We need mentors for women in healthcare now more than ever. For the first time in history, women are the majority of US medical school enrollees, and the margin has been increasing annually. Yet they remain at only about a quarter of faculty and deans. In an era of healthcare worker attrition, half of women are experiencing mistreatment and burnout in medical school, and the rate increases for BIPOC and queer women. This affects retention. Among those who graduate, it adversely affects health outcomes for both female physicians and their patients. Since women are now the majority of medical school enrollees, we can expect that medical workforce shortages will worsen if these issues are not addressed.
While the percentage of women medical students has increased, diversity among people of all genders has declined. Approaching Supreme Court decisions about Affirmative Action could further diminish racial diversity among women in medical school. Advancement of intersectionally-congruent mentoring is therefore critical in our present moment. Patients fare better with providers who look and speak like them and/or who come from their own communities.
Mentoring can make a huge impact on gender inequity in medicine and promote success and wellbeing in women, but there are key considerations for implementing and scaling the practice:
- Intersectionally-congruent mentoring structures should be priorities because they are crucial for establishing trust and effective guidance that centers the mentee.
- Mentoring relationships across different social identities and positions are also important. In these contexts, a mutual relationship of trust is critical to avoid power- and privilege-based advising that can ultimately do more damage than good. The mentor must be an active listener, practice humility and cultural care, and remain flexible in responding and adapting to a mentee’s needs and experiences.
- Peer- and near-peer mentoring can be highly effective.
- Special interest groups are recommended so that mentees and mentors can choose how they self-identify and connect with others to share experiences and resources safely.
- To best support the full spectrum of women in healthcare, mentoring networks have advantages over traditional one-on-one relationships. Networks of women at various stages of their careers have a combined wealth of diverse experiences and expertise. Mentees could gain more comprehensive and agile guidance from a network of mentors pooling their resources and offering what they can from their bailiwick, with flexibility to refer mentees to other mentors, as needed.
Healthcare education requires structural change to ensure equity in admissions, teaching, and training environments. In this context, it’s critical to protect and promote opportunities for women mentors and mentees who are diversely, multiply positioned regarding race, ethnicity, religious affiliation, disability, gender expression, sexuality, socioeconomic status, first-generation status, veteran status, immigrant identity and status, and more.
Healthcare institutions must create structural conditions to support a spectrum of sustainable mentoring relationships. In general, mentoring work among people of marginalized identities largely takes place outside of formal programs, invisible to institutional evaluations. Formal mentoring program guidelines should include gender and intersectional specificity to create dedicated institutional space for women. Equally important to support inclusive women-centered mentoring, the free input of women is needed before planning gets underway. Providing funding and space not only for professional development but also for social interactions is equally important. Women earn less than men and advance in academic and decanal roles at a fraction of the rate of men; therefore, programs structured to reward women’s full participation are particularly urgent. Clear inclusion of mentoring activity in tenure, promotion, and compensation criteria should be standard for every institution.
The benefits of mentoring are mutual and can support a network of intergenerational women in the profession, promoting social and psychological protection from burnout and sustaining a majority-female medical workforce. These benefits are clearly aligned with healthcare efficacy, physician wellbeing, and patient outcomes.
Acknowledgment: Special thanks to Elianna Sanchez, New York Institute of Technology College of Osteopathic Medicine, for her insights into effective mentoring practices presented in “Equity, Diversity, and Inclusion in Healthcare Education: A Longitudinal Health Humanities Approach” at the 2023 annual Health Humanities Consortium conference.
Sarah L. Berry, PhD is an adjunct Assistant Professor at Connecticut College.
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