NEW GRADUATE SURVIVAL MANUAL
Being the best mentor
WE'RE HERE TO HELP SUPPORT YOU AS A MENTOR
A Practical Guide to the Mentoring Relationship.
By Bree Montana, DVM, VIN Foundation Vets4Vets® Program Leader and the VIN Foundation team
Everyone has a first day at work, and if this is your first mentoring experience you may be feeling similar jitters. Remember you don’t need to be board-certified in anything to be a great mentor. The only requirement is a willingness to communicate.
PERKS OF MENTORING
I waited a bit too long before hiring my first associate. When she came on board, I was overwhelmed by my practice load. One of the unexpected pleasures she brought was a wonderful level of enthusiasm; she was like a breath of fresh air for our practice! Take a moment to dream about some of the cool new qualities, skills, and enthusiasms that you hope your new mentee/associate will bring to your practice.
BASIC GUIDELINES
When you are inviting a new associate into your practice, provide a handout with your basic guidelines such as:
- Hospital rules and routines
- Vaccine protocols
- Infectious disease protocols
- Laws of finance (estimates, deposits, payments).
Working through this list can help you to get to know each other’s practice and communication styles. You may find there are areas needing negotiation, and in all cases working through these questions will help your medical team figure out where you are flexible and where you aren’t.
To help your new mentee settle in also provide helpful information guides like:
- Who to contact for: HR, billing questions
- Other partner businesses in the area: specialty practices, shelters, in home euthanasia, mobile vets, etc.
KNOWING THEIR GOALS
Mentees know themselves better than anyone else, so help them to identify personal goals. What are they hoping to learn? What topics, medical concepts, or skills do they feel are areas of improvement?
Mentees should also have an idea of how they learn best. If your mentee is unsure, encourage them to think about which rotations they felt they learned the most on during clinics. Were there faculty members, interns, or residents that they enjoyed working with, what was it about those individuals that appealed to their learning style?
COMMON SCENARIOS
You don’t have to tell your colleague how to practice medicine, but it’s helpful for them to know how you approach common scenarios. It’s also helpful for your support team to have a feel for the way you both handle frequently seen problems.
For example, if your schedule shows a pet with urinary problems, it might be helpful for your team to have the ultrasound fired up before the appointment, and advising your client to prevent the animal from urinating for a couple of hours prior to the appointment. Some veterinarians prefer to try and perform an ultrasound guided cysto-centesis and in-house urinalysis (and culture if appropriate) with these cases. Now, if your new associate feels the urine needs to be sent out to the lab, that can create an opportunity to chat about the option. The key is discussing these basic presentations in a low-stress environment, before the situation arises. This provides great practice for future discussions during more challenging situations.
These early discussions are most profitable when both parties come to these discussions ready to really discuss topics that are important to them.
Do you feel dental radiographs are important for every mouth, or do you only take them when you’re looking for a tooth root abscess?
Suggested common scenarios could include:
- Pet with urinary problems
- Dental radiographs
COMMON PROTOCOLS
What common protocols might you discuss with your new associate? Take a moment and think through some of the questions you had as a newly-employed veterinarian, and maybe update them for today’s practice setup. Topics such as IV catheters and pain meds for animals undergoing procedures, full-mouth dental rads, and appointment duration are some of the most contentious issues that each veterinarian has to negotiate when starting a new job.
While working through your mental list, remember there are one billion ways to “skin” a cat. Both the boss and the associate need to be ready to negotiate these topics. Remember, each person believes their position is a good one, maybe the best… But realize the person ACROSS the table feels that way as well. It’s the conversation you don’t have that’s going to cause the most distress!
Whether you are an owner, associate, or hospital manager, remember you work full time in your field of expertise — you are the expert at practicing medicine and surgery in your hospital!
CHECKING IN AND PROVIDING FEEDBACK
When it is time to provide feedback, first make sure the mentee is ready and prepared for feedback. Especially if the feedback is the result of an error or mistake. Rather than jumping straight into the deep end and catching your mentee unawares, make sure you are both on the same page and ready to discuss the situation and your feedback.
Make sure you also provide feedback on what you mentee is doing RIGHT. Feedback can have a negative connotation that it only involves discussion on what was done wrong – which is well, wrong! It is equally important to provide back on what is done right, so that keeps getting done! It is almost a guarantee that any new mentee will second guess their every move – make sure to provide them with positive feedback too. That will instill some confidence in them and allow them to focus on the things they really need to.
In the first months of mentorship having a set schedule for feedback can be very beneficial. This allows your mentee to know that feedback is coming and come to that conversation ready to discuss. As time goes on and your relationship with your mentee develops, that feedback schedule may be able to be spaced out or become less structured. This helps to ensure that as the clinic gets busy and the clinic adjusts to having a new doctor in the practice, feedback and growth discussions are still being prioritized. Feedback shouldn’t be only when something goes wrong, but should be intentional time with your mentee.
QUALIFICATIONS
You spend every day working in your area of expertise. You make intuitive leaps that are all but impossible without the experiences you’ve had! Your accumulated knowledge is of incredible value to a new associate. Think of the simple things, the obvious “pearls” and share those insights. Common sense is not common — it is earned and has great value. Anyone who has “been there, done that, and has the T-shirt” can be a mentor. Doctors with years of medicine under their belts aren’t the only folks who make great mentors. Consider having your Golden Tech work with your mentee for the first few weeks or months.
Remember that first week or two of your first job? It’s hard to know which tests can be run during an outpatient visit, and which ones work better with a drop-off. Did you have to ask for three different kinds of ophthalmic examination toys before you lit on the ones the hospital actually had available? There’s a good chance your more experienced techs or veterinary assistants know what’s handy for corneal anesthetic, dilation, staining, examining, and pressure reading. Encouraging your support team to help mentor your new associate will allow your newbie to maximize efficiency.
New grads can be great mentors as well. Think of a new associate as a chance to freshen your treatment protocols and learn new techniques. Hopefully, while you’re guiding them in your classical favorites, they’ll share something new and cool that they picked up. Anyone who has reached out in support of a colleague, answering questions on message boards or in person, has dabbled with mentoring. A formal mentor-mentee relationship is just a more structured version of that support system.
TIME CONSTRAINTS
There are many ways of mentoring — from intensive one-on-one training regimens to more casual remote mentoring relationships. You and your associate can design a relationship that suits both of you. For associates who are newer grads, a few days of shadowing will give a comfortable introduction to your practice’s style of communication.
During the first few days with a new associate, take time to introduce your new colleague to your clients, giving a ten second intro; basically “selling” the new associate’s awesomeness to the client. Then perform the exam, make the recommendations as per usual. Once the pet is in the treatment area, invite the shadowing associate to perform their own exam and make recommendations. It’s a good idea to leave time to chat about each of the cases, sharing ideas for diagnostics and treatments. Your goal during the shadowing period is to get the team comfortable working together. As soon as the new associate feels ready to go solo, you can start booking them appointments. It might be a good idea to try to schedule juvenile exams and easier cases for your new colleague during the first month or so. For scheduling purposes, it can help to schedule longer appointment times to begin with, then decrease them as your new colleague becomes more efficient.
With more experienced DVMs it can still be beneficial to provide longer appointment times initially. It can be helpful to schedule the new doctor with your most experienced technician for the first few weeks. Your tech team knows the clients well, and will help the doctor create estimates that make sense with our hospital’s style of medicine.
Take a moment to consider the kinds of scheduling modifications you are thinking of making during your new associate's first few months.
Some colleagues prefer to start new grads with longer appointments and only do anesthetic procedures on days they are together. From there you can adjust that over time. Some practices use intensive scheduling – 30 minute appointments with 15-min add-ins. This means the first appointment starts at 9am and runs to 9:30 am, the second appointment starts at 9:15 am and runs till 9:45 am. Don’t expect newer grads (even with internship training) to “go there” for quite awhile. This can depend on the culture of your practice, perhaps you prefer to be more information-intensive, educating clients and developing the bond. Every hospital, and every doctor, will develop the practice style best suited to their communication style and comfort level. Clients will settle in with the culture of practice that best suits their needs as well.
New associates need to be comfortable with the kinds of sedation your hospital offers; either you or an experienced support team member may need to provide support during sedated procedures for the first few months. For the first few weeks, it will be helpful to invite the new associate to scrub in with you on surgeries. These experiences offer an opportunity to discuss good surgery habits.
A few examples include:
- Setting up the surgery tray in the same way each time (i.e., sharps to the left, clamps to the right, etc.)
- Maintaining excellent posture
- Breathing – reminding yourself and your team that “when the going gets tough, the tough relax and breathe!”
- Self-focusing and calming techniques
Conversation during surgery lets your new team member relax and chat about comfortable topics while they work through their first surgeries in our facility. The topics also remind all of us — support staff as well as veterinarians– to recognize high-quality performance is a habit which benefits from being practiced.
It's important to acknowledge the elephant living in the surgery suite - - fear.
Explaining how to use self-focusing techniques whenever the blood squirts into the air allows less experienced doctors to accept they will experience some scary things in surgery and medicine, and that they will be able to face those challenges when they arise. When your body is tense, your mind is tense. It’s helpful to keep your body comfortable so you can make good decisions.
What focusing and calming techniques do you use when cases get tricky? One of the best things we can give our new associates is confidence. Sometimes that means the confidence to boldly go forward alone with diagnostics and procedures, and sometimes that means they’ll boldly go forward and call for help!
We’ve all probably had an experience or two where we’d have appreciated an in-person mentor. Work with your new colleague to plan ahead for the procedures where they might need some support. Some are obvious, such as GDVs, bad HBCs, DKAs…the classically tricky or scary stuff. However, it can also be helpful to sit with newer grads many, many times through abdominal ultrasound. Sometimes they don’t see key changes, and since they don’t see it, they miss it. It’s a tricky toy, ultrasound is. Dental rads and surgical flap extractions may seem simple to you, but they also take mental and dexterous finesse. As you observe each others’ strengths and growth opportunities, set out a plan to support each other.
CUSTOMIZE YOUR MENTORING
There are many ways of mentoring — from intensive one-on-one training regimens to more casual remote mentoring relationships. You and your mentee can design a relationship that suits both of you. If they are a newer grad, a few days of shadowing can help them to get used to the practice’s style of communication.
Customize your mentoring program to suit your own comfort level. Don’t let your mentoring become a chore!
Avoiding over-mentoring can be tricky, veterinarians tend to be driven folks who like to succeed and lead, so we are often tempted to “over train.” It can be hard letting the new associate make their own mistakes. Sometimes being a good mentor means allowing your associate to work their way through a case on their own.
Remember your goal is to push your new associate to work through problems on their own. Often, the problems that might occur with their cases haven’t even dawned on them yet. So tell them your stories about those tricky cases and clients, but don’t diagnose their cases for them.
How will you know when it’s the right time to step back?
What clues will you look for?
Hanging around “doing paperwork” on days when your support may be needed. And as you see your associate handling those tricky cases nicely, you can ease yourself out of the picture.
Let’s start in the surgery suite… you might be scrubbing in on those OVHs and splitting them until you see good tissue handling, good hemostasis, then you can just be “around” for a few. Then, maybe ask if my new associate is comfy and step out. If you prefer more control — you might rather lose some play time the first year than lose a patient. How will you know it’s okay to be off-site when your new associate is doing surgery? Focus on surgery because many practice owners are very possessive of the surgery suite — and this isn’t good for our business. We need to develop the ability to coach from the sidelines, then let them roll on their own once they have the skills.
REMOTE MENTORING
Remote mentoring may be an option for more experienced veterinarians. When they find themselves with a confusing case or difficult client, they can email you and together you can chat through options. You can decide how available you want to be, in person or via text message whenever they’re at work for about the first year. If they have a critical case, perhaps you come in from wherever you are and assist.
As the associates become more confident, you can swing by to review rads with them, or just be available for a quick question. Then, you can wean yourself away and be available by email or cell phone for questions.
It might be at least a few months before leaving a new associate completely alone. Everyone is unique, so you’ll need to feel your way with this one. Practice owners all want our clients and patients to be in great hands, but we experience that “tension of the opposites” as we’d also like a week in Bimini.
Scheduling time once a week to work side-by-side with your team members facilitates good communication. You might want to initially schedule all of your associates’ procedure days when you’re on-site running outpatient appointments. This way you’re readily available for unexpected crises and moral support.
THE MENTORSHIP TEAM
Mentor relationships aren’t and shouldn’t be restricted to one person. However, having a primary mentor is a good way to introduce a new grad to the team and help them get settled in. Then be open to growing that mentorship team as the new doctor develops additional relationships at the clinic and begins to identify additional goals.
Your team likely has individuals with many different skills. Encourage your mentee to learn from those team members as well. You may have a technician that has a sixth sense during anesthesia monitoring. Or an associate that loves working up endocrine cases, something you’d rather run from.
Many new grads also benefit from having a mentor about topics outside of medicine! This could be client communications, managing work and personal life expectations, or as a new leader working with support staff. Be sure to include this as part of your mentoring plan.
But wait, there’s more!! The VIN Virtual Veterinary Internship program is available for those who would love to take a deeper dive into learning while also practicing out in the real world. Learn more here!