Ep. 21 - Mentorship with Dr. Margaret Rush

In this episode, MDK sits down with Dr. Margaret Rush to unpack one of the most talked-about - but perhaps most nebulous - parts of training: mentorship. From finding your first mentor to building a mentorship “team,” Dr. Rush shares practical strategies, common pitfalls, and how these relationships evolve from residency into fellowship and beyond. Whether you’re an intern just getting started or a senior looking to be more intentional, this episode offers actionable insights you can use right away.

Audio editor: Kaylee Morris

Transcript

SPEAKER_00 0:02

Hi, I'm Kyla.

SPEAKER_01 0:04

And I'm Mary. And you're listening to the long call.

SPEAKER_00 0:08

This podcast delves into the complexities, lessons, and triumphs of residency. Through candid conversations, we want to explore how meaning and connection can emerge from the challenges, chaos, and unexpected moments along the way. It's about discovering the purpose and sometimes even magic woven into the everyday work of being a physician.

SPEAKER_01 0:26

The views, thoughts, and opinions expressed in this podcast are solely our own and do not reflect the policies or positions of any institution, organization, or employer. This podcast is for informational and reflective purposes only, and is not affiliated with, endorsed by, or representative of any official entity. And while we are both doctors, we are not your doctors, and we are not providing any medical advice on this podcast.

SPEAKER_00 0:50

We're excited to unpack the mess, meaning, and magic of residency with you.

SPEAKER_01 0:55

Stay tuned for more. Hello, thanks for joining everyone for another episode of The Long Haul. I'm so pleased today I have an impromptu interview guest for you. Um, so I am with Dr. Margaret Rush. Marge, you want to introduce yourself?

SPEAKER_02 1:11

Yeah, thanks, Mary. My name is Maggie or Marge. I am a current third-year fellow in reproductive endocrinology and infertility. But I was once a mere intern when I asked Mary to please be my mentor. And so I am really honored to be your guest on your podcast. Thanks for having me.

SPEAKER_01 1:29

Thanks so much for joining us. And what a what a great topic to discuss with you then as we think about mentorship and you know, some ways that residents might think about mentorship, as well as those of us who mentor residents, what we can do to make it a fulfilling relationship. So I think most residents are told at some point during residency that they should find a mentor, but it might be more variable if they're actually given good advice as to how to go about that. So I wanted to start just by asking: do you remember back when you were a resident, or maybe even before that in your medical career or in life in general when you realized mentorship was valuable and that you might want to seek out mentors?

SPEAKER_02 2:10

You are right in that I was certainly encouraged as an intern that I was required to find a mentor. So that is how I landed in your very capable hands. But even before residency and really even before medicine, I always had mentors. I was an athlete in high school and in college, and really my first mentors were coaches. And um, I think that that relationship has informed a lot of the way that I think about mentorship now in my professional life.

SPEAKER_01 2:39

And then when you got to residency, I heard you saying, and it's still a facet of our program that we require our interns to find a mentor. Did you feel like that was kind of imposed on you then from the outside, or did it develop organically? What was the experience like for you?

SPEAKER_02 2:57

I think a little bit of both. I think, I mean, yes, it was a role. I had to find somebody. Yeah. But I think our relationship, or supposed to make it one-sided, the reason why I sought you out specifically was because I wanted mentorship on certain issues, and I felt like you in the role that you were in at that time were really the perfect person, and so yeah, a little bit of both.

SPEAKER_01 3:22

Yeah. Do you want to describe the role I was in at that time and why uh attracted you to me as a potential mentor?

SPEAKER_02 3:28

When I was an intern, you were a first-year attending. Yeah. And I didn't know quite what I wanted to do, but I knew I wanted to do something surgical, and I saw you as this young attending. You were also very surgical, and I saw you were sort of carving out this space for yourself, and I was really inspired to see a young person, specifically a young woman and a young mother, occupying the space, and I thought that you could be the right person as I looked for what I wanted in a career.

SPEAKER_01 4:00

Yeah, absolutely. That's lovely to hear from your eyes, Marge, because first year as an attending is no joke. So to hear that that was actually inspiring to someone really means a lot. What do you think made you feel comfortable approaching me? Or as you think back to, I think later we'll talk about, you know, a team of mentors, you know, when you think about approaching mentors, asking for their guidance, what makes someone an approachable mentor and you feel willing to take the plunge to ask them to be your mentor?

SPEAKER_02 4:27

So, really good question because I have really significant imposter syndrome.

SPEAKER_01 4:34

As to many of us.

SPEAKER_02 4:35

Yes. So it makes it really scary. Yeah. Because almost by default, a mentor is somebody who, in this hierarchy of medicine, is several layers above you. But I think what helped me was have a really specific, clear question for your mentor or understand what that mentor will be mentoring you about. Sure. And for me, that made it more approachable because I wasn't going to XYZ person, you know, asking a favor, but rather I had a specific ask and a specific plan. And that made it easier for me to then approach that person.

SPEAKER_01 5:12

Yeah, I think that makes perfect sense. And I think I would just add from the role of mentor that maybe to make it a little less intimidating or scary, that most of us in medicine love mentorship, right? It's one of the most fulfilling parts of our career. So you're almost always going to get a resounding yes, at least has been my experience in seeking mentorship. I don't know if that rings true for you as well. Was there any moment during residency, either with me or another of your mentors, where you felt like having a mentor really meant a lot or changed kind of the course of your trajectory in medicine?

SPEAKER_02 5:49

I feel like, yes, this is a very loaded question. It's okay if the answer is no. No. You're making direct eye contact with you. I mean, I don't know if you remember this, Mary, but about, well, more than halfway, like three quarters of the way through my residency, I changed trajectories of my own career because I thought I was going to do one fellowship and I decided to apply to a very different, a very different fellowship. And I was in my PGY3 year, and this was a heightened emotional time. Yeah. And part of the stress of the situation was the stress of approaching people to say, I have this really scary idea that I don't want to do this thing I thought I wanted to do for a really long time. I actually want to try to do this other thing. You were one of the first people I told. And I remember this very distinctly. We were at dinner, and I was like, oh, what do you think, Mary? Maybe what if? And you were so instantly supportive, and that made it 10 times easier to go in this direction because it's almost like the first time you tell somebody something, if they're supportive of it, it makes you believe in it that much more. Um, and so yeah, I could not have had the confidence in my decision without your excellent mentorship.

SPEAKER_01 7:03

Well, I do remember that moment very well, and I I I mean it was a big deal, like you know, not to not to build it up, but it it was you had thought you were going to do one thing for a long time and then you were you were changing roots, but it both like made sense to me and kind of regardless, right? That the role of a mentor I think is to be that supportive person, right? And ask the curious questions and you know, help to guide you, but not to be, you know, judging you or trying to change your mind. So, and how do you think that decision turned out now, reflecting back?

SPEAKER_02 7:38

I think it was the right decision.

SPEAKER_01 7:40

Absolutely, I would agree with that. So, while I have really enjoyed our our mentoring relationship, and we actually just finished a mentoring dinner, which it's been lovely to maintain this over the years. I'm obviously not your only mentor, and there are a lot of ways I couldn't be your mentor in the work that you're doing now and that you hope to accomplish in the future. So, when did you start to realize that you know one mentor couldn't fulfill all of your needs? And how did you kind of approach that?

SPEAKER_02 8:08

I think that it was early on in residency as well, because I knew I wanted to go into a fellowship. Really wasn't sure what, but I knew that in order to strengthen my application I would need research, and so in that vein I sought out a research mentor, and it was only natural that that wasn't the same as my sort of go-to life mentor, that they they wore different hats and they had different skills. In residency, I also found a surgical mentor, and for me it was important that that was yet another third party because they could be more objective than somebody that I had developed more of a personal relationship with. And then certainly when I changed trajectories and decided to go into a different fellowship than I was initially planning, I had to quickly acquire new mentors who could give me more specific advice into applying applying into REI. And so it came up very organically. I knew that I needed help and mentorship with a new task, a new thing that I needed to learn. And so I sought out mentorship in that in those specific areas.

SPEAKER_01 9:16

Yeah, absolutely. That makes perfect sense to me. So I heard you say you had kind of a life mentor, research mentor, surgical mentorslash coach, and you had to pivot to kind of like fellowship application, mentorship. Are there any other kind of like hats or roles of mentors that you would recommend residency gout now looking back?

SPEAKER_02 9:37

I think the other mentorship roles that maybe you could argue aren't mentors per se, but I have really enjoyed having a champion as well. Um, somebody in your back pocket who isn't necessarily helping you work through complex ideas or giving you day-to-day advice or even learning plans or goals, but rather as somebody who can sort of speak positively about you when you're not in the room.

SPEAKER_01 10:06

Yeah.

SPEAKER_02 10:06

Um, that has been really helpful for me.

SPEAKER_01 10:08

I think that's really important. I've heard those folks called sponsors as well. Um, and I think, yeah, it's important that we we collect those folks as well. And they might not, like you said, be as in tune with the nitty-gritty details of our life or helping us solve our problems, but they're there to kind of speak for us, and having those folks um in your corner can be really meaningful. So we've talked a little bit, a little bit about what types of mentors you might want, but let's flip it a little bit to think about being a mentee because mentorship is a two-way relationship. So, what do you think a great mentee looks like from your perspective now?

SPEAKER_02 10:45

I think a great mentee, I mean, I've spoken a little bit about I have different mentors for different reasons, and and there's a little bit of a specificity in developing that ro developing that relationship. But I think the same is true for being a mentee, which is you need to go into the relationship understanding the role that you will play, the benefit that you are giving that person, but also what you are asking that person for. And so I do think that there's an intentionality to being a mentee that's really important.

SPEAKER_01 11:18

Yeah, so I guess on the flip side of that, have you seen any like common mistakes that you saw your co-residents make or that you maybe have seen, you know, since becoming a fellow as you know, residents go to you as a mentor, some common pitfalls that residents could avoid.

SPEAKER_02 11:34

Yeah, I think it does come back to that intentionality. You you do have to identify a mentor for whatever reason, even if it is a personal life sort of mentor, there is sort of a specific ask or specific goal that you should have in mind, and then taking it a step further, there should be sort of progression. And so you might ask a mentee for specific advice about XYZ, you make a plan to see them again, and then you have worked on XYZ, and maybe there's a new ask for something totally different. But when I see these relationships fall apart, or even when I've had them fall apart in my own life, it is because we are we don't really define the relationship.

SPEAKER_01 12:17

Sure.

SPEAKER_02 12:17

We don't DTR and we don't make a plan. We don't make a plan to see each other again, and then it becomes this really difficult, like amorphous kind of conversation that really isn't benefiting anybody.

SPEAKER_01 12:30

Yeah. Speaking to that a little bit more than what do you think a mentee should do to prepare for a meeting, whether it's like a formal research meeting or even, hey, we're gonna, you know, grab dinner together.

SPEAKER_02 12:42

Yeah. I always try to do this with you when I email you, it's been a while, we need a mentorship dinner, I have questions about this, this, and this. And I try to go into it almost like you're getting ready for a blind date and you have your conversation cards. Like you do, you need your talking points, and you have to have some idea of this is what I want to get out of this conversation. Yeah. Or I want to leave knowing more about XYZ.

SPEAKER_01 13:05

Yeah, absolutely. That makes sense. And I I still do the same thing for what it's worth. How do you follow up or maintain relationships over time? I think you know, it's it's really special to me that you asked me to continue to be your mentor even when, you know, general OBGYN wasn't necessarily applicable to you anymore. So, how how do you approach that? And what do you think is maybe some of our success, or what makes long-term mentoring relationships sustainable?

SPEAKER_02 13:33

I think that understanding or knowing or accepting that mentorship relationships can change over time. Yeah. So initially, I wanted mentorship on, you know, being a surgeon with the with the idea of maybe a generalist OBGYN position and being a surgeon within that. But that's not necessarily where my trajectory took me. And over time, I think we have sort of pivoted to more being a woman in medicine, being a young leader in medicine, being a mom in medicine, having those common themes that carry you into the future. And then again, not to put too fine a point in it or be redundant, but there is that intentionality. Like I remember when I started fellowship being nervous that maybe you didn't want to be my mentor anymore.

SPEAKER_01 14:18

I was gonna kick you to the curb because you were over it.

SPEAKER_02 14:22

I was a fellow now, and maybe you were done. But I I I remember emailing you a very formal email, Mary, will you please still be my mentor for these specific reasons? And um, and I think that that has really helped.

SPEAKER_01 14:36

Yeah, I totally agree. I think um, you know, thinking into fellowship then, how did mentoring relationships change like beyond ours? But thinking about, you know, your mentors within the specialty, your outside of the specialty, what was different, you know, moving from being a resident to being a fellow.

SPEAKER_02 14:55

Yeah. It it is that shift of the the levels of hierarchy between you get fewer and fewer.

SPEAKER_01 15:03

Yeah.

SPEAKER_02 15:03

And so the relationship slowly shifts from being much more hierarchical to almost fulfilling the role of a peer mentor, which is good for other reasons, and then you identify new mentors who who are levels above you for when that matters. But I also think the closer that you get to being an attending, the more that you need peer mentors and the less that you need people who are, you know, several layers above you.

SPEAKER_01 15:28

Yeah, I can definitely speak to that. I think most of my most meaningful mentoring relationships, the one that I rely on day to day, are definitely like near peer mentors at this point. Thinking a little bit more about peer mentorships, though, did you have any of those during residency? Do you think there's a role for peer or near peer mentorship for residents?

SPEAKER_02 15:48

Yes, absolutely. I had mentors, largely I would say unofficial mentors. Sure. I think every person who has ever been an intern can picture their chief residence in their mind's eye and still probably do many things the way that they do it because their chief resident taught that, taught some to do that way. Um and that is still true for me, but I think that those were my first mentors in residency. And then I also consider many of my direct co-residents who were in my class to be my my peer mentors, and I still keep in touch with them. And like other relationships, the um the things that I get out of those mentoring components of our relationships have changed over time. Of course. Um, but there still is that peer mentorship component.

SPEAKER_01 16:32

Do you think there's uh I heard you say they're mostly informal in residency, which I think makes sense to some extent, but do you think there are any ways residents can be more intentional about supporting each other in these types of relationships?

SPEAKER_02 16:45

Yeah, I do. It becomes the most clear in a situation where one of your co-residents, or maybe a resident who is with you who's several years above you, is doing something that you see yourself doing, applying into a fellowship that you're interested in, or going after a job that you would be interested in. But I think that the cool thing about peer mentorship and residency is that as you get older in residency and then as as you graduate, that really becomes your network.

SPEAKER_01 17:13

Yeah.

SPEAKER_02 17:14

And so it's such a nice transition because then those are the people who you see at conferences, or those are the people that you're collaborating with for papers or whatever it may be. And so I think that's where some of the fun can really happen too.

SPEAKER_01 17:29

Absolutely. I just saw one of my um long-lost co-residents at our educational conference a couple of months ago, and it was it was so fun to see him and reconnect, and you know, and just also yeah, like re-establish that relationship that I hadn't thought about in many years. So, thinking about some kind of practical points maybe for our listeners, if you had to give an intern kind of a step-by-step approach to finding a mentor, what would you say?

SPEAKER_02 17:58

I think it starts with some introspection. What do you need at this current time?

SPEAKER_01 18:06

Yeah.

SPEAKER_02 18:06

And that can look like uh different things. Maybe you are somebody who really knows what your future career will look like, then it makes sense to identify a mentor in that future role. Maybe you are somebody who doesn't quite know what that will look like, but you know, for example, for me, surgery is going to be a part of it. Sure. Or maybe you are somebody that doesn't know but would rather have mentorship on how to balance the stresses of residency and family life. Or so I think it really starts with um some introspection of what you need and what you want in a mentor at that time. And then you can sort of look outwards and say, who do you feel comfortable approaching, or who does it make most sense to connect with? Um, but but yeah.

SPEAKER_01 18:52

Yeah, I love that you said introspection just about what you need right now, because a mentor doesn't need to be like your one-time all-life mentor, you know, for the for the rest of your life, right? So I love that um emphasis on what would benefit you right now and who is the person in your life who can fulfill that. And you're gonna continue to build up these relationships over time. Do you have any advice about how you can ask someone to be your mentor without it being too like awkward or uncomfortable?

SPEAKER_02 19:24

Well, I do fear that if I look back at myself as an intern, awkward and uncomfortable were my middle names.

SPEAKER_01 19:33

I don't remember that actually.

SPEAKER_02 19:35

I think that along the same vein of being intentional and introspective about entering into these relationships, I think you can't go wrong with a semi-formal email and saying, whoever, dear whoever, um, I have admired you for XYZ reasons, I would love to pursue a mentorship relationship, these are the things that I would like help on. Is this something that you have interest and availability to pursue? That's a great question at the end. Yeah.

SPEAKER_01 20:11

Yeah, someone could be very interested, but if they can't actually commit the time, they're probably not going to be a great mentor.

SPEAKER_02 20:18

Yeah.

SPEAKER_01 20:18

Yeah. And these days you could even draft it and ask Chat GBT to make it, you know, sound better or make it more likely that they will say yes. I don't think that was an option when you asked me, right? No, yeah, that's a new thing. But I would encourage you to go back and forth with it and see what it what it gets you. What about when you know you maybe have had this mentoring relationship and maybe it was great or maybe it just isn't going well, but for one reason or another, like the time of this mentorship relationship has closed. How do you approach, you know, that conversation or that situation?

SPEAKER_02 20:53

Oftentimes these relationships take their course organically.

SPEAKER_01 20:57

Yeah.

SPEAKER_02 20:58

And oftentimes, there, in my opinion, there doesn't need to be a formal end to the mentor relationship. But I think along the lines of having a formal start, if the situation calls for it, I think a warm thank you can oftentimes be enough. And you know, obviously for professionalism reasons, you never want to burn a bridge or you never really want to close an avenue. And so I think saying um as professionally as possible, thank you next can often be what it takes.

SPEAKER_01 21:34

Absolutely. And I like um your insights that, right, you don't want to build a bridge, you want to keep things professional. I found for myself in some of these relationships, like you said, they just kind of peter out organically, and it's not that you know you had I had to say anything, right? It was more just that like things that we each needed had come to a close. And it's actually nice to maintain those at least friendships. To some extent, because then there could be a situation in the future where their mentorship could be meaningful to you again. So keeping the connection open, even if it's not, you know, the routine meetings that you were used to before. Alright, do you have one piece of mentorship advice that you wish someone had told you as an intern, Marge?

SPEAKER_02 22:21

What I wish I was told, or I was probably told this, but what I wish I could have fully embodied. Fair enough. If you're picking, if you're reading between the lines, I was not a very confident person during my intern year. But I I wish somebody would have told me that mentors benefit as alm as much or almost as much as mentees. And as Mary said, most people, if not all people, especially within an academic practice, enjoy mentorship. And to some extent, in whatever the practice model is, maybe even are required to act as mentors or that benefits them professionally. And so if there is somebody that you want on your team or you want to identify as a mentor, even if they are the CEO of the hospital, I think that you should have the confidence to reach out. And the worst you can be told is no, but probably you will be told yes.

SPEAKER_01 23:21

Yeah, I think that's a that's a really good point. Alright, just to recap some of the important points we talked about then, uh, I think uh you emphasize the point that you're not trying to find one perfect mentor, rather kind of building a team of mentors for what you need in the season. Mentorship can be formal, but it can also be informal, and you benefit from all of those relationships in different ways. And then the last point I really like that you made a few times, Marge, is the importance of this intentionality and being specific to the mentor about what you're looking for and what you're hoping to gain from the relationship. Would you agree with this?

SPEAKER_02 23:58

I agree.

SPEAKER_01 23:58

Alright, we're gonna do a speed round. Okay, you ready?

SPEAKER_02 24:01

I'm ready.

SPEAKER_01 24:02

Whatever comes to mind. What is the best trait a mentor can have?

SPEAKER_02 24:07

Availability. That's a good one.

SPEAKER_01 24:09

What is the biggest mistake a mentee can make?

SPEAKER_02 24:13

Not having a clear goal in mind with the mentorship relationship.

SPEAKER_01 24:20

Love it. And then what is the most underrated source of mentorship in residents' lives?

SPEAKER_02 24:29

Probably people outside of medicine.

SPEAKER_01 24:31

Oh, that's a good one. I was gonna say program directors, but I'm biased.

SPEAKER_02 24:35

Oh, that's a good one too. The opposite of that.

SPEAKER_01 24:40

Awesome. Well, this has been so great, Marge. I loved um, you know, hearing your insights, and obviously I got to see a lot of your um growth over the years, but it's been been great to hear this perspective. So we always close each episode with a magical moment, which is something that we've experienced in the past week that has brought us, you know, joy, especially in the role of academic medicine or residency. Do you want to go first or do you want me to go?

SPEAKER_02 25:08

Um, I can go first. Go right ahead. My magical moment of the last week has been me and a resident have been working on a manuscript for too long at this point, but it is finally ready to submit, and that feels pretty magical.

SPEAKER_01 25:26

That's amazing, and what a good example of you now acting as the mentor. That's awesome, Marge. Um, mine was actually related to the ACGME survey, which hopefully many of our listeners have completed in the past few months. Um, but I actually um went away for a little family trip for my children's spring break last week, and I was, you know, furiously trying to get everyone to, you know, complete their surveys while I was gone, so that hopefully I wouldn't have to stress about it in the few days after my return before it was due. And I logged in earlier this week and saw that 100% of our residents had completed the survey, which must be a record of some sort, I'm sure. So I was just so happy and thankful and really speaks to the you know the the um amazing dedication of our residents to continue to engage and improve our program.

SPEAKER_02 26:20

That is awesome.

SPEAKER_01 26:21

Great. Well, thank you so much, Marge. This has been so fun. Thanks for having me.

SPEAKER_00 26:26

Thanks for listening.

SPEAKER_01 26:27

If you have comments, questions, or ideas for a future episode, please reach out to us via email at longcallpodcast at gmail.com.

SPEAKER_00 26:36

Catch you on call next time.