UK Shape of Training steering group: report annexes

Annex 8: Notes from the UK Academy of Medical Royal Colleges consensus meeting on mentoring

Academy of Medical Royal Colleges

Notes from Shape of Training Mentoring Seminar
9 February 2016

1. Welcome from Professor Jane Dacre, Academy Education Lead

Professor Dacre welcomed members to the meeting which the Academy was hosting on behalf of the UK Shape of Training Steering Group. She noted that the Junior Doctors' dispute had identified issues regarding junior doctors feeling undervalued and not supported and the Shape of Training Review had identified the same theme. What we are doing to support doctors currently is not enough.

2. Context from UK Shape of Training Steering Group and Academy mapping exercise

This proposal has arisen from discussion at both the Shape of Training workshops and during the Academy Mapping Exercise. It was felt that in principle the incorporation of a period of formalised mentoring would appear to have much to commend. It provides support to new consultants at a vulnerable time in their careers and safeguards patients while clinicians gain experience in the workplace. It would also fulfil one of the key recommendations proposed by the Shape of Training that there is a requirement for more apprentice experience in training pathways.

3. Examples of current models of mentoring schemes

Brief presentations were given of three current models to inform discussions.

• RCP London model
  This is a new scheme offering a "near peer" match. Mentees are F1s to pre consultants. Mentors are ST3 and up. Mentors must be trained and there is online training for mentees. Mentees choose their own mentors. So far the RCPL has not found a way of badging the standards of mentoring training, however the European Mentoring and Coaching Council was suggested as one possible means of doing this. This scheme is working towards excellence not supporting remediation.
• Academy of Medical Sciences Model
  It is a light touch scheme. Mentees can select a Fellow - all Fellows are potential mentors. There is some training available. It is not near peer. They recommend choosing a mentor outside their own institution. Mentoring meetings should take place 3-4 times a year and the relationships tend to last 2-3 years. They can have a no blame "divorce "if it doesn't work out. This scheme is working towards excellence not supporting remediation.
• GPs in Midlands/ RCGP
  Mentors trained and meet 5/6 times a year. Those referred can be "good doctors in a bad place" e.g. health/personal issues and the mentors help them find a way to succeed and continue in the workplace.

4. Discussion

Set out below are key points from the general discussion:-

Overarching issues

• The definitions and language need to be clarified. What do we actually mean by mentoring? How does it relate to coaching, supervision, buddying etc.?
• In essence are we talking about
  • Support and guidance sought by a mentee on a voluntary basis on their personal development and career progression or
  • Professional support linked to the workplace and properly resourced to support development of skills and expertise particularly at points of career transition?
• Whether mentoring should be seen as entirely voluntary or a mandatory employer requirement at employer level depends on what is meant by mentoring on what was meant.
• There was broad consensus that the personal development support had to be voluntary whilst workplace transition support should be a requirement for employers and individuals
• There was a clear view that mentoring was not the same as clinical supervision which might be required irrespective of mentoring.
• Mentoring is not a performance management tool
• Employers need to buy in to mentoring - although employers say that mentoring on appointment this may be somewhat ad hoc in many cases.
• Whilst there was support for mentoring a query was raised over the evidence for mentoring being effective/cost effective.

Issues of detail

• Is there support for developing a formal process for mentoring after appointment to a consultant post?
• A selection and matching process is needed
• There needs to be the option of a "no fault divorce"
• Engagement is key and ensures motivation.
• Cross specialty mentoring should be one option.
• Developing coaching/mentoring skills in trainees will have benefits down the road

5. Points raised which require further clarification

It was recognised that if proposals for mentoring were to be taken forward the following issues would need to be addressed:

• What is the purpose and objective of mentoring?
• Clarifying the balance between striving for excellence and supporting doctors in difficulty
• What is the offer for the mentee?
  What is the offer for the mentor?
  What is the offer for the employer?
  What is the offer for the patients?
• The voluntary/mandatory tension.
• Who is the offer for? - All doctors, doctors in training, doctors at transition?
• Should there be a pilot/pilots?
• How this will be resourced and promoted needs further clarification?
• Terminology needs to be agreed
• A formalised process with common principles needs to be made available

6. Conclusions

• There was general consensus over the value of mentoring with some disagreement on terminology which needs to be unpicked
• There should be a general expectation that mentoring is usual practice especially at transition points. The support needs to be given at employer level but employers will need help to make this a reality.
• Employer based mentoring should not preclude external personal development mentoring provided by professional organisations
• Further work should be undertaken by the group to take forward and develop principles for mentoring schemes

7. Next steps

1. A draft set of principles for mentoring (based on the above points) will be developed and circulated for consideration electronically

2. The Group would then to meet again to agree a document and consider how it could be taken forward and promoted by Colleges, UK Governments and employers