Mentorship and rural medicine practice: Supporting the mental health of rural medical students and junior doctors
Main Article Content
Abstract
The transition from medical student to first-year doctor is widely acknowledged as one of the most challenging periods in a medical career. High rates of transition failure, mental ill health, and suicide are often reported among early-career doctors, with those working in rural medicine potentially at even higher risk due to additional challenges such as professional isolation, limited resources, and demanding workloads. Mentorship has emerged as a critical form of support for medical students and doctors. However, rural healthcare organizations often struggle to find qualified mentors due to time constraints, limited institutional resources, and the high operational costs associated with formal programs. Research has shown that mentorship can take multiple forms, each with its own advantages and challenges. While traditional one-on-one peer mentorship may be the preferred option, exploring non-traditional types of mentorships (e.g., self-mentoring, online mentorship, and non-faculty individual or group support) and identifying the best fit may offer a more convenient and cost-effective way to support rural doctors. Overall, mentorship is important for the mental health of doctors, and rural healthcare organizations can foster a more competent, resilient, and mentally healthy workforce by encouraging rural doctors to engage in mentorship programs.
Keywords:
Mentorship, rural medicine, mental health, well-being, resilience, selfcare, peer support
Article Details
How to Cite
KOKAVEC, Anna.
Mentorship and rural medicine practice: Supporting the mental health of rural medical students and junior doctors.
Medical Research Archives, [S.l.], v. 13, n. 5, may 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6548>. Date accessed: 21 june 2025.
doi: https://doi.org/10.18103/mra.v13i5.6548.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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12. World Health Organization. Addressing health inequities among people living in rural and remote areas. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO https://www.who.int/activities/addressing-health-inequities-among-people-living-in-rural-and-remote-areas. Accessed 23 April 2025.
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18. Zerzan J, Hess R, Schur E, Phillips R, Rigotti N. Making the most of mentors: A guide for mentees. Acad Med 2009;84(1):140–44.
19. Weng H, Huang Y, Tsai C, Chang Y, Lin E, Lee Y. Exploring the impact of mentoring functions on job satisfaction and organizational commitment of new staff nurses. BMC Health Services Research 2010; 10: 240. DOI link, PMid:20712873
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23. Holland E. "Mentoring communities of practice: what’s in it for the mentor?", International Journal of Mentoring and Coaching in Education 2018; 7(2): 110-126. https://doi.org/10.1108/IJMCE-04-2017-0034
24. Cruess, Richard L. MD; Cruess, Sylvia R. MD; Steinert, Yvonne PhD. Medicine as a Community of Practice: Implications for Medical Education. Academic Medicine 93(2):p 185-191, February 2018. | DOI: 10.1097/ACM.0000000000001826
25. Stoller, A. Traditional and Critical Mentoring. Radical Teacher 2021;119: 52–60. https://doi.org/10.5195/rt.2021.765
26. Mohd Noor NF, Zulkifli Z, Ramli RA, Fariz M. Reinventing Mentorship: From Traditional One-on-One Mentoring to Self-Mentoring. International Journal of Research and Scientific Innovation 2024;11:99-107.
27. Musgrove E, Bil D, Bridson T, McDermott B. Australian healthcare workers experiences of peer support training during COVID-19: Hand-n-hand peer support. Australian Psychiatry 2022;30(6): 722-727.
28. Oak S, Glickman C, McMackin K. Near-peer Mentorship: Promoting Medical Student Research With Resident Pairing. J Med Educ Curric Dev. 2025 Mar 17;12:23821205251329659. doi: 10.1177/23821205251329659. PMID: 40103580; PMCID: PMC11915252.
29. Akinla O, Hagan P, Atiomo W. A systematic review of the literature describing the outcomes of near-peer mentoring programs for first year medical students. BMC Med Educ. 2018.
30. Oliveira R. Group mentoring in practice. Journal of New Librarianship 2018; 3(2):375–378. https://doi.org/10.21173/newlibs/5/20
31. Khatchikian, A.D., Chahal, B.S. & Kielar, A. Mosaic mentoring: finding the right mentor for the issue at hand. Abdom Radiol 2021;6: 5480–5484. https://doi.org/10.1007/s00261-021-03314-2
32. Wallis JAM, Riddell JK, Smith C, Silvertown J, Pepler DJ. Investigating patterns of participation and conversation content in an online mentoring program for Northern Canadian youth. Mentoring and Tutoring: Partnership in Learning 2015; 23(3): 228-247. DOI link
33. Young L, Kent L, Walters L. The John Flynn Placement Program: Evidence for repeated rural exposure for medical students. Aust J Rural Health 2011;19(3):147– 53.
34. National Rural Health Alliance. Rural Australia Medical Undergraduate Scholarship. Deakin, ACT: National Rural Health Alliance, 2015. Available at ramus.ruralhealth. org.au.
35. Sharma, G, Narula, N, Ansari-Ramandi, M, & Mouyis, K. The Importance of Mentorship and Sponsorship: Tips for Fellows-in-Training and Early Career Cardiologists. Journal of the American College of Cardiology Case Reports, 2019 Aug, 1 (2) 232–234.https://doi.org/10.1016/j.jaccas.2019.06.007
36. Peifer J S, Lawrence E C, Williams J L, Leyton-Armakan J. The culture of mentoring: Ethnocultural empathy and ethnic identity in mentoring for minority girls. Cultural Diversity and Ethnic Minority Psychology 2016; 22(3): 440-6. https://doi.org/10.1037/cdp0000078
37. Dyrbye LN, Thomas MR, Eacker A, Harper W, Massie Jr FS, Power DV, et al. Race, ethnicity, and medical student well-being in the United States. Archives of Internal Medicine 2007; 167: 2103–2109.
38. Leahy CM, Peterson RF, Wilson IG, Newbury JW, Tonkin AL, Turnbull D. Distress levels and self-reported treatment rates for medicine, law, psychology and mechanical engineering tertiary students: Cross-sectional study. Australian and New Zealand Journal of Psychiatry 2010;44:608–615.
39. Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA 2016; 316: 2214–2236.
40. Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Medical Education 2016; 50:132–149.
41. Hu KS, Chibnall JT, Slavin SJ. Maladaptive perfectionism, impostorism, and cognitive distortions: Threats to the mental health of pre-clinical medical students. Academic Psychiatry 2019; 43: 381-385.
42. Winderbaum J, Coventry LL. The benefits, barriers and facilitators of mentoring programs for first-year doctors: A systematic review. Med Educ. 2024;58(6): 687‐696. doi:10.1111/medu.15299.
43. Chanchlani S, Chang D, Ong JS, Anwar A. The value of peer mentoring for the psychosocial wellbeing of junior doctors: a randomised controlled study. Med J Aust. 2018;209(9):401-405. doi: 10.5694/mja17.01106.
44. Sng JH, Pei Y, Toh YP, Peh TY, Neo SH, Krishna LKR. Mentoring relationships between senior doctors and junior doctors and/or medical students: a thematic review. Med Teach. 2017;39(8):866-875. doi:10.1080/0142159X.2017.1332360
45. Ong J, Swift C, Magill N, et al. The association between mentoring and training outcomes in junior doctors in medicine: an observational study. BMJ Open. 2018;8(9):e020721. doi:10.1136/bmjopen-2017-020721.
46. Sambunjak D, Straus S, Marusic A. A systematic review of qualitative research on the meaning and characteristics of mentoring in academic medicine. J Gen Intern Med 2010;25(1):72–78.
47. Alliott R. Facilitatory mentoring in general practice. BMJ 1996;313(suppl): S2–7060.
48. Eley D, Baker P, Chater B. The Rural Clinical School Tracking Project: More IS better – Confirming factors that influence early career entry into the rural medical workforce. Med Teach 2009;31(10):e454–49.
49. Daly M, Perkins D, Kumar K, Roberts C, Moore M. What factors in rural and remote extended clinical placements may contribute to preparedness for practice from the perspective of students and clinician? Med Teach 2013;35(11):900–07.
50. Pethrick H, Nowell L, Paolucci EO, Lorenzetti L, Jacobsen M, Clancy T, Lorenzetti DL. Peer mentoring in medical residency education: A systematic review. Can Med Educ J. 2020 Dec 7;11(6):e128-e137. doi: 10.36834/cmej.68751. PMID: 33349761; PMCID: PMC7749692.
51. Darling LA. What to do about toxic mentors. Nurse Educator 1986 March;11(2):29-30.
52. Carr ML. The Invisible Teacher: A Self-Mentoring Sustainability Model. Center for teaching excellence, 2011.
53. Aquino J F, Riss R R, Multerer SM, Mogilner LN, Turner TL. A step-by-step guide for mentors to facilitate team building and communication in virtual teams. Medical Education Online 2022; 27(1). https://doi.org/10.1080/10872981.2022.2094529.
54. Oshiro J, Wisener K, Nash AL, Stanley B, Jarvis-Selinger S. Recruiting the next generation of rural healthcare practitioners: the impact of an online mentoring program on career and educational goals in rural youth. Rural and Remote Health 2023; 23: 8216. https://doi.org/10.22605/RRH8216.
55. Garringer M, McQuillin S, McDaniel H. Examining youth mentoring services across America: findings from the 2016 National Mentoring Program Survey. Boston, MA: MENTOR: The National Mentoring Partnership, July 2017.
56. Kokavec A, Harte J, Ross S. Student Support in Medical Education: What Does Evidence-based Practice Look Like? In Mental Health and Higher Education in Australia. 2022. Francis, A.P. & Carter M. Springer.
2. Shanafelt TD, Sloan JA, Habermann TM, The well-being of doctors, Am J. Med 2003; 114(6): 513–519.
3. Kumar S. Burnout and Doctors: Prevalence, Prevention and Intervention. Healthcare (Basel). 2016 Jun 30;4(3):37. doi: 10.3390/healthcare4030037. PMID: 27417625; PMCID: PMC5041038.
4. Dean W, Talbot S, Dean A. Reframing clinician distress: moral injury not burnout, Fed. Pract 2019; 36 (9): 400–402.
5. Hansen N, Jensen K, MacNiven I, Pollock N, D’Hont T, Chatwood S. Exploring the impact of rural health system factors on doctor burnout: a mixed-methods study in Northern Canada. BMC Health Serv Res 2021;21: 869. https://doi.org/10.1186/s12913-021-06899-y
6. Lespérance S, Anaraki NR, Ashgari S, Churchill A. Systemic challenges and resiliency in rural family practice. Canadian Journal of Rural Medicine 2022 Jul-Sep; 27(3): 91-98. DOI: 10.4103/cjrm.cjrm_39_21
7. Rohatinsky N, Cave J, Krauter C. Establishing a mentorship program in rural workplaces: connection, communication, and support required. Rural and Remote Health 2020; 20: 5640. https://doi.org/10.22605/RRH5640
8. Taherian, K, Shekarchian, M. Mentoring for doctors. Do its benefits outweigh its disadvantages? Medical Teacher 2008;30(4), e95–e99. https://doi.org/10.1080/01421590801929968
9. Seehusen DA, Rogers TS, Al Achkar M, Chang T. Coaching, Mentoring, and Sponsoring as Career Development Tools. Fam Med. 2021;53(3):175-180. https://doi.org/10.22454/FamMed.2021.341047.
10. Fishman JA. Mentorship in academic medicine: Competitive advantage while reducing burnout? Health Sciences Review 2021;1: 100004, ISSN 2772-6320, https://doi.org/10.1016/j.hsr.2021.100004.
11. Jakubik L, Eliades A, Weese M. Part 1: an overview of mentoring practices and mentoring benefits. Pediatric Nursing 2016; 42(1): 37-38.
12. World Health Organization. Addressing health inequities among people living in rural and remote areas. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO https://www.who.int/activities/addressing-health-inequities-among-people-living-in-rural-and-remote-areas. Accessed 23 April 2025.
13. Avon F, Fuata C. The health of our rural practitioners 2023. Rural Doctors Foundation: Rural and remote medical practitioners and community needs Research Report, 2024. https://ruraldoctorsfoundation.org.au/wp-content/uploads/2024/07/Rural-practitioner-health-report.pdf
14. Grossman SC. Mentoring in nursing: a dynamic and collaborative process. 2nd edn. New York, NY: Springer, 2013.
15. Rohatinsky N, Udod, S, Anonson J, Rennie D, Jenkins M. Rural mentorships in health care: factors influencing their development and sustainability. Journal of Continuing Education in Nursing 2018; 49(7): 322-328. DOI link, PMid:29939380
16. Fishman JA.Matrix mentorship in academic medicine: sustainability of competitive advantage, Biennial Review of Healthcare Management: Meso Perspectives in Advances in Healthcare Management 2009;8:155–171.
17. Fraser, J. (2016). Mentoring medical students in your general practice. Australian Family Doctor, 45(5), 270-273.
18. Zerzan J, Hess R, Schur E, Phillips R, Rigotti N. Making the most of mentors: A guide for mentees. Acad Med 2009;84(1):140–44.
19. Weng H, Huang Y, Tsai C, Chang Y, Lin E, Lee Y. Exploring the impact of mentoring functions on job satisfaction and organizational commitment of new staff nurses. BMC Health Services Research 2010; 10: 240. DOI link, PMid:20712873
20. Barrera, M., & Bonds, D.D. (2005). Mentoring relationships and social support. In Du Bois, D., & Karcher, M.J. (Eds)., Handbook of Youth Mentoring, pp. 133-142. Sage Publications. ISBN: 1452261709, 9781452261706
21. Ryan RM, Deci EL. Self-Determination Theory: Basic Psychological Needs in Motivation Development and Wellness. Guilford Publishing; 2017.
22. Merritt C, Daniel M, Munzer BW, Nocera M, Ross JC, Santen SA. A Cognitive Apprenticeship-Based Faculty Development Intervention for Emergency Medicine Educators. West J Emerg Med. 2018 Jan;19(1):198-204. doi: 10.5811/westjem.2017.11.36429. Epub 2017 Dec 18. PMID: 29383081; PMCID: PMC5785194.
23. Holland E. "Mentoring communities of practice: what’s in it for the mentor?", International Journal of Mentoring and Coaching in Education 2018; 7(2): 110-126. https://doi.org/10.1108/IJMCE-04-2017-0034
24. Cruess, Richard L. MD; Cruess, Sylvia R. MD; Steinert, Yvonne PhD. Medicine as a Community of Practice: Implications for Medical Education. Academic Medicine 93(2):p 185-191, February 2018. | DOI: 10.1097/ACM.0000000000001826
25. Stoller, A. Traditional and Critical Mentoring. Radical Teacher 2021;119: 52–60. https://doi.org/10.5195/rt.2021.765
26. Mohd Noor NF, Zulkifli Z, Ramli RA, Fariz M. Reinventing Mentorship: From Traditional One-on-One Mentoring to Self-Mentoring. International Journal of Research and Scientific Innovation 2024;11:99-107.
27. Musgrove E, Bil D, Bridson T, McDermott B. Australian healthcare workers experiences of peer support training during COVID-19: Hand-n-hand peer support. Australian Psychiatry 2022;30(6): 722-727.
28. Oak S, Glickman C, McMackin K. Near-peer Mentorship: Promoting Medical Student Research With Resident Pairing. J Med Educ Curric Dev. 2025 Mar 17;12:23821205251329659. doi: 10.1177/23821205251329659. PMID: 40103580; PMCID: PMC11915252.
29. Akinla O, Hagan P, Atiomo W. A systematic review of the literature describing the outcomes of near-peer mentoring programs for first year medical students. BMC Med Educ. 2018.
30. Oliveira R. Group mentoring in practice. Journal of New Librarianship 2018; 3(2):375–378. https://doi.org/10.21173/newlibs/5/20
31. Khatchikian, A.D., Chahal, B.S. & Kielar, A. Mosaic mentoring: finding the right mentor for the issue at hand. Abdom Radiol 2021;6: 5480–5484. https://doi.org/10.1007/s00261-021-03314-2
32. Wallis JAM, Riddell JK, Smith C, Silvertown J, Pepler DJ. Investigating patterns of participation and conversation content in an online mentoring program for Northern Canadian youth. Mentoring and Tutoring: Partnership in Learning 2015; 23(3): 228-247. DOI link
33. Young L, Kent L, Walters L. The John Flynn Placement Program: Evidence for repeated rural exposure for medical students. Aust J Rural Health 2011;19(3):147– 53.
34. National Rural Health Alliance. Rural Australia Medical Undergraduate Scholarship. Deakin, ACT: National Rural Health Alliance, 2015. Available at ramus.ruralhealth. org.au.
35. Sharma, G, Narula, N, Ansari-Ramandi, M, & Mouyis, K. The Importance of Mentorship and Sponsorship: Tips for Fellows-in-Training and Early Career Cardiologists. Journal of the American College of Cardiology Case Reports, 2019 Aug, 1 (2) 232–234.https://doi.org/10.1016/j.jaccas.2019.06.007
36. Peifer J S, Lawrence E C, Williams J L, Leyton-Armakan J. The culture of mentoring: Ethnocultural empathy and ethnic identity in mentoring for minority girls. Cultural Diversity and Ethnic Minority Psychology 2016; 22(3): 440-6. https://doi.org/10.1037/cdp0000078
37. Dyrbye LN, Thomas MR, Eacker A, Harper W, Massie Jr FS, Power DV, et al. Race, ethnicity, and medical student well-being in the United States. Archives of Internal Medicine 2007; 167: 2103–2109.
38. Leahy CM, Peterson RF, Wilson IG, Newbury JW, Tonkin AL, Turnbull D. Distress levels and self-reported treatment rates for medicine, law, psychology and mechanical engineering tertiary students: Cross-sectional study. Australian and New Zealand Journal of Psychiatry 2010;44:608–615.
39. Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA 2016; 316: 2214–2236.
40. Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Medical Education 2016; 50:132–149.
41. Hu KS, Chibnall JT, Slavin SJ. Maladaptive perfectionism, impostorism, and cognitive distortions: Threats to the mental health of pre-clinical medical students. Academic Psychiatry 2019; 43: 381-385.
42. Winderbaum J, Coventry LL. The benefits, barriers and facilitators of mentoring programs for first-year doctors: A systematic review. Med Educ. 2024;58(6): 687‐696. doi:10.1111/medu.15299.
43. Chanchlani S, Chang D, Ong JS, Anwar A. The value of peer mentoring for the psychosocial wellbeing of junior doctors: a randomised controlled study. Med J Aust. 2018;209(9):401-405. doi: 10.5694/mja17.01106.
44. Sng JH, Pei Y, Toh YP, Peh TY, Neo SH, Krishna LKR. Mentoring relationships between senior doctors and junior doctors and/or medical students: a thematic review. Med Teach. 2017;39(8):866-875. doi:10.1080/0142159X.2017.1332360
45. Ong J, Swift C, Magill N, et al. The association between mentoring and training outcomes in junior doctors in medicine: an observational study. BMJ Open. 2018;8(9):e020721. doi:10.1136/bmjopen-2017-020721.
46. Sambunjak D, Straus S, Marusic A. A systematic review of qualitative research on the meaning and characteristics of mentoring in academic medicine. J Gen Intern Med 2010;25(1):72–78.
47. Alliott R. Facilitatory mentoring in general practice. BMJ 1996;313(suppl): S2–7060.
48. Eley D, Baker P, Chater B. The Rural Clinical School Tracking Project: More IS better – Confirming factors that influence early career entry into the rural medical workforce. Med Teach 2009;31(10):e454–49.
49. Daly M, Perkins D, Kumar K, Roberts C, Moore M. What factors in rural and remote extended clinical placements may contribute to preparedness for practice from the perspective of students and clinician? Med Teach 2013;35(11):900–07.
50. Pethrick H, Nowell L, Paolucci EO, Lorenzetti L, Jacobsen M, Clancy T, Lorenzetti DL. Peer mentoring in medical residency education: A systematic review. Can Med Educ J. 2020 Dec 7;11(6):e128-e137. doi: 10.36834/cmej.68751. PMID: 33349761; PMCID: PMC7749692.
51. Darling LA. What to do about toxic mentors. Nurse Educator 1986 March;11(2):29-30.
52. Carr ML. The Invisible Teacher: A Self-Mentoring Sustainability Model. Center for teaching excellence, 2011.
53. Aquino J F, Riss R R, Multerer SM, Mogilner LN, Turner TL. A step-by-step guide for mentors to facilitate team building and communication in virtual teams. Medical Education Online 2022; 27(1). https://doi.org/10.1080/10872981.2022.2094529.
54. Oshiro J, Wisener K, Nash AL, Stanley B, Jarvis-Selinger S. Recruiting the next generation of rural healthcare practitioners: the impact of an online mentoring program on career and educational goals in rural youth. Rural and Remote Health 2023; 23: 8216. https://doi.org/10.22605/RRH8216.
55. Garringer M, McQuillin S, McDaniel H. Examining youth mentoring services across America: findings from the 2016 National Mentoring Program Survey. Boston, MA: MENTOR: The National Mentoring Partnership, July 2017.
56. Kokavec A, Harte J, Ross S. Student Support in Medical Education: What Does Evidence-based Practice Look Like? In Mental Health and Higher Education in Australia. 2022. Francis, A.P. & Carter M. Springer.