I’ve had a mentor since I was 13 years old. My mentors afforded me experiences as a high school student that many of my peers lacked. I worked at scientific laboratories at Mount Sinai in New York City, interned at executive offices, and traveled to Puerto Rico to study marine biology, all before my junior year in high school. In college, my biology professor helped me navigate a premed major and wrote a letter of recommendation for medical school. My emergency medicine residency director mentored me as a medical student and supported me during the match and residency life. As a young attending, I took pride in mentoring medical and high school students along their path.

Then my current medical director, Alfred Sacchetti, MD, FACEP, did something I was not used to—he told me to apply for the board of NJ-ACEP. He didn’t just give advice on my career, he used his influence to create opportunities for my career advancement. Now I am the associate director of my department, and I realized that Dr. Sacchetti was more than a mentor. He was and is a sponsor, and there is a huge difference.

Mentor Versus Sponsor

This difference is stated perfectly by Harvard Business Review: “While a mentor is someone who has knowledge and will share it with you, a sponsor is a person who has power and will use it for you.”¹ This concept is very different from the culture of medicine and residency training where the focus is on the attainment of knowledge. Many residency programs and academic attending positions have mentorship tracks ingrained in curricula and pathways for career advancement. In fact, women overall have more mentors than men. However, despite all that mentoring and the fact that 50 percent of medical students are women, only 18 percent of hospital CEOs and 16 percent of medical school deans are women. Quite frankly, knowledge alone is not enough. Career advancement in general and within the house of medicine is about who you know and their willingness to use their power to sponsor your advancement—and willingness to sponsor is affected by implicit race and gender biases. If a sponsor is unaware of these biases, they may continue to elevate the groups who have traditionally benefited from sponsorship while overlooking underrepresented groups.

The question is, does the house of medicine need more sponsors or does the face of sponsorship need a face-lift? To glean some answers, I decided to ask my very own sponsor, Dr. Sacchetti.

JB: How do you see your role in career advancement for your staff?

AS: Everything I have been able to accomplish in my career can be traced back to opportunities given me by someone else. Whether as a speaker for a conference, an author for a book, or member of a committee, someone had to open that door for me.

I have never forgotten the role these people have played in my own career development and have incorporated that as part of my mission as a leader in emergency medicine. Whenever I encounter a clinician working to advance their career, I feel it is my responsibility to do all I can to help them. If their goal is to be a great emergency physician, then I need to put them into a position to practice great emergency medicine. If they wish to have an administrative career, then I need to provide them entry to any position with related administrative activities. If they wish to become an author or researcher, then I must invite them to join in any projects with which I am involved.

There are very many talented emergency practitioners out there. The only thing stopping them from advancing their careers is the chance to prove what they can do to the right individual. My job is to give them that chance.

JB: Should sponsees seek you out directly?

AS: As a leader, it is my role to be aware of any individual who needs help advancing their career. In that respect, these individuals should not have to seek me out. That said, it is not possible to be aware of everyone who could benefit from my help. To address that issue, I need to make it as clear as possible that I am a resource for career advancement. I need to be visible and approachable for anyone who might need some help with the direction of their career choices.

JB: Is there a formalized sponsorship program?

AS: I imagine there are some formalized sponsorship programs, but I am not aware of any. For me, sponsorship is a personal activity when one individual gets advice or help from another rather than a formal activity.

JB: Do you actively give opportunities to diverse physicians?

AS: Diversity clearly contributes to the success of any organization, particularly when the different characteristics of diverse individuals are essential to the accomplishment of an organization’s goals. However, embracing diversity simply for the sake of diversity itself is not beneficial and, in fact, can be counterproductive.

If I am to be honest to the patients who seek care at my institution, then it is my responsibility to place the most qualified individuals in the role of clinician there, regardless of their gender, ethnicity, religion, or any other non-performance-related descriptor. Our mission statement is patient care, and patient care depends on the medical skills of the personnel in our department. In adding any new member to our medical staff, my primary focus has to be on identifying the best individual for the role.

What may go unrecognized in such a statement is that a person’s background, culture, and other earmarks of diversity contribute to their qualifications. For example, a clinician who speaks both English and Spanish would be better able to elicit a history in a predominantly Spanish-speaking patient population, greatly enhancing their ability to deliver care. Such an individual may be selected not because of their diversity but because their diversity makes them a better clinician and a better member of the department. However, if that same individual was unable to perform key resuscitation procedures, then their language skills would have no beneficial impact on patient outcomes. The advantage of their diversity to the department would be nullified by their lack of clinical performance.

In direct answer to your question, absolutely I look to encourage diversity in our department but never at the expense of medical quality.

The relationship of sponsor to protégé is not top-down. The protégé needs to own this process. First, you must excel in your field—we are all doctors with type A personalities, so I know we all can excel. Your performance is critical because the sponsor will use their “status chips” on your behalf. Second, within your organization, identify the key players and influential decision-makers. These individuals may not only be your boss but likely someone more senior than your boss. This person may be in your field but at a different company or organization. Your mentor may even introduce you to a great potential sponsor. Use these networking opportunities to actively seek out a sponsor. Third, be clear and state the goals you would like to achieve with their sponsorship. And you don’t just need one sponsor. Stretching your network with mentors to grow internally and sponsors to expand externally is crucial to everyone’s career development. If we in medicine want to be more diverse, we need to rethink our traditional mentorship tracks, create sponsorships, and educate sponsors about implicit biases and advantages of diverse teams that will ultimately benefit the sponsor and protégés alike.