Literature coming from business and human resource management suggests that women are over-mentored and under-sponsored. However, if you have been reading reports about women in medicine, then you likely have heard that women are both over-mentored and under-mentored. Where does the truth lie? That depends on various factors including the definitions of these terms.

What exactly do these words mean? In the business sector, mentorship is generally considered advice or counsel from someone who is more knowledgeable, and sponsorship is typically defined as someone who is influential in a company or organization putting a person forth to support career advancement including promotions.

The Harvard Business Review summarized the landmark report “The Sponsor Effect: Breaking Through the Last Glass Ceiling,” which described a sponsor as “someone who uses chips on his or her protégé’s behalf and advocates for his or her next promotion.” The article goes on to explain that a sponsor is responsible for “expanding the perception of what the protégé can do; making connections to senior leaders; promoting his or her visibility; opening up career opportunities; offering advice on appearance and executive presence; making connections outside the company; and giving advice.”

Economist Sylvia Ann Hewlett, a noted authority on sponsorship, elaborated in The New York Times “Mentors Are Good. Sponsors Are Better”:

“Our two-year study, which sampled some 12,000 men and women in white-collar occupations across the United States and Britain, shows how sponsorship — unlike mentorship, its weaker cousin — makes a measurable difference in career progress … A sponsor can lean in on a woman’s behalf, apprising others of her exceptional performance and keeping her on the fast track.”

Shifting our lens to medicine, in a report published in the journal Academic Medicine and titled “A Review of Mentoring in Academic Medicine” Geraci and Thigpen noted, “A notable deficiency in the field is the lack of a standardized, fully operational definition of mentoring.” Despite the absence of a gold-standard definition, they explain, “Almost universally, faculty members who have received high-quality mentoring cite it as a critical contributor to their career satisfaction and advancement, while those who failed to receive such support see this deficiency as having an important negative impact on their professional success and growth.” Interestingly, faculty on a research track may be getting “high-quality” mentorship, but those on other tracks (or who are not in academic medicine) may be at higher risk for inadequate mentoring.

The problem with the current definition of sponsorship when it is applied to academic medicine? Sponsors may provide some value in the academic promotions process; however, the usual process for advancement from the instructor to full professor level is granted after fulfilling a variety of pre-determined achievements. These can include activities such as peer-reviewed publications, recognition awards, invited lectures on local, regional and national levels and medical society leadership positions. Accomplishments are documented on a templated curriculum vitae (CV) where the applicant “fills in the blanks” in pre-existing and circumscribed categories.

When an applicant is up for promotion, this CV is circulated to senior academicians who write letters on her or his behalf. The departmental chair then submits the letters and CV to a promotions committee consisting of professors from different departments. The committee members rely heavily, though not exclusively, on the CV and the letters of recommendation which are, of course, in part based on the CV. In academia, the rules for promotion are meant to be as impartial and objective as possible. Thus, the role for sponsorship, based on its current definition, may have a more limited role in academic medicine than it does in a Fortune 500 company.

So, does that mean sponsorship isn’t important in academic medicine? No. Recently, Carr et al. reported that women lag behind men in promotions even after accounting for publication rates. It makes sense that senior leaders may help to close this gap by using their influence and actively advocating for the promotion of qualified women faculty. Moreover, mentoring itself can be a double-edged sword. For example, in my article titled “Diversity and Inclusion are Core Leadership Competencies: A Primer for Busy Leaders,” I wrote about the issue of telling highly qualified women that they need more mentoring. This is tantamount to telling them they need “fixing” when, as my research with colleagues (and other studies) has shown, it is really our healthcare institutions and other organizations that need fixing.

Neither mentorship nor sponsorship alone is as beneficial as the two working in synergy. This powerful combination of influential people advocating for you in tandem with an impressive CV is your passport to career success. Moreover, this passport can provide more equitable upward mobility across all genders, races and other demographics as well as in every specialty and sector of health care.

To make things easier to explain in an efficient manner (e.g., during a lecture), I have been expanding the definition of sponsorship to include not only using influence to pull someone up the career ladder but also focusing on specific invitations, assignments or roles that can be documented on her or his CV.

Let’s face it, no matter what, the language is confusing. And, this blog is not long enough to cover a bevy of other important terms such as coach, role model, advocate. However, the path forward is crystal clear: We all need people who advocate for us and provide us with specific opportunities that result in documentable accomplishments. I am working on being an intentional mentor and sponsor to every person — regardless of gender, race or other factors — that I have the responsibility to support and to many others who I have the resources and capacity to lift up.

Julie Silver a physiatrist and director, cancer rehabilitation, Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, MA.  She can be reached on Twitter @juliesilvermd.

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