to my life beyond just what was happening in my. My PhD. And so the conversations I had with them really were helpful in helping me to get out of this plan for the next few stages ahead.
- [08:44]
A
Alfred, thank you for sharing that. And I have always appreciated how open and honest and vulnerable you are when we come to you to ask. I know I personally have come to you about a lot of things, especially as I was finding my first job and such, so thank you for sharing that perspective. Hetty, I'm curious to hear your take on this as well. Could you describe one of these experiences
- [09:04]
E
for me as a student? When I was a medical student, I had an interest in things and I one of those that I am a feeler. I decide that this feels good. I'm going to, I think I'm going to go down this road. And as a medical student, I decided that my pathology teacher was just phenomenal. He was so good. And so after my second year of med school, I decided to do a post sophomore year in pathology because of my pathology instructor. He was that good. There were four of us in our class of 100 that decided to sign up to be interns in pathology. And then after, as a result of that year, I then knew, hey, I don't think I'm going to do pathology, but I think I'm going to do something that's kind of adjacent to that, like hematology. Hematology, oncology. Because I wanted to be patient facing. I remember my parents when I was telling them that I wanted to do path for a year, they were really not thinking that that was a good decision. They were questioning me and. But you know, as soon as I submerged myself into that space, there were tons of fantastic pathologists that loved every piece and part of what they spent every hour doing. Whether it was our heme pathologist Bruce Woda, or whether it was our thyroid pathologist, whomever it was, whatever space there was, there was opportunity to learn and there was opportunity for research. Because of that year, when I launched into my my clinical years, I then my differential diagnoses were far better because I had spent a year learning about pathology and I knew what to think about. And so it was very much a learning experience that was won by kind of doing. And I figured out pretty early how I liked learning. And then as a result of that, I found mentee mentors along the way that encouraged me to pursue that. And ultimately, when I did my sub I in medicine, there was a professor that I ended up working with and she basically said like, what you want to do and the things that I'm hearing that you like, I think you need to do a rotation away. And I would never have done that if she hadn't recommended that. There's no way I would have done that. And once I did that, when I did a rotation away, I then met another person who then said, you need to come here, you need to do these things. And then one thing led to the other and I followed my Intuition, but it was really the people. As much as I thought and believed that I was pursuing something that I was interested in, I ultimately really think the kernel, the core of it all were the people. And the people really mattered in mentorship
- [11:41]
F
a lot of times, whether we know it or not. And everything you illustrate in your own life, I think sort of underscores this. We seek out people as mentors who we want to be, Right? But then in the process, we end up not actually becoming them, but just something different. Right. We take something from them. And a really beneficial relationship of a mentee and a mentor is when the mentor helps to impart those things that make you unique while taking the best of the mentor and adopting it. Right. You started off wanting to be this pathologist, and you ended up something very different. But you took elements from him and other people along the way, and everyone kind of molded you to the successful person you are today.
- [12:21]
C
So it sounds like mentors played a really pivotal role in either uncertain or times of failure in both of your guys lives. And Alfred, you started touching on this already a little bit. But for someone who's in Nick and I's position, someone who's looking for a mentor to help guide them through these types of situations, what kind of criteria should people be looking for for the kind of people who are going to be best able to help them through those difficult times? What might be overlooked or not emphasized enough?
- [12:49]
F
Yeah, great question. As we were kind of discussing just a moment ago with Hetty's example, I do think there's a big piece in seeking out the right mentor of wanting to be that person. But how you define wanting to be that person varies depending on your own personal and professional goals and on that person's Persona and what they do. You know, sometimes you want to be someone because you think their research is really cool, and you actually want to have that level of research mastery in your field. Sometimes you want to be someone because they seem like a cool person, and you like the way that they sort of approach their life. You like how they balance their work and their life in the clinical world. Sometimes you want to be people because we think they're great clinicians, whether they're great diagnosticians or whether they're just really good at taking care of people or whether they're very compassionate teachers. But I think a key element, again, in seeking mentors is finding people that on some level you kind of want to be and seeking them out and learning from them and taking parts of them to help mold yourself into someone. Slightly different than what you started with at the beginning of that relationship. To heti's point, like, 20 years ago, when she and I were in training and schooling and going through this process, we all had one mentor who was like our research mentor. And we would, like, live and breathe by that person and then sort of grow and develop something on our own. But, you know, in all the years that I was going through training, I used to tell people that I had three mentors. One person was the one I wanted to do research with. The second was the person whose career I wanted to ultimately model. And the third was the person that I could talk to about anything and not feel any judgment and know that person was always in my corner.
- [14:24]
E
As you were talking, Alfred, and even earlier, I started thinking about, like, how was it that I chose my mentor? Right? Like, that's in general. How did you pick who it is that was your mentor or your mentor tree? I named it after a book that I'm currently reading called you have to. Your mentor has to be a likable badass. So that person has to hold you accountable in a way that is both kind and also critical. And you have to be in a place where you're comfortable and you trust them enough to be honest with you. And so that's not easy to find, but it's easy to look for.
- [15:02]
C
Right?
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E
Are they doing that for themselves? Are they doing that for others? One of the things that I chose, the mentor that I chose during fellowship was, did he pass the cheese table test? Like, I found my mentor at a going away party at the cheese table. I love cheese and he loves cheese. Right. So are there things that you love in common outside of work that get you to a place where you feel like, hey, I can talk to this person about things that are hard and also things that are good and celebrate?
- [15:31]
B
So we just want to take a quick break from our episode to hear a little bit more from Nick and Claire about the Ash Trainee Council, something that's a very great opportunity for many of you who listen to this podcast.
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D
The Ashtray Council was created in 2001 to provide a forum for hematology trainees like you and me to discuss the issues relevant to their experiences in career development. Our primary function is to do everything and anything that helps trainees, including helping with the educational needs, career development, and trainee services.
- [15:59]
C
Well, if you guys want to hang out with Nick and I on the Trainee council, then you are in luck, because applications for the next cycle of the Training Council are open right now and available through March 26th. So head on over to the ASH website and submit your application. We hope to see you there.
- [16:15]
D
I think on that note, sometimes the relationship between a mentor and mentee changes. The mentor's in a different place, the mentee's in a different place. And I think, you know, in very modern terms, there's a time to redefine the relationship or even end a relationship between a mentor and mentee. And I think that we're moving towards being more formal about that. And so I guess, do you have any tips on when trainees should identify those time points and how to approach the conversation and be respectful of your time and our time? And it's really an awkward, honestly, situation to be in, especially as a mentee. But how to do that, you know, in a very professional manner?
- [16:53]
F
To your question, Nick, I think a large part of it comes back to just having trying to establish very good communication between the mentee and the mentor. We all communicate in different ways and we all are seeking different things. Sometimes some of us want a little more touchy fuzziness than others do. But at the core of every good mentor mentee relationship is figuring out a very trustworthy line of communication both ways, so that both the mentee and the mentor can talk candidly and supportively about times and instances where the relationship begins to change. I think on the mentee end, it starts with a lot of reflection. It's helpful to have for mentees to have benchmarks, both concrete benchmarks for what type of research and career and professional progress they want to make, but also sort of personal growth benchmarks and emotional benchmarks, asking oneself if you're happy with the relationship, if you feel like you're getting what you need out of it, and if you're not, then reflecting on what sorts of things you do need and then developing scripts to kind of initiate those conversations with the mentor. Some people view a mentor as the older sibling, best friend kind of relationship. And in those situations, it's not too difficult for people to talk candidly. Other people view their mentor in a much more hierarchical fashion. And again, having scripts that kind of focus on objective markers of development and objective metrics can sometimes be helpful in highlighting areas of need that a mentee might not be getting in order to figure out if a mentor can morph and provide some better support or more appropriately matched support, or whether there needs to be further changes in the relationship.
- [18:32]
E
It's really hard, right? I don't want to be that mentee that has to walk into a mentor's office that says, hey, dude, like, you don't have enough time for me. You know, I think just like Alfred, I agree with you. Like, establishing a relationship up front, some guideposts along the way that allow you to have conversations of what's working and what's not really can matter. Then that's the cheese table test. Is this somebody that I can be normal with? Right? Like, that I can be my best self and my worst self in front of, and there's gonna be both. Like, that's being human. These conversations. Listen, like, I guess my perspective has changed with time. Just given the patients that we take care of, things can be really hard. But these mentoring relationships matter. People don't want to waste time, Mentees don't want to waste time, and mentors don't want to waste time. That's one of the most valuable commodities. And people are really important. And if you're invested in somebody, then you have a conversation with them and say, I am invested in our relationship in terms of mentee, mentor, or my research or the work that I'm doing is pivoting, and I want to walk through the why behind that so that I can double back and touch back with you at some later point. You never know what's going to happen. And I would encourage people not to burn a bridge, but rather to have an open conversation about what's happening and why, because you never know what that person may offer and how things may change, also knowing when to walk away. And so that piece, I think, is really the hardest. There are times where it is appropriate to kind of just say, this isn't working for me, and you might not go back. And that might need to be okay because you need to stand up for it and be responsible for your own time and your own value of your own time.
- [20:25]
A
It sounds like the fundamental piece behind what you guys are saying is the importance of self reflection and really understanding what it is that you're looking for in a mentor, mentee relationship. And yes, these conversations can be very, very awkward. But, you know, I think it's so important to keep that perspective. That time is a commodity that is so finite, right? And we really need to be doing the things that serve us and help our careers develop. And so I feel like even hearing this now as very, very junior faculty, I feel more empowered now to be able to take that moment to reflect and figure out what it is that I really need to advance my career and what I need to let go. So thank you for sharing that perspective.
- [21:09]
B
I'll also say that I think to really hone in on one of the important questions that a trainee has is, let's say my interests change. I want to do something totally different. How do I bring that up to my mentor? And the reality is, and I think what's been talked about by Alfred and Hetty here, is that at the end of the day, when you have that open relationship with your mentor, when you choose your mentor, you're looking for that cheese table test. I love that analogy where you can have that open conversation and a good mentor is going to support you and figure out how they can get you to the right person. They will spend their time doing that. I did that for myself. Having gone through different things now entering in towards heading into three, four years on faculty, my interests have changed and it changes constantly. And that's okay. And I know we've all been through that. So it's really important as a trainee to understand that nobody's going to be mad at you when you have a chain interest. In fact, that mentor very likely has had a change in interest in their life at some point and feel empowered to do that. And having a committee, a mentor, mentorship committee, is so critical to being successful.
- [22:11]
F
I love everything that y' all are saying to your point, Vivek. I think it's absolutely true. And this is the theme that, you know, everyone keeps saying over and over again and during this session that mentors, good mentors, are really invested in the mentee. It's always about much more than just the research or just the professional advice or whatever, Right? Like, good mentors, on some level, kind of live and breathe and die by their mentee and how successful their mentee is by whatever metric one defines that success. So what I've often encountered on this side of the line is that if a mentee feels that something isn't quite right, or their interests have shifted, or they feel like we're, quote, unquote, kind of growing apart if they don't feel that things are quite right, oftentimes the mentor can sense that, too. And the mentor probably knows. And just as everyone's saying that it's important to have open lines of communication and talk, and it's important for mentees to feel empowered to be able to have these candid and gentle conversations. I would say the corollary is that the worst thing anyone in the mentee or in the mentee or the mentor role can do when the relationship shifts is to completely ignore that and, like, shy away and pretend that there hasn't been a change. That's sort of a. I wouldn't say a surefire recipe for disaster, but that does make it much more difficult for the relationship to work for both individuals.
- [23:26]
C
One thing that I was curious to hear about as a trainee in closing was the mentor mentee relationship goes both ways. And can you both share a quick, unexpected lesson that you've learned from a mentee in one of your mentee mentor relationships?
- [23:42]
E
Oh, my gosh. Like anything from what are the pearls and pitfalls of how to use red cap? To what's the best restaurant to go to in Cleveland?
- [23:53]
C
Right.
- [23:54]
E
Like any of the things. But also stopping and celebrating, you kind of lose that piece of you. I think there's. As I get older, I have some superstitions about celebrating if you celebrate too soon or whatever, but just keeping that as a part of the joy in our life and making sure that we pause and take time for that and celebrate one another. I think that's probably one of the things that I learn over and over from mentees.
- [24:21]
F
One of our faculty at Yale, who's in my division, the classical hematology division, has been a longtime mentee of mine ever since he was a resident, and it was mostly like clinical mentorship. And then once he joined our faculty, it's a different relationship, but there's still a large portion that's built on a clinical relationship mentoring relationship. I remember one day there was a patient in whose care we were both sharing. So it was a guy that I had seen for a while, and then this patient ended up hospitalized for something, and my mentee, now on faculty, was on service, and then ended up seeing that patient. And so now this guy sort of this patient sort of shuttles between my faculty mentee and then myself. This patient needed a surgery, and they reached out to me first for the perioperative plan, and I came up with something, and then they reached out separately to my mentee, and the plan that he came up with was so much better than mine. It was, like, really detailed and had every single scenario possible. And I remember I turned to my nurse when we were reading this, and I was like, oh, my gosh, he is such a better hematologist than I am. But it felt really exhilarating and rewarding. And I think that's another lesson that I learned from mentees, that the relationship of a mentee and a mentor is really, really rewarding.
- [25:33]
D
Wow. Well, this has been great. I'm so excited that maybe my attending somewhere is really thinks that I have a great plan. But thank you so much. To both of you for all the tips and pearls on mentorship. And I mean, I have learned so much from both of you and from everyone here, really and really excited that this is our first conversation.
- [25:54]
A
And I also just want to say thank you to you guys. I've known the two of you for many years now, and I feel better about the fact that I've asked you for advice along the way, and now we can share a lot of that advice with so many other people. So thank you for all that you've done for me personally and what you're doing for our trainees in this podcast. Guys, I think this wraps up a fantastic episode of the Fellow on Call, and this time in partnership with hematopoiesis and the American Society of Hematology. We'd love to hear your thoughts about what you want to hear on our next edition of this, which will come out in a few months. So if you have suggestions, things that are on your mind, please feel free to send us messages, emails, Instagram posts, whatever. We want to make sure that these episodes are helpful to you and help you get the insights that you need to help you decide your career. All right, guys, so that's it for today. Until next time. We'll see you all later.
- [26:49]
B
Sam.