A Conversation with Dr. John Ratelle

“If you really want to get the most out of mentorship, it’s important to be open about your limitations. Be curious, be willing to try and fail.”

Bio

John Ratelle, MD, is an Attending Physician in Hospital Medicine at Mayo Clinic and the Associate Program Director in the Internal Medicine Residency Program, where he focuses on systems-based practice. Dr. Ratelle has been extensively involved in resident education and mentorship from being a chief resident of his residency program to pursuing research in medical education, quality improvement and patient safety, and interprofessional teamwork. He has been recognized for Excellence in Clinical Teaching through many awards including Teacher of the Year in 2019 and the Laureate Award at Mayo. Dr. Ratelle is a member of the Gold Humanism Honor Society.

What role has mentorship played in your life’s journey?

“I’m a midwestern native, born and raised in Minnesota,” Dr. Ratelle began. “I’m actually an only child which probably influenced the role of mentors in my life a bit differently than it may have for people who have siblings. My parents are wonderful individuals. They certainly formed my life and taught me some great values and skills through my childhood, and through grade school, and up into college and beyond. But beyond that, looking outside of my house to mentors beyond my immediate family was important. People like my grandmother, who was a primary caregiver for me through much of my childhood, to family friends, and personal friends. Mentorship has been important certainly before I started my medical training, and obviously now into my medical career and to today.”

Mentorship is personal for Dr. Ratelle. “The word that comes to mind when I think about mentorship is fiduciary. For those that are listening, that term might sound vaguely familiar from business or accounting, but it kind of boils down to the concept of trust. It’s having a mentee’s best interest in mind and trying to give them advice to help them clarify and achieve their goals, even if they aren’t necessarily my goals.”

What is your advice to mentees who have not been able to find effective mentors?

“I try to encourage learners to think about what their objective is when they’re seeking out a mentor. And that it’s okay to have different mentors for different purposes.”

“Take the time to make sure it’s the right fit.” One piece of advice Dr. Ratelle received and passes along to his mentees today is to enter into a new mentoring relationship with caution. “It’s okay to take time and just say, ‘Boy, this sounds like a great opportunity. Is it okay if I take the night to think about it and get back to you tomorrow?’”

“Sometimes just by the nature of power differential between mentor and mentee, the mentee may feel obligated to over commit to things during the first meeting. And that’s not a position that you want to be in. If the mentor is the right fit for you, they’re going to be there tomorrow. And if they try to pressure you into committing at the moment, that means they’re probably not the right mentor for you.”

What are some of the biggest challenges that you see in resident education today?

“I think one of the biggest challenges is the switch in mindset from being a student who’s focused on short term objectives to the lifelong learner, who is always trying to get better. And part of being a lifelong learner and being an effective mentee is a willingness to be vulnerable and to admit our limitations and not play our cards so close to the vest.”

“If you really want to get the most out of mentorship, it’s important to be open about your limitations. Be curious, be willing to try and fail. I would encourage people to be open with their attendings upfront to say, ‘Hey, we’re just working together or meeting each other for the first time on the wards and the clinic. Here are the things that I want to work on. Here are the things that I’m struggling with.’ To be open and honest with them because that’ll really help target the feedback that you get from your supervisors to make your experience the best it can be.”

What are the key traits and habits of the most successful residents?

“If I had to label three, I would probably say number one is the growth mindset. I would encourage those that are not familiar with the growth mindset to look up the work of Dr. Dweck. It’s really informative of just the way that we view the world and our skills and abilities, and always wanting to be better, and trying to improve ourselves and resilience.”

“I think the second would be curiosity, and that sort of bridges both our external curiosity and about just what we’re interested in, but also our gaps of, ‘Hey, I don’t know what this is. Can you explain that to me?’”

“And then number three is just compassion. Compassion to our colleagues, to our patients, to our community, to ourselves. Medicine is a long game. And we can always get better. And as long as we’re doing our best for ourselves and our patients and our colleagues and our society, that’s all we can ask.”

What’s one thing that you wish you knew when you started medical school or residency?

“One thing that I wish I knew was if I’m feeling uncertain about something, or I don’t know something, the odds are that someone else is feeling the same. And to be the one to just label it. I wish I would have done that more.”

“So often, I was afraid of looking foolish or being wrong. But over time, I’ve come to recognize that we all make it to this stage in training because we’re intelligent and thoughtful people. And probably, it’s not just me being an idiot. It can really be endearing to say, ‘You know what? I don’t get this. It just doesn’t make sense to me,’ or ‘Can you guys help me out with this?’”

Pearls of Wisdom

1. Develop a growth mindset. Be open to failure and use it as a stimulus for change.
2. Identify your area of weakness. Ask yourself tough questions “What is the hardest part of my day? What don’t I look forward to? And what’s my action plan for it?”
3. Be open and honest with your mentors. Know that this is something they will generally appreciate and embrace.