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Ferrari et al. Art Int Surg 2022;2:177-85 https://dx.doi.org/10.20517/ais.2022.16 Page 179

[19]
goals .

[13]
Mentorship during surgical training includes technical and non-technical skills . Non-technical skills
embrace patient assessment, decision making, the ability to organize daily activities and the understanding
of how to prioritize them. Furthermore, mentors should have an active role in providing mentees access to
their own networks. Technical skills are a robust component of training in surgical disciplines, and mentors
who spend additional time teaching surgical procedures function as skill masters. In most surgical training
programs, skill master mentors-mentees relationships have a limited time duration, secondary to surgical
rotations of trainees.

One of the most important transitions in surgery is from training to the first few years of clinical practice.
This period, in the absence of formal and structured support, brings considerable pressure to young
[8]
attendings . To overcome this delicate period, support from senior colleagues in the same department is
pivotal, as well as support from organizations and specialized societies. Early years practice is not only
characterized by the establishment of a new role within a department, but also by the acquisition of skills
that are usually not taught during training. Young practitioners should master how to deal with complaints,
litigations and possible complications, as well as learn how to assume a leadership role within their work
team .
[7]

Mid-career surgeons have established themselves as expert practitioners; the main problem they face is how
to continue to self-improve and learn new skills, in order to offer the best opportunities to their patients and
[7]
colleagues . Self-improvement in this phase includes both the adoption and mastering of new technical
skills and the perfection of patient management; acquiring these skills might be difficult, particularly in the
setting of a busy practice in peripheral institutions . Finally, mid-career might be accompanied by the
[7]
assumption of leadership and academic positions, for which additional training and mentorship are
required . Leadership in surgery entails professionalism, technical competence, motivation, innovation,
[20]
teamwork, communication skills and decision-making. Leadership skills are usually not acquired by formal
or mandatory courses, but developed through experience and observation, using a framework including
[20]
mentoring, coaching and networking .
MENTORSHIP FOR WOMEN AND UNDERREPRESENTED MINORITIES IN SURGERY
Women and underrepresented minority populations in surgery are less likely to have mentors, mainly due
to the paucity of people belonging to underrepresented minorities who are organized to serve as
mentors [21-23] . However, this group of surgeons might benefit the most from having same-gender and same-
ethnicity mentors to gain a sense of inclusion and advance their careers. Therefore, the lack of mentorship
might be a major problem limiting the diversity of healthcare workforce .
[23]
[24]
In a recent study , Mahendran interviewed 35 women in surgery, including 14 faculties, 11 residents, and
10 fourth-year medical students. Twenty (57%) participants self-identified as White, 7 (20%) as Asian, 6
(17.1%) as Black, and 2 (5.7%) as Other. The aim of this research was to determine access to mentorship for
women in surgery of different career levels and racial backgrounds. The results showed that access to
mentorship is easier for medical students and residents rotations, while it becomes difficult to achieve for
female faculty, who lack formal mentorship networks. Furthermore, the lack of formal mentorship
programs penalizes women in surgery. The informal nature of seeking individual peer mentorship leaves
female faculty isolated and disadvantaged compared with their male colleagues, who have many senior male
colleagues with whom they can conduct activities outside of the hospital.