By Asmi Chattaraj, MD, Muhammad Salman Faisal, MBBS, and Faiz Anwer, MD

Hematology and Oncology Fellows Network (HOFN) is a group on Twitter (@hemoncfellows) that helps fellows by organizing discussions related to hematology and oncology (hem-onc) training. Here we present our discussion from the October 26, 2021, session on the role of fellows as mentors, held on Twitter Spaces. Our guest for the event was Dr. Faiz Anwer (@FaizAnwerMD1), an associate professor and myeloma attending physician at Cleveland Clinic Taussig Cancer Center. Dr. Anwer is an academician and has mentored hundreds of medical students, residents, and fellows internationally for more than 10 years. He delivered a riveting talk on “The Role of the Fellow as a Mentor.” Dr. Muhammad Salman Faisal (@msalmanfaisal) moderated the session.

MSF: When should a fellow start mentoring?

FA: Typically, in the first year, the curriculum is very heavy on clinical rotations, such as in-patient and bone marrow transplantation floors, and also includes taking internal medicine boards, so a PGY-4 fellow might not have much time to mentor. Mentoring is a volunteer effort, and a motivated person can find some time to guide the juniors, residents, and medical students; however, getting involved in anything beyond a phone call or a few messages might not be possible. However, in the second and third years, when there is more time allotted for research and electives, fellows will have more time for mentorship and coaching and will be able to involve others in research projects. It is appropriate to begin mentoring later if a person needs more time to focus on their desired research topics, rotations, and family, perhaps starting to mentor in year 3. As I said, it is a voluntary position, so it is commendable for any fellow who is motivated to be a guide and mentor to aspiring juniors. 

MSF: How can a first-year fellow on an in-patient service be a good mentor to the medical students and residents rotating along?

FA: It depends on how busy and critical your rotation is at that moment. However, as second- and third-year internal medicine residents and some fellows who have been chief residents, you already have experience in supervising students and residents on service. You already know how much liberty you can give your residents in managing a patient’s care. On in-patient rotations, you encounter many cases which are interesting and will provide good educational value. As fellows, you should encourage your residents and medical students to read about the topic and to publish case reports if they have novel findings. If you have time, you should discuss a topic or interesting presentations of in-patient cases with your residents. You should also start guiding them on topics including the timeline to apply for fellowship, initiating publications, and building research skills.

MSF: What expectation should a fellow set for residents and medical students while mentoring them?

FA: For medical students, one should be lenient, mainly expecting the student to show genuine interest and take some responsibility. If someone is showing promise, start to increase their responsibilities. Make sure they follow up on their work and discuss the concepts in more detail if there is any confusion.

For the residents, especially for those who are building their portfolio to apply for competitive fellowship, they have to produce academically. They must be proactive in asking questions, developing their own ideas for research/abstracts. As they advance through their residency, they should be able to perform varying parts of a research project, work on review articles, and ultimately lead a project on their own. They must have a basic understanding of the topics of hematology and oncology while constantly updating their knowledge on emerging therapies and new discoveries. As a mentor, your role is to navigate them toward learning. Always delegate tasks clearly, make a timeline for your projects, and discuss ideas. At the same time, teach them the value of productivity by being an example for them. Be clear in communicating your expectations. Reply to their emails in a timely fashion. Meet on a regular basis in order to keep them focused on their work.

MSF: What does a fellow get out of mentorship?

FA: It depends on what you value in life. Mentoring juniors is a rewarding experience. A mentor and mentee sometimes learn from each other and inspire each other. If your student has done a great deal of research on a particular topic, you should be open to learning something new from them. Being a good teacher and inspiring interest in students is an achievement. It is not only giving, but also receiving in the long run. It is a relationship built upon mutual respect, accommodation, and trust. Above all, it’s the gratitude that your mentees have for you that will fill your heart. You don’t just want to finish your fellowship, but you want to mature as a person, investigator, and teacher, all the while developing a comprehensive thought process and becoming a good team leader. Being a mentor will always lead you down that path. 

MSF: Given the clinical, research, teaching, and mentorship responsibilities, and having a family and life outside of work, how does one strike a good work-life balance? 

FA: It is an ongoing struggle. The first step is to understand your priorities. Learn to realize when to say no and be clear with your communication about it to your seniors as well as your juniors. Find a balance that suits your life and goals. Learn to be efficient and have a daily target. Distribute your time every day, accordingly, making sure to devote ample time for family and personal wellbeing. When working on a project, distribute the work within the team and seek help when needed. Creating a supportive work environment is also important. There will be times when you have to prioritize work, such as meeting conference abstract deadlines, presentation/didactic deadlines, or a hectic clinic day or in-patient rotation. Reward yourself after the hard work is over so that you can relax and heal. 

Audience question: I just started my first year and it has been a steep learning curve. I feel I am missing opportunities. Is it okay to slow down as a first-year fellow and to say no to some research opportunities?

FA: The first-year schedule is very hectic, so it is okay to slow down if you need to do so, but do not lose sight of your goals in life. Learn to say no in a polite way and with honest reasons. If you receive a research opportunity via email or verbally from an attending, ask for some time to think about it before answering. Then think about your timeline and other responsibilities and how this particular opportunity would affect your career and your life. Once you have an answer, communicate it clearly and politely.

Audience question: As a first-year fellow, I may want to research and write on certain topics that my medical students/residents are not up to yet. Should I hold off on writing these for 1 to 2 years, until they catch up?

FA: You may not need to wait that long if you are thoughtful about how you assign the tasks. The way to approach this is to ask the medical student to help with things they can handle, such as the introduction, and to ask the resident to help in writing the discussion section. You can review their work and oversee the final touches to the paper. Keep in mind that your team needs to give you ample time to review their work because doing so will require you to take time away from your busy first-year schedule. However, if while reviewing the mentee’s work, you find that they are not able to do justice to the topic, it is okay to hold off on the idea for a year.

MSF: Thank you so much for your time and discussion, Dr. Faiz—it was helpful for me and other first-year fellows.

FA: Thank you so much for having me.

Authorship statement: Dr. Chattaraj summarized the discussion. Dr. Faisal moderated the session and also participated in reviewing the script; he is the corresponding author of this commentary. Dr. Anwer participated as an expert in the session and finalized the script.

Dr. Chattaraj is a second-year internal medicine resident at UPMC McKeesport. Follow her on Twitter @asmi_chattaraj. Disclosure.

Dr. Faisal is a fellow at Roswell Park Cancer Institute. Follow him on Twitter @msalmanfaisal. Disclosure.

Dr. Anwer is an attending physician in Department of Myeloma at the Cleveland Clinic Taussig Cancer Center. Follow him on Twitter @FaizAnwerMD1. Disclosure.