What is the Role of a Mentor?

Guest post by Karmen S. Williams, DrPH, MBA, Assistant Professor at City University of New York Graduate School of Public Health and Health Policy, and Meera G. Subash, MD, Assistant Professor and Division Quality Officer for the Division of Rheumatology at the University of Texas Health Science Center, McGovern Medical School.

“Everyone, at every point in their career, has the potential to be a mentor as well as [to] seek a mentor. It is the combination of being and doing in mentorship that makes it such a rewarding and important part of a professional career.”

Medical informatics pioneer and NLM Director Patricia Flatley Brennan, RN, PhD, recently spoke these words when she joined us for a special podcast hosted by the American Medical Informatics Association (AMIA)—a crossover episode between For Your Informatics, led by the Women in AMIA Initiative, and ACIF Go-Live, directed by the AMIA Clinical Informatics Fellows.

Bryan McConomy, MD, began our inaugural episode with an introduction to medical informatics, highlighting the early work of Dr. G. Octo Barnett and his team’s development of the MUMPS integrated programming language at Massachusetts General Hospital in the 1960s. Being a relatively young field, we can look to the trailblazers who first used computers to augment clinical decision-making and improve health care discovery and delivery. We pay homage to the rich tapestry of innovative leaders and educators, such as Homer Warner, MD, PhD; Reed Gardner, PhD; Clement McDonald, MD; Margo Cook, RN; Lawrence Weed, MD; and Edward Shortliffe, MD, PhD, to name a few.

We started the History of Medical Informatics joint podcast series with those two AMIA podcasts with the understanding that we need to connect our past with the present. This ongoing series catalogs this history through the eyes of pioneers in the field of health informatics. By highlighting how historical events merge with contemporary topics of interest in health informatics, we intend to strengthen the bridge for new and upcoming professionals both in and outside of informatics.

In our episode titled “History of Medical Informatics – Mentorship” with Dr. Brennan, we focus on how mentorship was established in a field that, until recently, was virtually nonexistent. Dr. Brennan was not only our first guest on the joint series, but she was also featured in a March 2020 episode of For Your Informatics titled “Training the Next Generation of Informaticians,” which also offers valuable information on mentorship. She has been a full-circle guest by highlighting the past, present, and future of mentorship in health informatics.

Dr. Brennan will also be our keynote speaker at this week’s 2022 AMIA Clinical Informatics Conference, which will give us an opportunity to reflect on the real meaning of mentorship. What is mentorship? How did health informatics pioneers build mentorship in a new and novel field? What is the role of a mentor?

Dr. Brennan recalls some of the best parts of her mentorship experience, including having the freedom to explore, engage with like-minded individuals, establish trust, push boundaries beyond your starting point, and open new doors. Mentors are there for your failures in life, for the deeply embarrassing moments, and to help pick you up when you hit a bump in your career.

However, not all mentorships are created equal. There are some that are lifelong, while some are short term. Some aren’t always mutually beneficial, while others are mutually uplifting. Some mentors come from other fields, while others may be in the same field. The commitment to mentorship may be formalized or just a passing activity.

The style of mentorship can also vary. Some may bring a mentee into a research group to work side by side with them while some may only have periodic conversations. Either way, the mentor must be ready and willing to go through the process.

We’d like to share some wisdom we’ve received over the years: seek out people for a cup of coffee and find someone with whom you can share your successes and challenges. This is important because not all skills are learned in the classroom. For example, academicians need to know how to interpret faculty governance, engage with management, and position research and teaching. Dr. Brennan points out that “these things are difficult to learn on your own, and that’s where mentors can come in.”

The point is that mentorship must be purposeful and built on the trust needed to guide the direction of mentees’ careers and important life choices. It is a decision that should not be taken lightly. Mentorship in any arena is pertinent to career development, but it is especially valuable in groundbreaking fields like health informatics.

What is the best advice you’ve received from a mentor?

Headshot of Dr. Karmen S. Williams.

Dr. Williams completed a post-doctorate fellowship in public and population health informatics at Indiana University and Regenstrief Institute, where she focused on systemic informatics integration. Dr. Williams serves as the director of AMIA’s For Your Informatics podcast, which features individuals at all career stages to reveal the diverse world of biomedical and health informatics professions. She is a member of the AMIA Diversity, Equity, and Inclusion Committee; Women in AMIA Pathways Subcommittee; and AMIA Dental Informatics Working Group.

Headshot of Dr. Meera G. Subash.

Dr. Subash received her undergraduate degree from Stanford University and her medical degree from Texas Tech University Health Sciences Center School of Medicine. She continued to University of California San Francisco to complete both her Rheumatology and Clinical Informatics Fellowships. She is Epic Physician Builder certified, and her interest area is implementing and evaluating health IT and electronic health record tools to improve patient care in rheumatology and ambulatory care.

Please Join Us in Honoring Milton Corn, MD

This blog post is based on remarks given at the May 17 Milton Corn Memorial Concert.

Yesterday, I was honored to join in a beautiful celebration for the life of Dr. Milton Corn, an amazing man who I regarded as my adviser, colleague, and—most importantly—my friend. I would like to thank his wife Gilan and all of Milt’s friends and family for creating that wonderful moment of togetherness. Many of us knew Milt when he was Dean of the School of Medicine at Georgetown University or in his role with the National Library of Medicine, and I suspect that some even knew him as a bon vivant around town!

While I’m sure many of you can remember the moment you met Milt, I actually can’t—in my mind, it seems like he was an ever-present professional of the big data and scientific technology community! As a newly minted PhD in the late 1980s/early 1990s, I remember Milt as eminent in our field… and that was 30 years ago! I got to know Milt as part of the medical informatics community that was just emerging as a research powerhouse. Milt was a mentor to me; he reached into the visions I had for—and breathed life into—the ways technology could support patient engagement. He was always supportive, but he was also a hard questioner who wanted to know the value of the community’s investment.

Milt brought so many gifts to the field of biomedical informatics. He brought his wisdom as a physician executive to a fledgling field, applying his gentle but direct guidance to inspire research in the domain. Milt also funded my research; I remember a phone call one August afternoon over 20 years ago when Milt said, “Do you still need money for this project? Because we have some end-of-year money for you, and it’s available if you want to use it,” which of course let us advance our original ComputerLink project.

Interestingly enough, I actually know very little about Milt’s role at NLM, although I know a lot about his contributions! He joined our beloved NLM in 1990 during the first decade of applying computer technology to health care, in support of Don Lindberg’s visionary leadership. Milt served as NLM’s ambassador to the broader academic and research community as both their instigator and a supporter of many novel research ideas. Milt was in love with ideas, but he never let that love cloud his judgment or interfere with his expectation that emerging fields needed good science. He was as enchanted with a novel approach to genetic analysis as he was with securing proposals to write important books that detailed the history of medicine.

Milt became a colleague, a trusted advisor, and someone I could talk with about biomedical informatics. We could laugh about the field while enjoying its growth. Later, Milt became my friend. We shared family stories, our love for our children, and the challenges we faced with them. I loved his humor—he had the best sardonic laugh in the world. And then, surprise of all surprises, Milt became my employee, which had nothing to do with his actions, but with my actions! I remember being very mindful of Milt during my first NIH interview, where one of the committee members asked what it was going to be like for me, and I said I’m now going to be the boss of someone who I felt that I have learned from my whole career… it’s going to be fabulous!

Not that it wasn’t daunting; for 25 years, my career success depended on Milt! And he was wise: on my first day on the job, Milt stopped by with a little gift—a bag of peanut M&Ms! What a way to level the playing field. Sometime during those first few weeks, Milt came to my office and said, “Anytime you need my desk for someone else, you just let me know, and I’ll go home.” Every year he would say that sentence, and every year I thought not yet, I need you here. I couldn’t be without Milt, the magic maker.

After working more closely with Milt, I realized his judgment, discernment, and incredibly keen sense of what was a good investment—and, more importantly, what wasn’t—were critical to how NLM functioned. Later in our time at NLM, we needed a single scientific director to unify our intramural programs, and Milt took this responsibility on. Adding the title of Acting Scientific Director to his already stretched ambit, Milt aligned our two very strong intramural research groups: one addressing computational biology, and the other, clinical health informatics. He guided these two very disparate groups of investigators into a single structure… not totally unified, but respectful of each other and clearly willing to meet halfway across the bridge.

I turned to Milt many times as counselor to my position. Navigating the federal waters as director of a venerable institute like the NIH National Library of Medicine was a challenge—even for someone who thought herself quite sophisticated in dealing with complex organizations. Periodically, I’d walk over to Milt’s office, settle into one of his nice leather chairs, and lay out whatever issue I was confronting or a personality that perplexed me. Through a question or a brief comment, he led me to solutions, insights, and confidence, but none more so than the day he said, “Your job is important, and you deserve to have fun—so make sure that you do that!” I am brimming with tears as I remember how his strength made me strong!

In October of 2020, Milt told me that the pandemic was good for him. What an odd statement, I thought. However, he revealed that our maximum telework posture, with everyone working from home, eliminated the need for him to make the long commute from Virginia to Bethesda. Working from home made it possible for him to continue to engage. And engage he did! He remained a mentor all the way up until his very last weeks at the National Library of Medicine. I remember the night he called me and said, “I don’t think I can come back to work anymore,” but he reminded me, “You can call me if you need me.” I took his generous offer to heart and took it up as often as I could.

Above all, Milt was important to me, to the National Library of Medicine, and to the entire scientific and clinical world. Thank you.

Gearing Up for 2023 Part II: Implementing the NIH Data Management and Sharing Policy

This blog post is by Lyric Jorgenson, PhD, the Acting Director of the NIH Office of Science Policy. It was originally posted on May 12 on the NIH Office of Science Policy Under the Poliscope blog. We encourage you to read it and submit comments and feedback on the draft supplemental information to the NIH Policy for Data Management and Sharing: Protecting Privacy When Sharing Human Research Participant Data by June 27.

Sequels are all the rage these days.  I figure if Marvel can make endless “Avengers” movies, I could start making blog sequels.  Back in the beginning of the year, I wrote Part I of this blog series about how NIH is working to implement the new NIH Data Management and Sharing Policy (DMS Policy).  I mentioned at that time that additional resources were forthcoming.

I should note that when we started to receive comments on what was to become the NIH DMS Policy, one thing in particular stood out to us.  Many commentors told us it would be helpful to have clear information on how to protect the privacy and respect the autonomy of participants when sharing data.  Now, we all know that cliffhangers build anticipation, so without further delay, I want to share with you some of the tools NIH has been working on to answer that call.

First, if you have seen the Avengers movies, you likely will have noticed that they tend to introduce a new villain that the team needs to battle with either new tools (think of OSP with Thor’s Stormbreaker axe) or the help of new superheroes like Captain Marvel. While not exactly a new villain, the lack of consistent consent language to facilitate secondary research with data and biospecimens is certainly a challenge many of our stakeholders have raised and one that we thought we could help address.

NIH has a long history of developing consent language and, as such, our team worked across the agency – and with you! – to develop a new resource that shares best practices for developing informed consents to facilitate data/biospecimen storage and sharing for future use.  It also provides modifiable sample language that investigators and IRBs can use to assist in the clear communication of potential risks and benefits associated with data/biospecimen storage and sharing.  In developing this resource, we engaged with key federal partners, as well as scientific societies and associations.  Importantly, we also considered the 102 comments from stakeholders in response to a RFI that we issued in 2021.

As for our second resource, we are requesting public comment on protecting the privacy of research participants when data is shared. I think I need to be upfront and acknowledge that we have issued many of these types of requests over the last several months and NIH understands the effort that folks take to thoughtfully respond.  With that said, we think the research community will greatly benefit from this resource and we want to hear your thoughts on whether it hits the mark or needs adjustment.

When reviewing the document, please bear in mind that the main purpose is to provide researchers with information on:

  • Operational Principles for Protecting Participant Privacy when Sharing Scientific Data
  • Best Practices for Protecting Participant Privacy when Sharing Scientific Data
  • Points to Consider for Designating Scientific Data for Controlled Access

Comments on the draft will be accepted until June 27, 2022, and full information and how to submit a comment can be found here.

Finally, every sequel needs a twist ending! In November 2021, NIH published a request for comments on the future directions of the NIH Genomic Data Sharing Policy.  We are still reviewing the many points and perspectives that were raised, but while we consider next steps, the comments we received are now available on the OSP website.  Okay, so maybe that twist wasn’t as big as, say, Darth Vader revealing he is (spoiler alert) Luke’s father in The Empire Strikes Back, but it’s still pretty good for the science policy world.

With a little more than half a year left until the implementation date of the NIH DMS Policy, we will continue to provide updates and resources over the next several months.

Midnight in the Library

Right now, I am reading The Midnight Library by Matt Haig. It’s a fanciful story of a woman in limbo between life and death who finds herself in a magical library, and each book represents one of the lives she could have lived had she made even one tiny different decision. She then finds herself in many of these lives, experiencing what could have been.

This book got me thinking about how NLM helps people experience lives that could be. I see this on two levels:

The first is the scientific pathway: What if . . . ? What if we knew more about the interactions between evolutionary forces and molecular constraints (like the work of Aravind Iyer, PhD), or fully appreciated the potential of proteins for genome engineering (like the discoveries made by Eugene Koonin, PhD), or could envision how and why proteins fold or switch their folds (as explored by Lauren Porter, PhD), or had the power to enable machines to understand human thought (like the research from Dina Demner-Fushman, MD, PhD). In addition to the discoveries by our NLM intramural researchers, our vast literature and data repositories hold answers that could change lives: why some genetic structures lead to human characteristics, or why a certain biochemical compound helps prevent infection. We help scientists discover these pathways and connections by providing them with the tools to uncover what could be.

The second is how NLM helps people see their what if using the amazing richness of the resources that we make available through our collections. Our resources—which encompass clinical insights, medical information, care guidelines, and self-management—help clinicians determine how to care for people with complex diseases or diagnose an illness in a timely manner. Our repository of clinical information available through PubMed ensures that those in need can access well-reasoned, recognized guiding principles for their care, and our MedlinePlus web resource provides patients and their families and friends with reliable, up-to-date health information to support and encourage healthy behavioral changes.

As in The Midnight Library, books alone do not inspire discovery, guide clinical care, or inform self-management. In Haig’s novel, a fictional librarian who knows the collection shows the main character how to select books by carefully listening to her goals and needs. It is the main character’s engagement with the books that helps her explore the lives she could have lived. At NLM, we too have librarians—located in Bethesda, Maryland, and around the country through NLM’s Network of the National Library of Medicine—who organize the library’s collections and guide patrons toward the best choice of resources. Our resources must be findable, accessible, interoperable, reusable, and actionable! And then, the person—scientist, clinician, patient—must actively engage with the material.

As we approach the future of data-powered health, guided by the NLM Strategic Plan (2017-2027), we will fulfill our mission to collect biomedical literature, organize it, preserve it, and make it accessible to the world. As the knowledge of health and biomedicine continues to grow faster than we can process, we will turn our attention to applying emerging tools, including machine learning and artificial intelligence, to make it easier to find our materials and more efficient to examine them. Through our Extramural Programs, we will continue to stimulate new ways of presenting information to scientists, clinicians, patients, and the public so they can explore possible lives to be lived and test out their promise of better health for society. What lives can we help you explore?

Nursing in the Headlines

Every year, we celebrate National Nurses Week between May 6, which is National Nurses Day, and May 12, which happens to be Florence Nightingale’s birthday. If you haven’t picked up a specialty journal or public newspaper in the past few months, you may not know that nursing has made it to the headlines:


Some of us might argue that any press is better than none, and others might say it’s about time that the real story about nurses and nursing become better known. While I believe a little in both perspectives, the real reason I’m glad to see them today is that they depict a much richer, more valid, and more robust story about who and what nurses are and how they serve society.

A recent article in The New York Times stated, “A Shrinking Band of Southern Nurses, Neck Deep in Another Covid Wave.” This news story brings into national view the importance of small, nonprofit safety-net hospitals and the experience of the nurses who work there. Told without romanticizing nurses’ dedication or pointing out their long-suffering compassionate nature, this article tells of the real challenges faced by nurses who want to do good for their communities but are faced with persistent shortages, significant illnesses that could have been avoided, and politically motivated, bureaucratic financial decisions. However, it also tells of the creative problem solving demonstrated by these nurses as they try to meet patient needs and the compassion they provide to their colleagues as they continue, yet another day, to address the needs of many with fewer and fewer resources.

Look at the first three headlines: together, these depict a professional field dedicated to meeting the conditions of its social contract—to provide high-quality patient care—and awash with opportunities for outstanding career growth, and at the same time at risk of losing some of its critical workforce due to unrelenting stress in the workplace. What does this say about nursing? Never has there been such opportunity, but never has the opportunity promised so little.

A beautiful story in March in The New York Times, “Confronting Grief, With Margaret Atwood, in ‘The Nurse Antigone,’” which talks about regular nurses participating with Margaret Atwood in the reading of the play Antigone, provides me with hope and vision. In this rendition, Atwood will play the blind prophet Theophanes and the nurses will be part of the Greek chorus. This story of Antigone’s determination to bury her brother, who died in battle, despite a law forbidding the burial of traitors mirrors the challenges nurses face by attending to those in need despite enormous challenges in acquiring resources needed to provide care, including sufficient time. An ethicist quoted in the article remarks that Antigone’s triumph over Creon’s prohibitions provides an apt mirror of the moral injury with which nurses cope, neither romanticizing their decision nor despairing at their deplorable conditions.

The final headline in the middle of the pack heralds nurses’ awakening to their economic power. The COVID-19 pandemic didn’t create the traveling nurse sector of our profession, but it certainly accelerated its growth across the country. Individual remuneration soared, leaving many nurses with the dilemma to remain as a loyal worker in a long-served institution or move on for financial gain. Hospitals too faced the challenge of differential staff compensation, with highly paid traveling nurse staff working next to more modestly paid existing staff. Fortunately, the perversity of this economic structure has led to hospitals and clinics improving staff nurse compensation, attending to their work conditions, and stabilizing the staffing complement.

As we celebrate National Nurses Week this year, please join me in recognizing the vibrant, rich picture of our profession. We are not unbuffered by these challenging times, and as a profession, we are responding in a way that serves our patients while preserving our profession. Accepting new models of care, innovative career trajectories, and an expanded understanding of how to create compassionate workplaces promises a future in which all nurses can work to the top of their licenses. Let us know how we can help you do this, too!

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