The Impact of Mentoring on Academic Career Success in Surgical Subspecialties: A Systematic Review

Abstract

Introduction: As of 2019, women comprise 52.4% of medical school matriculants, make up more than one-third of the active physician workforce, and nearly half of residents and fellows. Although the number of women physicians continues to increase, many surgical subspecialities, including orthopaedic surgery, have not seen a substantial increase in the percentage of women physicians. This may be due to a lack of mentorship. Efforts within the medical community to decrease the burden of gender bias on women include attempts to increase access to mentorship opportunities. Effective mentoring is a critical aspect of any resident physician's training. The purpose of this study was to analyze the most important aspects of mentorship in the academic advancement of female surgical subspecialists.

Methods: A systematic review of the literature was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in July 2022 using the electronic databases PubMed, EMBASE, Cochrane Database, Scopus, and Web of Science.¹⁰ Search terms can be found in Appendix 1. An initial abstract screen of each article was conducted by 3 authors. Studies were included if they focused on mentorship of women in academic surgery, were published from 2000-2023, were peer-reviewed articles in the English language, and conducted in the United States. Two reviewers screened each article based on the criteria; the remaining studies were then reviewed in full text. After the full text screen, the eligible articles underwent data extraction and quality assessment using AXIS tool or CASP checklist. The results were then analyzed and synthesized. Additionally, risk of bias was assessed using the 2018 version of the Mixed Methods Appraisal Tool (MMAT).

Results: Several common themes among the 10 studies were identified. Six (60%) studies discussed the impact of mentorship on career success. One of the most important ways that mentors assist mentees is by serving as positive role models. Two (20%) studies noted that goal-setting assistance is one of the most helpful ways mentors can provide guidance. Guidance with academic politics (such as funding and research priorities) was identified as a major contribution by mentors in two (20%) studies. The second most common theme was female mentors (6; 60%). Most studies (9; 90%) agree that it's important for women surgeons to have female mentors. The importance of multiple mentors was explored in 4 (40%) papers. Three (30%) studies addressed the issue of balancing work and life responsibilities among female surgeons.

Conclusion: This review suggests that female surgical subspecialists value mentorship in regard to career development, managing work-life balance, and academic productivity. Although many studies found that female physicians were more likely to express the desire for a same-sex mentor, these female subspecialists were also more likely to report not only a lack of mentorship but a lack of available female mentors. Effective mentoring from multiple mentors, preferably some of whom identify as female, may improve career advancement in female surgical subspecialists and promote gender equality in these fields. More research is needed to establish a baseline of knowledge on how mentoring specifically affects quantitative aspects of career development, such as research productivity and promotions, to continue to equilibrate these historically male-dominated subspecialities.

Keywords: Academic advancement; Mentorship; Surgical subspecialties; Women surgeons; gender bias.