Your mentor is not your coach.

Potential mentors are everywhere; potential coaches are not. Remember this distinction when seeking help with high-stakes multiple choice exams. Unfortunately, medical students and residents frequently confuse mentors and coaches, often with negative consequences. It is easy to determine someone’s rank within a hospital. Title (Professor, Chair, Dean), letters (MD, PhD, FACS), and clothing (long white coat, surgical scrub hat) make it easy to determine “who’s who” in the healthcare hierarchy. Surgical trainees are often drawn to the most experienced, most senior, and most decorated members of the team for advice. With respect to test taking, this is often a mistake: great mentors aren’t necessarily great coaches.

Bill Russell is one of the greatest basketball players to ever live. His accomplishments on the court, and his grace in the decades that followed, are undeniable. Many current NBA stars, including 2021 NBA Finals MVP Giannis Antetokounmpo consider Mr. Russell a mentor. They do not, however, consider him their coach. Why is this distinction important? Mentorship is ideally a long-term relationship that is development driven (holistic approach); coaching, in contrast, is often a short-term relationship that is performance driven (skill specific). Bill Russell does not teach Giannis how to shoot free throws. That is a coach’s job.  

Giannis Antetokounmpo (Photo Source: AtlantaNewsMedia.com)

The doubling time of medical information is less than 5 years. This staggering fact suggests that surgeons who have been out of practice for 10 years will likely be current on only 25% of the material on the exam. While lifelong learning keeps experienced surgeons up to date on their specialty, most practicing surgeons are ill equipped to help medical students and trainees prepare for the wide-ranging material present on trainee’s multiple choice exams. Need proof? Ask the Chair of your surgical program to take the United States Medical Licensing Exam (USMLE) Step 1 required of second year medical students. Bonus points: ask him/her to share their score publicly. My prediction is you will find no takers. Even the brightest professors realize they no longer have mastery of this material. Testing advice from mentors is likely to be out of date.

I encourage trainees to find a coach who can help them address their specific test taking concerns. Many online medical and surgical “test prep” programs are simply question banks with explanations provided by recent graduates who aced standardized exams. In my experience, these testing “coaches” do not necessarily understand the exam (question p-values, beta questions, etc.) or the challenges facing so many test takers. Excellent test takers do not need advice from other excellent test takers. Similarly, excellent test takers are frequently unable to help those who do not naturally share their approach to these exams. This creates a tremendous coaching need for those looking for help (coaching) in medical school and residency, especially for those not inherently using the most efficient study techniques for these exams.  

Finding a coach is a more nuanced, and in my experience more difficult, process than finding a mentor. Effective coaching isn’t dependent on connections, educational pedigree, or motivational platitudes. Coaching is finding someone who can help you get better at a task. Coaches who have faced similar challenges, and overcome them, are a unique resource for trainees at all levels. Find a coach.

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