Sound familiar? Every applicant has to come up with an answer to the question “Why psychiatry?” when interviewing for residency. My answer may not have been universal, but it reflects an important point. I went into this field because of an initial interest, and in spite of incomplete information about what I would be doing for the rest of my life. The reality of my career has not always matched the fantasy I had (not so many) years ago. There have been, and still are, progresses and pitfalls. Choices continually need to be made. Some paths are followed, some are ignored. I can take only partial credit for my successes to date. I owe much to good mentorship and count myself lucky to be able to say so.

There are many career options available, and the early career psychiatrist may choose to specialize in a particular clinical problem or population and to get additional specialized training. Residents may see only a few of these options in vivo, if they are lucky enough to find someone who is actually doing what they are considering. In these cases, residents may establish a mentorship relationship that will continue beyond residency. Often the task of mentoring residents falls to training directors, department chairs, and senior academic faculty who may have limited experience with the particular path the resident is considering. In many cases, the resident scrambles around for advice, makes choices, (sometimes informed, sometimes not) and takes a job after graduation. And then the fun begins.

The transition from residency to a stable career in psychiatry is a very delicate maneuver. Many struggle through this fledgling period on sheer determination and long hours, without mentorship. Hard work may lead to relative security in employment, but not necessarily a career. Career development takes mentorship, lots of it, and mentorship is often hard to get once residency is completed. In the academic realm, this might be someone to help the new attending in research and in developing excellence in teaching and clinical skills. In a group or private practice, mentorship helps the newcomer to develop a clinical niche in the community, to network with other clinicians, and to stay active in local and national organizations.

Early career psychiatrists (ECPs) may need more than one mentor in order to develop the many facets of a career. For example, one psychiatrist may provide the best information and guidance in developing a career in research, but may be a poor mentor at staying active politically. Further, the needs for mentorship change as careers progress, and someone who is a good mentor today may be less helpful in the future.

So what’s the problem? It’s lack of mentorship availability. Psychiatrists leave the nest of residency every year, flying off on uncertain wings to jobs and programs across the country. Many seek out mentors, but few are fortunate enough to find them. Why? Because mentoring is a burden, sometimes with only intangible rewards. In academia there are people available to act as mentors if someone wants do what they do. This helps bring in grant funding for more research by the group – this a situation that does have tangible rewards for the mentor. But what about advising a junior colleague on his or her career in private practice? Would-be mentors are torn between a desire to assist their younger colleagues and the need to do more work in their own practices to keep up with the ever-increasing burdens of managed care.

For some, membership in professional organizations, such as the APA and the MPS, provides an opportunity to find mentors. The APA has put great effort into recruiting early career psychiatrists, but the system still relies on the efforts of the new members to find the services and opportunities for participation. Mentors can guide ECPs to participate in the APA. Individual mentorship of ECPs by organizationally active members needs to be the rule, rather than the exception. Efforts at the state and national levels must be made to bring ECPs into leadership roles, ensuring the promise of qualified national leadership in the future.

Come on, all of you experienced psychiatrists, answer the want ad!