Jeremy Branzetti: Clinician. Educator. Scholar. Coach.

A recent survey of family medicine chairs sought to identify what influences were significant to these subjects’ achieving their position as chair (Seehausen et al. 2021). Mentorship was, predictably, quite important, with about 65% of respondents identifying it as the developmental tool that played the largest role in their personal development into an academic leader. Coaching, on the other hand, was only seen as the dominant factor by 20%, with sponsorship being the least important of the three (~15%). This article highlights two important realities:

1. There are a number of important types of professional relationship within academic medicine
2. There is not a lot of understanding about their specific meanings or how they can best be used.

Identifying and defining the common professional relationships:

Mentoring is a longitudinal relationship between a senior and junior person, “with the mentor intentionally transferring specific knowledge and skills and guiding the learner’s activities.” (Deiorio et al. 2016)

Advising is similar to mentoring in that the advisor provides specific information to help the advisee, but it tends to be of short duration and more issue-focused (Deiorio et al. 2021).

Sponsoring is “episodic public support by an influential person for the purpose of professional advancement” (Seehusen et al. 2021)

Coaching is a process of guided “inquiry, encouragement, and accountability to increase self-awareness, motivation, and the capacity to take effective action” in the coachee (Dyrbye et al. 2019).

It should be noted that though these specific definitions are generally agreed upon, the literature is rife with examples wherein terms like mentoring and coaching are used interchangeably. Nevertheless, these definitions provide important context to highlight the foundational differences between these relationships:

	Mentoring	Advising	Sponsoring	Coaching
Drives the agenda	Mentor	Advisee	Sponsor	Coachee
Shared expertise domain	Yes	Yes	Yes	No
Tacit difference in seniority	Yes	Yes	Yes	No
Duration of relationship	Long term	One-off or episodic	One-off or episodic	Fixed term or open-ended

So what’s the right professional relationship for you?

Each of these relationships can be incredibly valuable if you understand how they work and know what you want to accomplish. A little bit of time spent understanding them now will pay off in spades later:

The shared expertise domain and seniority of mentoring mean that this relationship is ideal for career development over the long term. The more senior mentor can help identify domain-specific opportunities for the mentee to pursue, facilitate professional connections to expand the mentee’s network, and provide wisdom gleaned from their junior years to help the mentee better navigate common challenges.

Advising is almost exclusively a relationship between a learner and an official within an educational program. This relationship can help learners understand rotation-specific responsibilities, make the most of the specific learning environment, or better understand how they’ll be assessed.

Sponsoring is similar to mentorship, but more short-term or instance-specific. For instance, if a junior faculty member is interested in medical school administration, a department chair can help them by nominating them to serve on the medical school recruitment committee.

Coaching, by contrast to all of the above, is a relationship that is ideal for someone looking to change their professional status quo: solve a problem, cultivate a specific skill, or change directions in their career. A coaching relationship is predicated upon empowerment of the coachee and lacks any implicit power dynamic. These two points are very important to understand for those looking to understand coaching to determine if it’s right for them, so I’ll take a minute to dig into them. Plus, hey, this is a coaching blog – what did you expect?

• Empowerment: this  manifests as the coachee determining what issues need to be addressed, self-identifying meaningful goals, and choosing the actions that will help them accomplish these goals. One could credibly ask “well, what the heck is the coach there for if the coachee is doing all the work?” The best analogy I can think of is therapy: a therapist doesn’t really tell you what is right or wrong, or what you should do; instead, they reflect things you say and pose that might challenge your assumptions. In both instances, the coach/therapist “guides” the coachee/client using effective listening and probative questions to prompt self-reflection, but the latter always chooses the issues to be addressed, the goals to achieve, and actions they will take to achieve those goals. In effect, you can consider a coach a “career therapist.”
• Lack of an implicit power dynamic: Mentors, sponsors, and advisors are all more senior, established, and respected; there is an unspoken deference to them. In many instances, this deference is actually overt subordinance since these same people often serve as leaders within a departmental hierarchy. Ask yourself honestly: how comfortable do you feel telling your chairperson/sponsor that you haven’t been happy at your department and considering changing jobs? Would you be comfortable telling your mentor within your department that you’re considering a career change to some other professional niche? Probably not. Therefore, an ideal coach is outside of your practice group (e.g., department, institution, or even field), is not in your group leadership, or does not professionally assess you in a summative way to determine resource allocation (e.g. bonus, CME funds, academic time).

Summary

Professional relationships are instrumental to personal growth from budding student to academic physician. Each type of relationship has specific dynamics – overall purpose, power differential, duration, etc. – that determine the fit for your circumstances. Armed with an understanding of the dynamics of these relationships, you’ll be in a great position to succeed!