The Hidden Curriculum: Mentorship and Mindfulness in Medicine

— We wouldn't be where we are today without our mentors

A photo of young male and female physicians shaking hands.
Bhaskar and Kimata are medical students.

"Ars longa, vita brevis [art is long, life is short]" -- Hippocrates

The medical profession extends beyond simply a career. Rather, physicians are expected to be holistic providers who sit at the nexus of mentor, friend, confidant, and advisor to their future patients. To achieve this level of proficiency and care, medical students are challenged with mastering rigorous courses that encompass both the biological processes that underlie disease and the humanistic, often intangible art of becoming a healer. Critically important in this process is discovering the "hidden curriculum" of medical training -- wisdom and values shared by mentors who guide our clinical trajectories with years of learned experience caring for people in a complex healthcare system.

Along our journey to become holistic and empathetic clinicians, we have begun to appreciate the significance of supportive mentorship in informing our academic and interpersonal development. In short, we stand on the shoulders of those who come before us. Learning procedural skills, examination and diagnosis abilities, and knowledge of pathophysiology from mentors is essential to clinical competency. However, because medicine is a rapidly evolving field, it is equally as important to have mentors who motivate lifelong learning. Developing this ability to engage in self-initiated intellectual exploration supports the advancement of clinical and scientific knowledge throughout one's career. As physicians in training, we have been fortunate to have mentors who have shown us the realities, both good and challenging, of practicing medicine in a rapidly evolving political, financial, and intellectual climate. From these experiences, we highlight three key facets of mentorship that are instrumental to growth as a medical trainee.

Humanistic and Holistic Care Comes From the Person, Not the Doctor

While medicine is an incredibly rewarding profession, the long hours spent in the hospital, doing research, or studying can lead trainees to feel isolated from their support systems. Many students do not have family or mentors in healthcare before starting medical training. Thus, the mentors we choose become invaluable sources of support and role models who shape our perspectives on creating work-life balance and building emotional resilience.

Physicians spend a considerable amount of time working, but it is not all-encompassing; true happiness stems from work you love and being surrounded by people -- friends, family, mentors, and colleagues -- with whom you can find enjoyment, encouragement, and peace. While medicine can sometimes feel like never-ending training and work, our mentors teach us to embrace our hobbies and routines to ensure we remain committed to our own well-being and can show up for our patients each day.

Providing psychological support to trainees is also essential to producing a cohort of physicians who are capable of caring for their patients. Medical training is long and often exacting, physically and emotionally. Experiencing burnout, particularly compassion fatigue, is a "when," not an "if." Having mentors who are willing to share advice on navigating the complicated experience of caring for critically ill or medically complex patients is invaluable, and aids trainees in developing a repertoire of strategies to cope with the emotionally exacting situations that characterize the practice of medicine.

Financial and Administrative Support

Medical care is not about money, but trainees need financial and administrative support to succeed. One of the most important ways that mentors assist students is by providing them with access to resources and experiences that will promote their career development. This includes mentoring students through grant writing, supporting their applications for scholarships and fellowships, or providing departmental travel funding when available. Navigating the administrative components of medicine, including the nuances of the EMR and how new technology integrates into clinical practice, is also a valuable component of mentorship.

Representative Mentorship

Clinicians who belong to underrepresented populations in medicine provide perspectives to mentees on how to navigate the unique challenges of being a minority in their specialty. Having a mentor who "looks like you" or who encompasses identities outside of the "stereotypical" view of a physician or scientist is encouraging for students who come from diverse academic, socioeconomic, and cultural backgrounds and can reaffirm that diverse perspectives belong and deserve to thrive in medicine.

Learning both the pathophysiology of diseases and the humanistic facets of medicine is integral to becoming a healer, and having mentors who support these parallel goals is instrumental to building a successful, sustainable career. We look to them as models of who we could become, and in turn, they provide space and support, allowing us to mature into holistic physicians and become future drivers of medicine.

A key takeaway that our mentors instilled was the importance of making time to think. This lesson is easy to overlook when days are filled with rounds, patient appointments, and administrative duties. However, it is critical to cultivate the intellectual freedom and development of trainees. During this time we reflect on how to improve from our mistakes, reconcile new experiences, and generate ideas that allow us to contribute unique perspectives to the field. As our medical journeys progress, this lesson is also a reminder to appreciate the gift of opportunity that patients share with us in their most vulnerable state -- the opportunity to learn, care, and continue to push for a deeper understanding of the human condition.

Nidhi Bhaskar and Anna Kimata are both second-year medical students at the Warren Alpert Medical School of Brown University in Providence, Rhode Island.

Acknowledgments: The authors would like to thank Wael F. Asaad, MD, PhD, Athar N. Malik, MD, PhD, Linda M. Liau, MD, PhD, MBA, Edward Feller, MD, James Rudolph, MD, Richard Besdine, MD, Jacob Vandenberg, PhD, Judy Jang, MD, Julianne Ip, MD, and the many other mentors who have shaped the trajectory of our clinical and scientific journeys. We would not be who or where we are today without your guidance and support.