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Coaching vs Mentoring, A Word for Trainees and External Coaches

This week we are concluding the coaching vs. mentoring blog series in academic medicine. So far, I've offered the impetus for this series and my reflections on it, the difference between coaching and mentoring, strictly speaking, and the approach for core faculty, as I see it. Now, I'm coming full circle to mentoring and coaching related to residents, fellows, and external coaches. 


I am often the first professional coach with whom a resident has ever worked. Many physicians, trainees included, aren't familiar with coaching. Some trainees haven't identified a mentor, and those that have, often feel there is inadequate time to meet.


So it makes perfect sense when their program brings me into coach, they often start their first one-on-one coaching call with something like, "I'd like some tips on …". Oh, that was so very tempting when I first started coaching. I love to give tips! "Here, let me tell you about my many suggestions based on my experience." Ooops 😬. I was brought into coach, not mentor. Old habits die hard. And yet, it didn't take long for me to become ABSOLUTELY convinced that my coaching hat is my most important asset to bring to the call.


Those of you external physician coaches who have been doing this for a while already recognize that trainees often have been socialized to second-guess everything they think. The conditioning leads them to feel disempowered. We have too many attendings that carried that perspective forward from training who no longer trust their gut – maybe they no longer are in tune with it. (Myself included, once upon a time)


So, I often start with a short review of coaching. Then, when they ask direct questions about my ideas, I table them. "If you still want my ideas at the end, I'll be happy to share, but I'm more curious about yours." Once we really get going, I share my opinions less than 10% of the time because they have unlocked the gold within themselves. Now, that's not to say I may not make a teaching point. Say something like, "Self-care isn't selfish; it's how we sustain ourselves for the work and life outside of work." But they always get to decide if that makes sense for them and how, if at all, they apply it in the situations we are unpacking. I have no agenda. I hold teaching points loosely.  


The other fun part of my job is I have no reporting or evaluative role to play. Outside of the mandatory legal reporting, I only tell the program the number of sessions attended and the level of engagement, 1-3. (And basically, they'd have to just stare at me or grumble to get a 1 or a 2.) The coachee doesn't have to lean into vulnerability one moment and then worry the following week when I'm precepting in the clinic that it has colored my thinking about them. This assures a safe, confidential space without judgment. I had one resident who worked with me outside of her program. When she told her advisor that she had hired a coach, the advisor asked who it was. She declined to say. She wanted as many degrees of separation between myself and her program as possible. Again, the person being coached needs to make sure the coaching relationship feels safe. And as external coaches, we need to honor that and do everything within our power to ensure it.


So, residents and fellows (or attendings, for that matter), for those of you looking for a coach - Pause. What are you looking for? Do you want someone to give advice from experience further along a shared pathway? Then you want a mentor. Mentors are necessary and invaluable. Many of those relationships endure for the length of your career. You may click with your advisor. There isn't any reason they can't serve in both capacities for you. If you don't, look around; look back into the past. Who are those you respect and trust who seem to have so much wisdom in areas you desire it? As Brené Brown would encourage you, step into courage, lean into vulnerability and ask them to fill that role for you. Some of us attendings may miss subtle cues – so feel free to be clear about what you're looking for. The worst that can happen is they say they don't have the bandwidth and perhaps point you in a different direction. The best is that you have secured an essential part of your personal board of directors. Having a set of mentors is wonderful as they each have something unique to offer. 


If you are looking to grow in confidence and self-belief and gain clarity about what is best for you, you want a coach. Or if you want to discover what keeps you stuck and lose limiting beliefs holding you back from flourishing, then you want a coach. We are trained to help you lose unnecessary suffering, gain and protect your energy, and help you become your favorite version of yourself. (Shoutout to Dr. Melissa Parsons on the "favorite version" verbiage). The great thing about coaches is that you can tell us directly, "Meh, that falls flat for me." We love it! We are fine-tuning the experience to what works for you. We know that not every tool is for everyone.


And if you end up with a mentor trained in coaching, it can be magical. And if you end up with a coach like me, I may offer my ideas at the end if it's still important to you, but most of the time, you'll reveal to yourself precisely what you need. And also, if you end up with a coach like me, I will encourage you to identify your long-term mentors, though you'll never truly be out of my heart and mind. (I'm an email away.) I just play a different primary role than your mentor.

I can't wait to see what my brain comes up with for my next blog series. 😂 It's often as big a mystery to me as it is to you. 

Until next time, 

Have a joy-filled week!  Tonya

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