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Zach Klaassen: Hello, and thank you for joining us for this UroToday discussion. My name is Dr. Zach Klaassen. I'm an associate professor of urology and urologic oncologist at the Georgia Cancer Center in Augusta, Georgia. And I'm pleased to be joined by Dr. Angie Smith, who is the associate dean of Faculty Affairs and Leadership Development at the UNC School of Medicine. Welcome, Dr. Smith.

Angie Smith: Thanks. It's great to be here, Zach. Thanks for inviting me.

Zach Klaassen: We're looking forward to discussing mentorship and coaching in urology. So we're going to keep this sort of high level questions, and I just want you to take it however you see fit. So how do you define mentorship in urology and why are you passionate about mentorship specifically?

Angie Smith: When I think about mentorship, I think about having an individual or individuals in your life who you can depend on for advice, you can depend on for guidance in your own career, and I think of it almost like a toolbox. And when I think about mentorship I can't help but also think about coaching because I think they are complementary, they're different and distinct and they both fulfill different roles in your career, or can. Not everybody has a mentor and not everybody has a coach, but I feel like everybody can benefit from both. I'll just briefly describe what I see as the difference. And maybe we have a discussion about how that might look in urology, and I know it might look differently for different people. Mentorship, as I mentioned, is more about having a relationship with somebody who you admire.

I mean, you want a mentor who you can learn something from, who can provide you guidance in your own life. And I think that's distinct from coaching in which you have a relationship with somebody who is asking questions of you that are going to figure out the solution within yourself. And those are very distinct things because a mentor may give you advice that works for their life but it may not work for yours. You can pick and choose what your mentor says and apply it to yourself. A coach draws out sort of the next step in yourself, what will work for your career, what will work for your life?

And those are very distinct things because nobody, I don't think, wants to be an exact carbon copy of their mentor. Maybe so, maybe the most incredible mentor, but the truth is you're not the same person. You might not have even be existing in the same time span, and we are post-pandemic. It's just there are differences, so you kind of have to take what you get from a mentor and then apply it to your own life and where you see yourself going.

Zach Klaassen: That's great. Honestly, I hadn't thought about the distinction like that, but it makes a lot of sense. I think when we're going through residency and we're going through fellowship and your junior faculty, you have mentors... usually in your own institution but sometimes other institutions... you may have mentors that are clinical mentors or life mentors or research mentors. Can you delineate how that kind of fits in and how they compliment each other? I mean, having one for each, you don't have to have one for each but it seems like it almost organically happens to a degree. Would you agree?

Angie Smith: Yeah, I do. And I like the way you described it. There's not just one mentor, and maybe you could say there's a chief mentor, someone you really go to for most things. But I think what seems to work best for most people is a catalog of mentors. Because you're right, you might have a mentor that you look toward and you say, "I really like how they integrate their personal life into their work life." There might be another one, and you say, "Wow, I just really admire their success in research and how they got there." And maybe another one that you say, "Wow, they are stellar teachers in the OR and I really want to become that." But you have to have an awareness first of yourself. What do you want to be? And yeah, mentorship can come about organically, but I will say that there is value in being intentional about growing your mentorship portfolio so that you see and you say, "Hey, I want this, this, and this in my life. Who do I admire and who can I engage with who could become my mentor over time?"

I don't think mentorship happens like that. It's a conscious choice. You have to develop and cultivate a relationship over time, and you have to have a person who is willing to give you that time because mentorship takes time both ways, both from the mentee perspective and the mentor perspective.

Zach Klaassen: Absolutely. I definitely want to delve into the coaching, but I'll take the mentorship for one more question. So I often tell the interns you are in charge of teaching the medical students, teaching each other, it starts early, like the teaching starts early. How does one decide or how does it happen when you go from a mentee to a mentor, or are we always both?

Angie Smith: My philosophy is that we always can be both. Are we both? Probably not. But that's a choice you can make and you can start today. You can be listening to this and you can be an undergraduate thinking about medical school, or maybe you're a med student thinking about urology or a trainee thinking about your fellowship and on and on and on we go. Any of those listening can be a mentor. Absolutely. Because you came from somewhere, that's who you can mentor. And I'll also say don't pigeonhole yourself into the level you're in. Some people can be mentors in other ways and be at different levels. I think that happens less frequently, but it can happen. And the reason it happens is because if you think about mentorship in these different categories, it doesn't necessarily matter what level you are in. It matters where you are either emotionally or strategically or what experience you've had. And so you can actually be at different levels but still have a mentor who provides valuable information to you in a specific area of your life. So my suggestion is to be open-minded about your mentorship team.

Zach Klaassen: This question kind of just came to me, is there a difference between teaching and mentorship in your opinion?

Angie Smith: I would say yes, because I think teaching is... I think that they can certainly overlap, but teaching is a distinct skill where you are providing specific information to someone, whether it be an operative skill, some kind of knowledge that is passed along either experientially or from a book. Now mentorship, you could say, well, mentorship is also experiential passing on of information, but I think the distinction is that there is more of an interchange between the mentor and mentee. Because that mentor, a good mentor, is listening to hearing what the mentees needs are, and they're taking their prior experience and they're applying that to the current mentee's situation. So it's a little bit beyond teaching because it's customizable, it changes over time. It's reflective of the environment and what the mentee is going through, and then it is packaged in such a way that helps them at that juncture of their life.

Zach Klaassen: Yeah, that's fantastic. So let's switch to coaching a little bit. So I know recently you've gotten involved in coaching. Can you tell us a little bit about your background, how you got into it? Have you had formalized training? How does it look like in your sort of day-to-day life at this point?

Angie Smith: I got into coaching by being coached, quite simply. I was coached a little after, I would say, maybe my fourth or fifth year as a faculty member. And I'll say that proceeding that coaching experience I had burnt out. I was, I think, objectively doing well. I think if people objectively saw my accomplishments, they'd say, "Wow, yeah, she's successful." But I didn't feel that way in a number of ways. I mean, imposter syndrome and overwork and constant chatter in my head and adding two kids to my life, having babies, developing myself as a mom, and on and on we go. Coaching came to me serendipitously because a mentor of mine suggested it to me and provided me that opportunity. It was one of the greatest gifts ever given to me.

Zach Klaassen: Wow, that's awesome.

Angie Smith: I did that for probably six sessions or so and really got crystal clear on my goals. I really developed an awareness of who I am and who I want to be, and it really freed me in an incredible way to essentially fulfill my purpose. And that's such a general statement and it sounds like lip service, but the truth is a lot of our chatter takes us from why we do what we do and it can blind us to what our purpose. And once I got clear on that, everything became easier and it brought joy back to my work. It just made me feel great both at home and in my work and as a clinician and as a researcher and as a mentor. And then to your second question, how did I get into coaching itself, well, when you experience that kind of joy you want to give it to other people.

Zach Klaassen: Pay it forward, right?

Angie Smith: Exactly. I love urologists. I'm so excited to come to the AUA because I get to hang out with my friends. I love the people that I work with here at UNC and beyond, and so I realized that one way to do that is to be a coach. I think there's value in being a coach and also being a physician because you can wear that dual perspective of asking really bold, insightful questions to the person to unlock what's within themselves, while also understanding what it feels like to be in their shoes, at least to an extent. Because I've burned out, I've thought many of the thoughts that many of my coaching clients think. And so now I am getting what they call a ACC and PCC coaching credentialing through the International Coaching Federation, which takes quite a lot of time. It's a lot of coaching hours, but it's incredibly meaningful work and I hope to give back and I'm doing that now to our urology community and beyond.

Zach Klaassen: That's fantastic. I think you touched on a lot of good topics here. I think just to dovetail a little bit, we've seen the studies, the burnout rate in general among physicians and among urologists. I mean, let's be honest, if you look at the data we're at the top and we could have a whole conversation on why that may be the case. Do you feel that this sort of rising up of coaching over the last several years is perhaps the best way to tackle these burnout rates? What are your thoughts on that?

Angie Smith: I think saying it's the best way it would be hard for me to agree with. I think it is a really wonderful way. Perhaps there are other ways to address it because there are systematic issues or I should even say systemic issues, but also systematic in the way that our healthcare profession operates. And those things need to be addressed too. So I don't want to say that only addressing this internally is the solution, but it's a really important element because what coaching allows us to do when done well is reflect on our thoughts and it opens us up to possibilities. In medicine, we grow up in a specific culture that makes us believe that certain things are fact, certain things we must do, which are not true. And coaching allows you to explore what is actually true and what is not, what is actually in your control and what is not.

I always say every last thing you do, and I do, that we do, we have a choice. Even though many days, and I even find myself caught in that statement, I had no choice, that's not true. You did have a choice. It's just that the alternate choice was really difficult for some reason. And coaching asks the question, what is that reason? Is it cause of a narrative that you've been taught years ago that is no longer relevant? Is it serving you in some way that you're not seeing? How is it holding you back? And it allows you to start seeing both sides of the coin. We've seen only one side for so long that you believe it is absolutely true when that isn't really the case.

And so that's, I think, the beauty of it and that's why it is so helpful in an era of burnout. Because in burnout, you really are seeing the one side of the coin. Everything is very negative in that moment. You can't see any possibility, and that's the definition of it. And coaching, that is exactly what it does, it provides possibility again to your brain, and that is really powerful.

Zach Klaassen: That's great. So if somebody out there is listening in UroToday land and they are interested in a coach or they're trying to figure out how to get in touch with one, maybe yourself, maybe one of your colleagues, what's the best way to make that process start?

Angie Smith: Great question. The first thing I would say is that many coaches, I mean, there's a cost involved and that can be a barrier for many individuals. I would think of that cost as an investment. You can go to Google and even just search coaching medicine and you'll find a list of coaching opportunities that would exist. But I'd also just begin with your institution and ask. Mine was sponsored by my institution and I was grateful for that. I wouldn't have thought to do that on my own. That's not to say that if they say no, you can't do it on your own. I would say it is absolutely worth the cost because it's such an investment. I also think that just like a mentor a coach is a fit. You have to really connect with them because you're going to hopefully be saying some really deeply personal things.

I always say coaching is about the who and the what, and it's really most important to start with the who, like who are you? And that might, again, seem very high level, but I'll tell you, it is the most important thing and we don't ever have a moment to reflect on it. But when you get a really clear understanding of who you are, who you want to be, everything else actually becomes much easier. So you want somebody you connect with, that you feel comfortable doing that. And so many coaches offer a free session to feel that out. And you get to feel out do you like coaching? What do you think about it? So I would start with investigating what resources you have. Maybe that's something you could negotiate with your institution. And if that's not the case, you could go on your own and then have an introductory session with someone you think you might connect with and then try it out and go from there.

Zach Klaassen: That's great. So just sort of a wrap up I want to give you an opportunity to touch on anything we haven't touched on that you want to communicate to our listeners, but also as a final sort of additional wrap up, is there any take home points either from mentorship or coaching that you'd like to give to our listeners as well?

Angie Smith: I think my take home point would be this, we lead such busy lives we don't take a moment to consider what our needs are, what support we might need to succeed. And I think ideally that support would come in the form of a mentorship team that addresses various areas of your life that you want to look a certain way, whether it be family life, balancing that with a work life, whether it be career trajectory and goals, education, you name it. But have an awareness of what you want to be and then construct. Go intentionally construct a mentorship team to address it. I think that mentorship team then gives you ideas of what you could be doing and you can internalize those ideas. But then a coach can allow you to sort through them and determine what is right for you. So I think having those two elements is sort of the, I would say, the dream, right? Because you have a team that gives you ideas based upon experience and then you have a coach who brings out within yourself the plan that is specific to you.

Zach Klaassen: That's fantastic. Listen, I can't thank you enough for your time. Your passion is evident for both of these topics. I really was looking forward to it and enjoyed it. I know our listeners will get a ton out of this, and I can't thank you enough, Dr. Smith, thank you.

Angie Smith: Well, thank you, Zach, for bringing it up. I love talking about it and I'm really, really delighted that you are addressing this topic. It's so important.

Zach Klaassen: Fantastic. Thanks again.

Angie Smith: You're welcome.