1. Mutual Respect and Trust: At the heart of a successful mentoring relationship is mutual respect and trust. Senior doctors must respect the ambitions and challenges faced by junior doctors, while junior doctors should value the experience and wisdom of their mentors. Building this relationship based on respect encourages open communication and a willingness to learn from each other.
2. Cultural and Contextual Awareness: Mentoring in sub-Saharan Africa requires a deep understanding of the cultural, social, and economic factors that influence healthcare delivery. Senior doctors should be culturally competent and sensitive to the local context, guiding junior doctors not only in clinical practice but also in navigating the complexities of working in diverse and often resource-constrained environments.
3. Tailored Guidance: Every junior doctor has unique strengths, weaknesses, and career aspirations. Effective mentoring involves personalized guidance that addresses the specific needs of the mentee. Whether the focus is on developing surgical skills, improving diagnostic acumen, or understanding public health challenges, mentors should tailor their advice and support to align with the mentee’s goals.
4. Empowerment and Encouragement: Mentoring should empower junior doctors to take initiative and develop confidence in their abilities. Senior doctors should encourage their mentees to make decisions, take on challenging cases, and participate in research or community health initiatives. This empowerment fosters independence and prepares junior doctors for leadership roles in the future.
5. Long-Term Commitment: Effective mentoring is not a one-time interaction but a sustained relationship that evolves over time. Senior doctors should commit to being available for ongoing support, providing feedback, and helping junior doctors navigate different stages of their careers. This long-term commitment helps junior doctors grow steadily and adapt to the evolving demands of the healthcare system.

1. Resource Constraints: In sub-Saharan Africa, healthcare facilities often face shortages of essential resources, including medical supplies, equipment, and staffing. This can make it challenging for senior doctors to find time for mentoring amidst heavy workloads. To address this, mentoring can be integrated into daily clinical activities, with senior doctors providing guidance during rounds, case discussions, and procedures. Additionally, leveraging group mentoring sessions can maximize the impact of limited time.
2. Diverse Learning Needs: Junior doctors in sub-Saharan Africa often come from diverse educational backgrounds and may have varying levels of exposure to certain medical conditions or procedures. Senior doctors should assess the specific learning needs of each mentee and adapt their teaching methods accordingly. Using a combination of hands-on training, case-based learning, and reflective practice can help meet these diverse needs.
3. Balancing Supervision with Independence: While junior doctors need supervision to ensure patient safety, they also need opportunities to develop independence. Senior doctors should strike a balance between providing guidance and allowing junior doctors to make decisions and learn from their experiences. This can be achieved by gradually increasing the level of responsibility given to junior doctors as their skills and confidence grow.
4. Psychosocial Support: Working in high-pressure environments with limited resources can take a toll on the mental and emotional well-being of junior doctors. Effective mentoring should include psychosocial support, helping junior doctors cope with stress, burnout, and the emotional challenges of dealing with critically ill patients. Senior doctors can model resilience and provide a safe space for mentees to discuss their concerns and challenges.
5. Fostering Research and Innovation: Mentoring should also encourage junior doctors to engage in research and innovation, which are critical for advancing healthcare in sub-Saharan Africa. Senior doctors can guide junior doctors in identifying research opportunities, developing proposals, and publishing their findings. Encouraging participation in local and international conferences and collaborations can further enhance their research skills and broaden their perspectives.

For mentoring to be effective, healthcare institutions in sub-Saharan Africa must create an enabling environment. This includes:

- Structured Mentoring Programs: Institutions should establish formal mentoring programs that pair senior and junior doctors based on mutual interests and career goals. These programs can provide a framework for regular meetings, progress assessments, and feedback.

- Training for Mentors: Senior doctors may benefit from training in mentoring skills, particularly in areas such as communication, feedback, and cultural competence. This training can enhance their effectiveness as mentors and ensure that they provide consistent and high-quality support to junior doctors. For example, it could be incorporated into postgraduate curriculum where consultants and resident doctors are trained on mentoring

- Recognition and Incentives: Recognizing the contributions of senior doctors who actively mentor junior colleagues can motivate more experienced doctors to take on mentoring roles. This recognition could be in the form of awards, professional development opportunities, or academic credit.

-Provision of tools to ease mentoring: Both the junior and senior doctors given telephones, laptops or credit cards to buy call data to ease communication even when the senior doctor is at home.

Context:

Dr. K, a senior doctor in a district hospital in sub-Saharan Africa, is mentoring Dr. N, a junior doctor who recently joined the hospital. During a particularly busy shift, Dr. N made a mistake in administering the wrong dosage of medication to a patient, which fortunately did not result in serious harm but had the potential to do so. Dr. K uses this situation as a learning opportunity, guiding Dr. N through a reflective and constructive mentoring session.

Dr. K: Good morning, Dr. N. Thank you for taking the time to meet with me. I wanted to discuss the situation from yesterday’s shift regarding the medication dosage. How are you feeling about it?

Dr. N: Good morning, Dr. K. I’ve been feeling really stressed about it. I know I made a mistake, and I’m worried about what could have happened to the patient. I’m sorry for the error.

Dr. K: It’s understandable to feel this way, and I appreciate your honesty. First, let me assure you that making mistakes, especially when we’re still learning, is something that happens to all of us. What’s important is how we respond to those mistakes and what we learn from them. Let’s walk through what happened together so we can identify where things went wrong and how to prevent it in the future. Can you tell me more about how you came to administer the dosage?

Dr. N: It was during the afternoon rounds, and I was in a rush because there were so many patients. I remember reading the patient’s chart, but I must have misread the dosage instructions. I didn’t double-check before administering the medication, and I realize now that I should have.

Dr. K: Thank you for explaining that. It sounds like the pressure of the situation played a big role, which is common in a busy hospital like ours. When we’re under stress, it’s easy to make mistakes, but recognizing this is the first step toward improving our practice. Let’s think about some strategies that could help in similar situations. What do you think you could do differently next time?

Dr. N: I think I should have slowed down and double-checked the chart, even if I was in a hurry. Maybe I could also ask a colleague to verify the dosage if I’m unsure, especially when I’m feeling overwhelmed.

Dr. K: Those are excellent ideas. Slowing down, even just for a moment to double-check, can make a big difference. And asking a colleague to verify when you’re unsure is a good practice—it’s not a sign of weakness but of responsible patient care. In busy environments like ours, teamwork is crucial, and we should always feel comfortable relying on each other for support.

Dr. N: I’ll do that in the future. I really don’t want to make such a mistake again.

Dr. K: I’m confident that you’ll improve with time and experience. Remember, learning from these situations is what makes us better doctors. I also want to remind you that it’s important to take care of your own well-being. Working in this environment can be stressful, and it’s okay to take a moment to gather yourself during hectic times. How are you managing the stress of the workload so far?

Dr. N: It’s been tough, but I’m trying to keep up. I think I need to find better ways to manage the stress, though. Maybe I should talk to someone about it.

Dr. K: That’s a good idea. Managing stress is as important as the clinical skills we develop. If you ever need to talk, I’m here, and we also have other resources available, like counseling services or even just informal discussions with colleagues who understand what you’re going through. Don’t hesitate to reach out. We’re all in this together.

Dr. N: Thank you, Dr. K. I appreciate your support and understanding. I’ll work on the things we discussed, and I’ll make sure to take better care of myself as well.

Dr. K: You’re doing well, Dr. N. Mistakes are part of the learning process, and I’m here to help you grow from them. Let’s keep the lines of communication open, and feel free to come to me with any questions or concerns. We’ll continue to work together to ensure you gain the confidence and experience you need. Let’s schedule a follow-up discussion next week to see how things are going. Does that work for you?

Dr. N: Yes, that sounds good. I’ll be ready. Thanks again, Dr. K.

Dr. K: You’re welcome, Dr. N. Keep up the good work and remember that every day is a learning opportunity.

Summary:

In this example, Dr. K demonstrates effective mentoring by addressing Dr. N’s mistake with empathy and a focus on learning. Rather than reprimanding, Dr. K creates a safe space for Dr. N to reflect on the error and identify practical strategies for improvement. The conversation emphasizes the importance of slowing down, double-checking, and seeking support when needed. Additionally, Dr. K recognizes the stressful environment and encourages Dr. N to take care of his well-being, reinforcing the idea that self-care is essential to effective medical practice. By following up with Dr. N, Dr. K ensures ongoing support and growth, fostering a positive and productive mentoring relationship.

Practicing medicine in Australia and Sweden have made us realise that effective mentoring is doable even in sub-Saharan Africa by having a senior that the junior colleague could ask questions or call when not sure. The reviewer has worked both in Nigeria, now responsible for mentoring of new medical doctors and students. In the absence of many consultants, group mentorship could be combined with individual ones for private issues. Continuous training of consultants and resident doctors in mentorship strengthen the health system.  What can ease mentorship is providing job phones that are often the analogue types that could be used solely for patient discussions. So that even if the mentor is away but still available. This makes patient care safe and improve the learning curve.