PracticeUpdate: Dr. Pal, what has driven you to become a mentor?
Dr. Pal: For me, becoming a mentor is a way of giving back. I've benefited so much over the years from individuals who have catapulted me in my career, giving me opportunities that were easily ones they could have taken themselves and elevated my career as a consequence. I'm trying to do the same for individuals who are around me. I have to tell you, while patient care is incredibly rewarding, mentoring can in many ways be equally rewarding in the sense that you feel you're creating a legacy of individuals who will have the same attention to patients’ needs, the same attention to research, that you've got, and I think mentors have such an essential place. There are many, many caring and compassionate physicians out there in oncology. I'm very grateful for that. I think that, in the mentoring community, the community of truly exceptional mentors is actually very limited. So, being a good mentor, helping craft the careers of others, is something that, I think, is altogether rare and something we need to celebrate.
PracticeUpdate: What are the most important roles of a mentor?
Dr. Pal: A mentor has so many roles. I think that the first obligation of the mentor is to sit down with the mentee and create a 10-year plan. And that 10-year plan, to be fair—and I've learned this the hard way—should not be a reflection of what the mentor wants for the mentee. It should truly be what the mentee wants for himself or herself. I think that there are many situations in which we, as mentors, think, okay, the career that this individual envisions is exactly what I'm doing right now, although it's just not true. I've had psychologists work with me; both plotted out really prominent careers in psycho-oncology. I've had folks who are destined for clinical careers work with me as well. And I've learned over the course of time that there's a certain way to group those individuals.
I think that coming up with that 10-year plan is really essential. Beyond that, it is really the mentor's imperative to create an even distribution of projects among his or her mentees that elevates each to the extent that they need to be elevated. For example, there are individuals who are destined for a clinical career, where it may not be so essential to hand them first off a Lancet Oncology editorial. Those individuals may reasonably be put on projects where they are amassing clinical data and so forth.
If, however, you have somebody who says, "I really want to be the next great kidney cancer researcher," that person is the one who you really have to home in on and give those more specific and high-level projects to. So, the distribution of projects is very critical. And I think that entails sacrifice; you, as the mentor, can't say I'm going to be the first author on everything. Of course, at a certain stage in your career, when you're an assistant professor and, maybe, in the early days as an associate professor, you've got to put yourself first to some extent; but, once you've climbed beyond those rungs, and once you're a full professor like I am, I think the entire focus has to be on taking that seat as last author and pushing other folks forward into that first authorship position and really giving them a chance to shine.
PracticeUpdate: How should medical students select their mentors?
Dr. Pal: The first thing I'd recommend that medical students do when they're seeking out mentors is to jump onto MEDLINE. You've got to get onto PubMed and then just search who you are considering for mentors. Make sure that they have published; if not, chances are you're not going to get an opportunity to publish either. And then the next thing to look at—and, again, this is easy to do—is to see whether or not they have published extensively. Are they leading the studies? Are they in that first-author or last-author slot? Because if they're not, if they are mainly contributors to multi-institutional studies or other efforts—which certainly doesn't detract from their abilities as fantastic investigators—it means that they may not be in a position to offer you first authorships or leaderships on research programs. The third consideration is to find out whether or not they have a track record of taking junior folks—either medical students, residents, whatever your level is—and elevating them into leadership roles on these publications.
If you want to do research, you need to look for a mentor who's had a history of putting others first. If you are considering a mentor who, for instance, has any number of first-author publications but has not promoted junior faculty or fellows or medical students to first authorship or other prominent positions, chances are, you're not going to get that exposure either out of the experience
Then, the last piece of this, which isn't among those three elements that you can search easily on MEDLINE, is the intangible, which is reputation. You may need to do a little bit of digging to find out whether or not folks on the whole have had a positive experience with a particular mentor, or if the relationship has been antagonistic and what I'll describe as the old-school method of mentorship, which involves squeezing every ounce of energy out of the mentee. Are the mentors you’re considering the sort who are going to be shouting at you in their office, making you feel like scum, or are they the sort of mentor who is going to recognize any early mistakes that you make and work with you proactively to address them and remedy them? You really want those mentors who are in that latter bucket. If you can find a mentor who meets all those criteria, that person is gold, and you should stick with him or her until the day you die.
PracticeUpdate: Is it beneficial to have multiple mentors?
Dr. Pal: Having multiple mentors is a fantastic idea. I think that, as I look back at my career, there is certainly benefit to having multiple mentors. There are some mentor–mentee relationships that work great, some that are really going to last a lifetime. Others, despite your best efforts at selecting the right mentor, just are not meant to be. It may be sort of a personal relationship between you and your mentor that just doesn't mesh. It may potentially be the mentor being too aloof or not responsive to your needs. So, pick multiple mentors. I always go by a rule of fives in oncology—and I don't know if this is pertinent to other fields—but I always think that if I apply for five grants, I'm going to get one of them. If I apply for five fellowships, I'm going to get one of them. I think it is also true, that if you pick five mentors, you're going to get one good mentor out of that group or one who really stands out. And, so, I would say picking multiple mentors is absolutely essential as you're plotting your career.
PracticeUpdate: If you have multiple mentors, should they be in the same field or different fields?
Dr. Pal: I think that it is reasonable to have multiple mentors within the same field. Again, if it's a field of interest to you, by my rule of fives, if you pick five mentors, you're going to have one who really works out. There is some benefit in having mentors in other disciplines too. I do find that it is very hard to build a multipronged focus in your career. I'm going to use the analogy of oncology because it's simply what I know. If I picked five mentors in kidney cancer, five mentors in colorectal cancer, and five mentors in head and neck cancer, chances are, I might potentially come away from all of this with a very divergent career focus and be pushed in multiple different directions.
And, ultimately, when people are examining your CV, what they want to see is some consistent theme that you've been working towards. It's fine at the level of a medical student or resident to really have a divergent focus. But, once you are an oncology fellow, for instance, or cardiology fellow, or rheumatology fellow—I assume this advice is consistent across the board—if you are moving into a specific domain, you've got to be confident that the pathway you defined is fairly linear. You don't want to be applying to a program for a position as a kidney cancer doctor and have your CV reflect work that you've done in breast, brain, and colorectal cancer. It's just going to be hard for folks to interpret where your heart sits. So, I think that having mentors in different fields is reasonable, but only up to some point; after that, you've really got to home in and focus.
Now, I will say that it is reasonable to consider having mentors in entirely different domains. For instance, you can have a clinical mentor and perhaps a laboratory-based mentor to guide you in projects in that domain. But, even there, you've got to be very careful that you establish yourself in one trajectory or the other. As you are thinking about a career trajectory, what department chairs don't want to hear is, I'm going to invest 50% of my energy in the clinic and 50% of my energy in the lab and then 50% of my efforts toward clinical research and 50% of my efforts toward laboratory research. There is just not 200% of time available. So, it is really critical that you pick one path and stick with it.
PracticeUpdate: What is some advice you would like to give to people who already are mentors or who want to become mentors?
Dr. Pal: If I had general advice for mentors, it would probably be to think of the folks who are approaching you for mentorship as the future and carefully select them; don't be all-inclusive. I think that you've got to be picky in terms of choosing mentees. You've got to home in on people who are going to be willing to put in the time and effort that it takes to rise in the same way as you've done in your career. And I think that, if you are a generous mentor, if you are somebody who likes to put your mentees first, as you should, you've really got to ensure that they're the right individuals to take on.
How do you tease that out? It's very challenging. What I've started to do, for instance, if I have international mentees who are interested in working with me, I'll often suggest to them that they should come and devote 3 months to work with me before I make a final decision as to whether or not they are right for the program. And that's been really instrumental. I've made mistakes before in terms of bringing on candidates who might not have been the right fit for the program and committed to extended durations of time. Whereas the approach I probably should have taken was getting to know them first, making sure that they were a personality fit within the program, and only then proceeding with their further career development.