Anemia In Academia: Part 6 - Erosion of mentorship (#543)

Force #6: The disappearance of apprenticeship.

There are things you learn from books.

And there are things you only learn standing beside someone.

How to feel the difference between a tense abdomen and a painful one.

How to enter a stall quietly so a nervous horse doesn’t startle.

How to pause - just long enough - before speaking to a worried owner.

No textbook teaches that pause.

Someone shows you.

And you carry it for the rest of your life.

When I think back to my own formation as a veterinarian, what I remember most clearly is not lectures or exams.

It’s the people.

Donald Sinclair (Siegfried) striding ahead of me across a muddy field, coat collar turned up against the wind, saying little but noticing everything.

Alf Wight (James Herriot) lingering with a farmer long after the clinical work was done, asking about the family, the weather, the lambing season, understanding that care extended beyond the animal.

I learned medicine from them, of course.

But more than that, I learned how to be a veterinarian.

How to stand.

How to listen.

How to decide.

It was apprenticeship.

Hand to hand.

Eye to eye.

Mentorship used to be the quiet heartbeat of academia.

Not scheduled. Not measured. Not assigned.

It simply happened.

You followed someone.

You watched.

You asked questions.

You absorbed the small, almost invisible habits that make up professional craft.

A raised eyebrow.

A gentle touch.

A moment of restraint when intervention wasn’t needed.

These were not competencies.

They were inheritances.

Passed down the way skills have always been passed down.

By proximity.

Now I walk through teaching hospitals and see something different.

Everyone is busy.

Always busy.

Faculty rushing between clinic and meetings.

Residents buried in documentation.

Students moving in packs from rotation to rotation, each stop shorter than the last.

No one lingers.

No one has time to simply watch.

Learning has become compressed.

Transactional.

Efficient.

We have optimized exposure.

But we have lost immersion.

And immersion is where mentorship lives.

I sometimes ask residents, “Who do you follow?”

Not formally.

Not who signs your evaluation.

Who do you shadow because you admire how they practice?

Often there’s a pause.

Then a polite answer.

But I can tell what’s missing.

They don’t have that person.

Not because the faculty don’t care.

Because the system doesn’t allow it.

Schedules are too tight.

Clinical loads too heavy.

Metrics too demanding.

The day is chopped into fragments.

And mentorship requires something we rarely protect anymore:

Unstructured time.

You cannot rush mentorship.

It happens in the spaces between tasks.

Walking to the next barn.

Driving between calls.

Standing quietly at the end of a surgery while the instruments are counted.

It happens when someone says, “Stay a minute and let me show you something.”

Those minutes are gold.

They are also the first thing bureaucracy and burnout steal.

Because they look inefficient.

Unproductive.

Unmeasurable.

And so, they disappear.

Quietly.

The consequences are subtle at first.

Graduates are competent.

Technically skilled.

They can intubate.

They can diagnose.

They can follow protocols.

But something feels thinner.

Less confident.

Less grounded.

Because real clinical judgment comes from watching hundreds of small decisions made by someone experienced.

Not from slides.

Not from modules.

From presence.

Without that presence, young clinicians feel alone sooner.

And feeling alone is one of the fastest ways out of academia.

Mentorship also nourishes the mentor.

We don’t talk about that enough.

Some of the most meaningful moments of my career were not publications or grants.

They were standing beside a student who finally understood.

Watching a resident perform a procedure smoothly for the first time.

Receiving a letter years later that began, “You probably don’t remember this, but you once told me…”

Of course I remembered.

Those moments are the real currency of academic life.

Take them away, and the job becomes just work.

And if it’s just work, the private sector will always win.

There is a particular sadness in losing mentorship.

Because unlike money or bureaucracy, it isn’t imposed from outside.

It erodes from neglect.

No one votes to eliminate it.

No memo announces its end.

We simply schedule ourselves so tightly that it cannot breathe.

Until one day we look around and realize:

No one is walking the halls together anymore.

Everyone is hurrying past each other.

When I think of the best days of my career, they almost always involve another person at my elbow.

A student.

A resident.

A colleague.

Medicine practiced together.

Stories shared.

Mistakes discussed openly.

Craft passed along like a well-worn instrument.

That is the university at its best.

Not a collection of metrics.

Not a set of policies.

But a community of teachers and learners, side by side.

Money may tempt people away.

Bureaucracy may slow them.

Burnout may exhaust them.

Loss of autonomy may discourage them.

Metrics may drain meaning.

But the loss of mentorship does something even quieter.

It removes the glue.

The human connection that makes staying worthwhile.

Without it, academia becomes lonely.

And lonely places do not keep people long.

If we want to restore strength to our institutions, the solution may be surprisingly simple.

Not another dashboard.

Not another strategic plan.

Just time.

Time to walk with a student.

Time to talk after a case.

Time to say, “Come with me and let me show you how I do this.”

Protect those minutes.

Guard them fiercely.

Because they are where the profession truly lives.

In Part 7, I want to explore the emotional consequence that follow when meaning, autonomy, and mentorship all thin out together.

Something deeper than burnout.

Something closer to heartbreak.

Moral injury.

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