Paying it Forward

Ronald Hoffman, MD
Professor of medicine in hematology and medical oncology at Icahn School of Medicine at Mount Sinai in New York

In this issue, we speak with Ronald Hoffman, MD, winner of a 2017 ASH Mentor Award. Dr. Hoffman is professor of medicine in hematology and medical oncology at Icahn School of Medicine at Mount Sinai in New York.

Why did you become a mentor?

I became a mentor because I was awed by the individuals I was fortunate enough to consider as my own mentors. Mentorship was my way of giving back: I wanted to do for others what was done for me and pass on the lessons I learned.

Who are your role models in mentorship?

As a student at the New York University School of Medicine, I took a hematology course organized by Robert Silber, MD, and Simon Karpatkin, MD, that captured my imagination. It hooked me on the discipline of hematology, which seemed to be a perfect marriage of pathology and clinical medicine. The teaching was outstanding, incorporating personalized instruction during laboratory sessions.

My time at New York University put me in contact with many outstanding academic physicians, and I quickly realized that I wanted to follow in their footsteps. The challenges and surprises of academic medicine best suited my personality.

I owe much of my early success to the efforts of two individuals: Ralph Zalusky, MD, and Esmail Zanjani, PhD, with whom I worked as a fellow at the Mount Sinai School of Medicine.

Dr. Zalusky made hematology an exciting discipline. When going over cases and reading marrows with fellows, he asked direct questions and had high standards. He had a fantastic wit and, best of all, was an expert joke-teller. Dr. Zanjani introduced me to the laboratory and taught me how to pipette. Most importantly, he introduced me to hematopoiesis and gave me the freedom to use his laboratory to explore hematologic diseases. He was a free spirit who taught me that work could be fun – if it was the correct work.

I also worked for a year with Louis Wasserman, MD, a legendary figure in American hematology. During that critical year, I worked in the laboratory and made daily rounds with him as he saw patients with myeloproliferative neoplasms. The rounds featured enlightening discussions about the group of diseases and their likely origin at the stem-cell level; that was where I realized that I could apply my growing interest in hematopoiesis to clinical medicine by focusing on those hematologic malignancies. Dr. Wasserman was a tough and gruff taskmaster, and he lit a fire under me. He taught me how to truly care for patients at a personal level. His passion was contagious, and he also taught me to appreciate art – his interest outside of work.

After fellowship, I was recruited to the hematology section at Yale University by Bernard Forget, MD, who was just beginning his tenure as section head. Dr. Forget offered a primer on achieving success in academic medicine: He helped me set up my laboratory, hire my technician, and write my papers. He widened my perspective of how high-quality laboratory research could impact patient care, and he insisted I submit grant after grant to fund my research. He was a mentor and friend who was there for me in the good times and bad. Seeing him with his wonderful family also made me appreciate the importance of such a foundation.

Because my work with Dr. Forget introduced me to a steady stream of talented fellows to work in my laboratory, he also indirectly showed me the benefits of mentorship: The successes of those fellows brought me a degree of joy that frequently exceeded what my individual work brought me.

“It [can be] difficult
for trainees to
confidently make
long-term plans.
Mentors should
serve as resources
to assure them
that there is a path

What qualities make a great mentor?

Each trainee has his or her own unique set of strengths and weaknesses. Mentors need to identify and nurture those strengths to best guide mentees down a focused path toward excellence.

As mentors, we also need to identify individuals whose careers are not going to be enhanced by working in our programs. By no means does this does mean they are less talented; it means that they just aren’t a good fit. Encouraging such individuals to consider alternative opportunities can be tough, but upfront honesty benefits everyone involved.

How has your approach to mentoring changed over the years?

My method of mentoring has evolved as our society and the culture of medicine have changed. My experiences working in academia, industry, and clinical practice during my career exposed me to the wide variety of career opportunities available to today’s trainees – many of which were not always apparent to me at the beginning of my career.

Rather than solely preparing individuals for positions within the traditional academic model, as might have sufficed earlier in my career, I have come to appreciate that success for a trainee can come in many different forms. I have trained individuals who have remained in academia, entered industry, started private practices, worked as administrators, or even started companies.

Given my own varied career history, I encourage trainees to take chances with their career choices. After my attempt at industry, I returned as an academic administrator but eventually shed my administrative role to pursue my real loves: laboratory-based and clinical research. It took me time to figure this out; trainees should take time to find the area where they can flourish.

“Our goals as mentors should not be just to have more trainees in our programs or laboratories, but to develop trainees to their fullest potential and move them on to successful careers.”

What lessons would you pass on to fellow mentors?

I would advise them to have an open mind when interacting with trainees – don’t be prematurely judgmental. Mentors should take their roles seriously. My trainees have been and continue to be uniformly talented individuals who have placed their careers in my hands; our fates will always be linked. If you choose to take on this serious responsibility, you need to be available on a day-to-day basis.

Our goals as mentors should not be just to have more trainees in our programs or laboratories, but to develop trainees to their fullest potential and move them on to successful careers.

We also have the important responsibility of making the training period fun. A few laughs lighten things up and lead to a healthier environment.

What has mentoring taught you?

Mentoring has taught me to be respectful of the choices trainees make. Trainees’ goals and objectives might not overlap with yours, but you can learn a lot by just listening.

I also have gained an appreciation for the tremendous contributions that foreign-trained physicians and scientists make to the hematology community. These are individuals who make enormous personal sacrifices to come to our country; I am inspired by their work ethic, enthusiasm, intellect, and perseverance. Working with these individuals has been an enriching experience, and I take special pride in their successes.

Finally, I have learned that everyone at some time needs a vacation to recharge. This may seem obvious, but I have seen too many individuals burn out without these vital breaks.

What are some unexpected challenges of mentoring?

In the early phases of my career, I didn’t fully appreciate the complexity of emotions that trainees encountered during the period we worked together. I was trained in an era when the senior faculty was largely revered – and behaved in a dictatorial fashion at times. That just does not cut it in today’s world. Showing kindness and consideration is a more effective strategy than being heavy-handed.

Trainees’ outside commitments are growing – they are often starting families, for instance – and I have learned that individuals are most successful when they are given the flexibility to accommodate both their day-to-day challenges at home and their responsibilities at work.

Unpredictable research funding or compensation for health-care delivery can make it difficult for trainees to confidently make long-term plans. Mentors should serve as resources to assure them that there is a path forward. I continue to believe that the good guys win in the end!