Mentorship as a concept has existed informally in medicine for a long time; however, it has increasingly become formalized as a crucial part of the professional and personal development within medical education. Traditionally, mentorship consists of an older, more experienced person guiding a younger mentee in developing the skills and knowledge necessary for their professional advancement. Within urology we have seen the creation of mentorship programs at the institutional, regional and national level. This is an important development, as mentorship has been linked to significant mentee benefits including facilitating specialty choice, career satisfaction and increased productivity.¹ There are numerous mentorship models that exist, such as the classical model, cascading mentoring, group mentoring, network mentoring, spot mentoring and virtual mentoring.² A more recent mentorship model that has been described is known as “reverse mentorship,” and it has potential benefits within medicine.

Reverse mentorship relies on the reversal of the traditional roles of mentor and mentee and abolishes the hierarchy inherent in this relationship. Typically, a younger specialist takes on the role of mentor to guide, assist or teach a more experienced mentee. This flipped relationship allows a more fluid 2-way learning process and can help to build social capital within the work place. The relationship is defined by a shared goal of collaboration and mutual learning as opposed to advancement of a single party as is typical in traditional mentorship.

Reverse mentorship developed largely in the technology and business fields. In 1999, Jack Welch, chief executive of General Electric, is said to have returned from a trip overseas and have ordered his senior staff to find junior mentors who could teach them computer skills.³ In rapidly developing technology fields, this was imperative so that the leaders at the top did not become out of touch with the reality on the ground. Studies in the technology and business literature suggest that reverse mentorship is particularly useful in fields with rapid transformation of technology, including social media.

The benefits of reverse mentoring are significant for both mentors and mentees. For the younger mentors it allows practice in providing honest feedback and mentorship, an opportunity to role model for more senior leaders, and improved workplace communication. Mentors benefit in exposure to new content and skills, increased research output,⁴ greater insight into workplace dynamics and renewed enthusiasm for a topic or task.

Reverse mentorship can also be used to advance minority voices, which may be absent among senior level staff members. This was done successfully to explore shortcomings within initiatives to increase diversity, equity and inclusion (DEI) at the NHS (National Health System) in the UK. Senior leaders in the NHS were paired with young minority staff who served as reverse mentors to them.⁵ Young mentors met one-on-one with the leaders and observed them in their departments. The aim was to use the insight gained to provide constructive feedback to the senior mentee to help them critically reflect on the “extent to which their behavior and department practices were effective or needed improvement.”⁵ This is an interesting use of reverse mentorship and encourages DEI initiatives as step-wise with gradual improvement over time. The more junior mentors felt that diversity and inclusion were skills that could be taught. On the other hand, this program did place the burden of making changes on the younger minority staff member, which can be very problematic if not done safely and in a secure, trusting relationship.

Within medicine we have many of the features that suggest reverse mentorship would be beneficial. Younger staff members are often more adept at the technology-laden delivery of modern medicine (eg electronic medical records and telehealth) and research methods/literature review.⁶ Current trainees and early career physicians have also championed physician well-being and novel medical education techniques. Learning from early career staff may be key to enhancing student engagement as we have seen an increased use of flipped classroom and social media use within medical education.⁷ Additionally, medicine remains hierarchical and regimented at many levels. There is a gap that exists between the younger “Millennial” staff and older “Boomer” leaders, which can create mismatched expectations.⁶ A JAMA op-ed article on “Mentoring Millennials” outlined this gap and suggested this can lead to conflict and unsuccessful mentorship relationships.⁸ Reverse mentorship provides a way to create mutual respect and learn together. Within medicine and urology specifically, it is also important to draw upon the diversity of younger staff members. Urology features a shifting demographic with under-represented minority and female urologists making up a greater proportion of early career providers.⁹ While we must be careful not to place the burden of DEI on underrepresented minorities, there is a lot to be gained by increasing the power of their voices.

Reverse mentorship is not without challenges. Inherent in the structure of reverse mentorship is a challenge to well-established power dynamics. There is a risk for a younger mentor to lack confidence. The goal is that by providing new and innovative knowledge to the relationship, the less experienced mentor is considered an equal to the more experienced mentee. However, this can fail and inhibit development of a successful mentorship relationship. Reverse mentorship will not be possible or appropriate in every situation or relationship. It is important when entering a relationship that challenges established hierarchy that expectations and goals are clearly set.

To have a successful reverse mentorship relationship, it is important that mutual trust and respect exist between mentor and mentee. An article about reverse mentorship in the technology field suggests 3 ground rules: 1) mentorship must be a 2-way street where insight flows in both directions, 2) co-create to have a tangible outcome of the mentorship relationship and 3) keep it informal by allowing an initial meaningful conversation to evolve into a substantive relationship.⁶ Reverse mentorship allows us to get fresh perspectives, improve diversity, challenge ingrained views and draw on the strengths of all members of the health care team.