Mentoring Programs for Underrepresented Minority Faculty in Academic Medical Centers: A Systematic Review of the Literature

Although numerous definitions of mentoring exist in the professional literature, traditionally it is a process through which a senior, experienced faculty member (mentor) provides guidance and support for a junior or less experienced colleague (mentee). Mentoring is a critical element for faculty career advancement in academic medicine,1–5 and mentors can play a variety of roles in helping mentees delineate and accomplish their career goals.1,6 Ideally, mentors can enable junior faculty to enhance productivity and can provide education about the written and unwritten rules that govern the academic environment.1 Faculty members with mentors express more confidence than their peers,7 report experiencing higher career satisfaction,8,9 are more likely to have productive careers,10,11 and feel greater support for their research careers.12 Unfortunately, many early-career faculty members, particularly those from underrepresented racial and ethnic minority (URM) groups, are often unaware of the significance of mentoring or cannot find mentors committed to their career success.13,14 Ironically, laudable traits such as self-reliance that helped URM early-career faculty to navigate graduate and medical school may actually isolate them and hinder them from achieving further success.15,16 Numerous studies have reported that URM faculty typically receive less mentoring than their nonminority peers.17–19 Mentoring programs designed to address unique challenges faced by URM faculty are critically needed. These challenges include marginalization, overt and covert racism, and a disproportionate share of activities that do not advance careers (e.g., serving on numerous committees; participation in community outreach endeavors; advising minority students, postdoctoral fellows, and residents).17–19 Finally, URM faculty often treat more financially marginalized patients who generate less revenue but whose clinical care requires more time.15,20 Two recent reports provide troubling evidence with regard to reversing these disparities and achieving the goal of enhancing successful career trajectories of URMs in academic health centers (AHCs). A 2010 report from the Association of American Medical Colleges (AAMC)21 indicated that nonwhite faculty are less likely to be promoted than white faculty. Another study, based on National Institutes of Health data (2000–2006), indicated that African American scientists are about 10% less likely than their white peers to obtain R01 grants.22 In a follow-up article that discussed the potential reasons for this disparity, Tabak and Collins23 hypothesized that variability in access to mentoring may be a causal factor. Leaders of several AHCs in the United States have acknowledged the relative paucity of URM faculty and are attempting to increase the diversity of students, trainees, and faculty.24 The AAMC has stated that enhancing the diversity of AHC faculty is a significant component in the overall strategy to reduce health care disparities in the United States.25 Over the last decade, a few AHCs have designed mentoring programs specifically for URM faculty to address these various disparities24,26; however, the pace of progress has been glacial, and it has yielded mixed results. We conducted a systematic review of the published literature with a focus on outcomes of mentoring programs designed for URM faculty employed in AHCs. This article extends the descriptive review of mentoring programs by Daley and colleagues26 for URM faculty in AHCs and includes the updated literature with a focus on published programmatic outcomes. We used the RE-AIM framework27 to synthesize and describe the primary components of the programs. From these publications, we gleaned “promising practices” that can be widely disseminated to other AHCs, and we suggest ways to enhance efforts to increase and sustain faculty diversity at AHCs.