The Mentor Gap: Why Good Mentors Don't Automatically Create Promotion-Ready Faculty

Academic medicine has invested heavily in mentorship. Most departments have formal programs. Many institutions have mentorship committees.

The assumption behind all of it: if you give faculty a good mentor, they will advance.

The data doesn't fully support that assumption.

A foundational systematic review by Sambunjak et al. found that mentorship has a significant influence on personal development and career guidance in academic medicine, but the evidence base for its effect on hard promotion outcomes was thin and methodologically limited.1 In a qualitative study of junior academic medicine faculty, 98% identified lack of mentorship as a barrier to career progression, but the inverse, that having a mentor reliably produces promotion, has been harder to demonstrate. This suggests that what works is structured, active mentorship embedded in a system, not the assignment of a mentor on its own.

What Mentors Can and Cannot Do

A good mentor provides guidance, opens doors, offers perspective from their own trajectory, and advocates within the institution. These are real and meaningful contributions. They are not substitutes for structured career infrastructure.

Early in my career I had access to Joe Kerschner, who went on to be the Dean of the Medical College of Wisconsin. He is a genuinely exceptional mentor. He was generous, credible, and deeply invested in the people he supported.

And still, I found myself holding back the questions I most needed answers to. What do the next two years need to look like? That is not a small question. But I worried about overasking. About using too much of his time. About being the mentee who needed too much.

That hesitation was not a relationship problem. It was a structural one.

The questions I was self-censoring were exactly the ones a structured career development system would have answered, not because the mentor couldn't, but because a system creates space for those conversations without the faculty member having to calculate the social cost of asking them.

The Relationship Problem

Mentorship is a relationship. Relationships have dynamics. Not all of those dynamics are conducive to the honest, direct conversations that promotion strategy requires.

A mentor who is also a direct collaborator has competing interests. A mentor who is a department leader may have limited time and many mentees. A mentor who trained in a different era may have promotion instincts miscalibrated for the current environment, where the bar has moved and the activities that built careers twenty years ago no longer carry the same weight.

None of this means mentors are unhelpful. It means mentorship alone, without structural support, leaves gaps that are hard to close. Most departments know this. The challenge is that building the complementary infrastructure requires time and resources that are genuinely scarce.

What Infrastructure Adds

Structured career development infrastructure is not a replacement for mentorship. It is the system that makes mentorship more effective.

When a faculty member has a clear promotion strategy, specific timelines, and a structured process for reviewing their trajectory, their mentor conversations become more productive. The mentor isn't filling in for a missing system, they are advising within one.

Infrastructure provides what relationships cannot: consistency, accountability, and a framework that works independent of the quality of any individual relationship.

When the infrastructure is built well, the effect is measurable. In a prospective longitudinal study of a formal mentorship program at Massachusetts General Hospital, mentees were significantly more likely than matched controls to hold senior faculty positions at long-term follow-up (47% vs. 13%, p=0.030), despite no difference in starting administrative rank. Among the subset who started as instructors, mentees were more likely to be funded and promoted than controls (p=0.030).2 The differentiator was not the existence of a mentor, but the structure that surrounded the relationship.

Infrastructure ensures that a faculty member whose mentor is busy, unavailable, or a poor fit doesn't fall through the gap.

What Happens When Infrastructure Is in Place

When structured career development support exists alongside mentorship, both work better. The mentor isn't filling in for a missing system, they are advising within one. Their time is used more efficiently. The faculty member arrives to mentor conversations with more clarity and more specific questions.

This is what FERI is designed to do, not replace what departments are already doing, but provide the dedicated capacity that makes everything else more effective.

The most effective career development happens before there's a problem. That is true for mentorship and it is true for the systems that support it.

What to Do This Week

• Write down the three questions you most need answered about your promotion trajectory right now and haven't asked anyone.
• Ask them. To your mentor, your chair, or a senior colleague who has been through promotion recently at your institution. If you're self-censoring, that's the gap.
• Evaluate your mentorship honestly: Is your mentor able to give you specific, institution-informed guidance on your promotion strategy, or do they offer general encouragement? Both are valuable. Only one closes the strategy gap.
• If your department has a formal mentorship program, ask the coordinator what structured career planning support exists beyond the mentor relationship itself.

Mentorship is essential, and it works better when structural support exists alongside it. FERI is that support.

Chairs and Deans: Learn more at www.amedsg.com/feri.

Faculty: Subscribe to the AMedSG newsletter for ongoing career development frameworks at www.amedsg.com.

References

1. Sambunjak D, Straus SE, Marusic A. Mentoring in academic medicine: a systematic review. JAMA. 2006;296(9):1103–1115.
2. Efstathiou JA, Drumm MR, Paly JP, et al. Long-term impact of a faculty mentoring program in academic medicine. PLoS One. 2018;13(11):e0207634.