Mentoring in medical residency: analysis of an experience in a public hospital in São Paulo

ABSTRACT

Introduction:   Although medical residency is considered the “gold standard” for specialization, this training often imposes physical exhaustion and emotional distress on residents. In this scenario, institutions have sought support strategies that promote the well-being and professional development of residents, such as mentoring, strengthening self-confidence and the integral development of the resident.

Objective:  To report on an experience and analyze, from the residents’ perspective, mentoring and the role of the mentor in a program implemented in the Medical Residency program of a large public hospital in the city of São Paulo.

Methodology:   A qualitative-quantitative, cross-sectional study with residents in internal medicine and general surgery. A questionnaire with open and closed questions was administered to 18 first-year residents. The closed questions were tabulated, and the open questions were submitted to content analysis, thematic modality.

Results:  Among the participants, 61.1% belonged to the medical clinic and 38.9% to general surgery; 44.4% performed paid work outside the residency. Most had male mentors from specialties other than their own. The degree of satisfaction of the resident physician with the mentoring program was predominantly positive, with 72.2% of them stating that mentoring provided educational support, with mentors showing concern/interest in their development. However, the impact of mentoring on professional conduct and future specialty choices fell short of expectations. Despite the positive perception, limitations were pointed out regarding the regularity of meetings, availability of time, and quality of communication, factors that compromise the full use of the training potential of mentoring in the Programs.

Conclusion:   Mentoring proved to be a relevant strategy for the personal and professional development of residents, favoring human and relational aspects in medical training. It is understood that investing in structured, evaluated, and inclusive mentoring programs is investing in the training of more competent, empathetic, and socially committed physicians.

Keywords:
Medical Residency; Mentorship; Education, Medical

RESUMO

Introdução:  Embora a residência médica seja considerada “padrão ouro” para a especialização, essa formação frequentemente impõe desgaste físico e sofrimento emocional aos residentes. Nesse cenário, as instituições têm buscado estratégias de suporte que favoreçam o bem-estar e o desenvolvimento profissional dos residentes como a mentoria, de modo a fortalecer a autoconfiança e o desenvolvimento integral deles.

Objetivo:  Este estudo teve como objetivos relatar uma experiência e analisar, sob a perspectiva dos residentes, a mentoria e o papel do mentor em um programa implementado na residência médica de um hospital público de grande porte no município de São Paulo.

Método:  Trata-se de um estudo qualiquantitativo, de corte transversal, realizado com residentes de clínica médica e cirurgia geral. Aplicou-se um questionário a 18 residentes do primeiro ano, com questões abertas e fechadas. Tabularam-se as questões fechadas, e as abertas foram submetidas à análise de conteúdo, modalidade temática.

Resultado:  Dentre os participantes, 61,1% pertenciam à clínica médica e 38,9% à cirurgia geral; 44,4% exerciam atividade remunerada fora da residência. A maioria possuía mentores do sexo masculino e de especialidades distintas da sua. O grau de satisfação do médico residente com o programa de mentoria foi predominantemente positivo. De acordo com 72,2% dos participantes, a mentoria propiciou apoio educacional, com mentores demonstrando preocupação/interesse em relação ao desenvolvimento dos residentes. No entanto, o impacto da mentoria na conduta profissional e na escolha futura de especialidade ficou aquém do desejado. Apesar da percepção positiva, foram apontadas limitações quanto à regularidade dos encontros, à disponibilidade de tempo e à qualidade da comunicação, fatores que comprometem o pleno aproveitamento do potencial formativo da mentoria nos programas.

Conclusão:  A mentoria mostrou-se uma estratégia relevante para o desenvolvimento pessoal e profissional dos residentes, pois favoreceu os aspectos humanos e relacionais na formação médica. Entende-se que investir em programas de mentoria estruturados, avaliados e inclusivos é investir na formação de médicos mais competentes, empáticos e comprometidos com a transformação social.

Palavras-chave:
Residência Médica; Mentoria; Educação Médica

INTRODUCTION

Medical residency (MR) is a period that represents more than just the aim of improving professional competence and training in a speciality; it is a possibility to acquire responsibility for professional acts, capacity for initiative, judgement and evaluation, as well as ethical standards and the development of a critical spirit for the practice of a medical speciality¹. Although considered the “gold standard” for training specialists, MR also causes physical exhaustion and emotional distress, not only as a result of the intense care activity, but also due to other factors such as overwork, low pay and inadequate working conditions².

In a study conducted at a public hospital in Santa Catarina, frequent conflicts were observed at the beginning of the MR, such as “moving to a new city, moving away from friends, expectations in relation to the residency and uncertainty about the new challenge³.” Faced with these challenges, institutions that offer Medical Residency Programmes (MRPs) have sought to develop strategies to support residents. Among these, mentoring stands out as a form of emotional, social and ethical support for the development of self-confidence and strengthening of the training process^4),(5.

Mentoring, although not a recent concept, demonstrates academic, psychological and professional benefits for both mentees and mentors⁶. It also contributes to institutional improvement, increasing professional performance, communication and organisational culture, with positive impacts for patients too^7),(8. Historically, a mentor is someone who guides decisions, supports personal and professional development and helps build a career path^7),(9.

The term “mentor” can be traced back to Homer’s Odyssey, in which Mentor is presented as responsible for the education and emotional formation of Telemachus, Odysseus’ son. In that context, Mentor acted as a genuine surrogate father. Similarly, in MR, the mentor is expected to prioritise the emotional and intellectual development of residents, preparing them for autonomous and safe medical practice¹⁰.

Studies show that mentoring programmes have a positive impact on resident training, supporting personal and professional growth⁵. In a systematic review, it was highlighted that mentoring provides essential psychosocial support, as well as motivating the development of academic and professional skills, although methodological heterogeneity makes more robust comparisons difficult¹¹. Another review, conducted in Canada and the United States and including structure, results and evaluation, identified weaknesses in the standardisation of programmes, insufficient evaluation tools, a shortage of qualitative studies and limited long-term evaluation data¹². A much-mentioned aspect is the training of mentors. A scoping review on mentor training in MR shows that structured training is a determining factor in the effectiveness of programmes, although it is still not very uniform and is not sufficiently assessed¹³.

The aim of this study is to report on the experience of implementing a mentoring programme in MR and to analyse, from the residents’ perspective, the role of the mentor in a large public hospital in the city of São Paulo.

METHOD

A mixed-methods, cross-sectional study was carried out to analyse a mentoring programme implemented in the MR at a public hospital in the city of São Paulo. The data collection instrument was a semi-structured questionnaire applied to residents taking part in the programme in 2024. The questionnaire contained socio-demographic information and specific questions about the residents’ experience with mentoring. The data was collected between May and July 2025, after signing the Informed Consent Form (ICF).

First-year resident doctors from the Internal Medicine (n = 13) and General Surgery (n = 10) programmes took part. In total, 18 residents answered the questionnaire (78.2%). Closed questions were tabulated and open questions were analysed using the thematic Content Analysis technique. The research followed the ethical principles defined by CNS Resolution 466/2012¹⁴ and was approved by the Research Ethics Committee of the Federal University of São Paulo (CAAE No. 82301424.0.0000.5505).

RESULTS

The mentoring programme

In 2022, the institution’s Medical Residency Committee (COREME) identified the need to expand support for residents, especially first-year residents, due to the impact of the COVID-19 pandemic on medical training, with the internship developed under different conditions. With the end of the state of emergency in public health in 2022, the need for new reception processes for residents became apparent. Thus, preceptors were invited to take part in a course on Interpersonal Communication in the Teaching Environment, where the mentoring programme was discussed and subsequently approved by the COREME Board.

The programme formally began in 2023, with seven mentors and a coordinator joining on a voluntary basis. Initially, residents with greater personal difficulties were invited to take part. In 2024, the programme began to be offered to all R1s, with compulsory participation for residents in Internal Medicine and General Surgery. Residents could nominate up to three mentors, and the pairings were made according to availability.

Registration took place via QR Code, with a choice of three mentors. Meetings are now scheduled directly between mentor and mentee, preferably face-to-face and one-to-one, at the hospital or externally. The mentors held monthly meetings to discuss cases and exchange experiences. COREME and the Teaching and Research sector offered complementary courses, such as the module “Understanding Socio-Emotional Competencies”.

Residents’ perceptions

Of the 18 participants, 66.7% were women and 88.9% self-declared white. The predominant age range was 0 to 29 years (88.9%). The majority were single (88.9%) and had graduated between two and five years previously. As for the programme, 61.1% were from Internal Medicine and 38.9% from General Surgery. In addition, 44.4% were in parallel paid work (Table 1).

Table 1
Socio-demographic data of the resident doctors who entered in 2024 and took part in the mentoring programme.

Population characteristics	N	%
Gender
Male	6	33.3
Female	12	66.7
Self-declared Race/Colour
Yellow	1	5.6
White	16	88.9
Not declared	1	5.6
Age group
< 25 years	1	5.6
25-29 years	16	88.9
30-34 years	1	5.6
Marital status
Single	16	88.9
Married	1	5.6
Civil Partnership	1	5.6
Time since graduation (years)
< 2 years	0	0.0
≥ 2 to 5 years	18	100.0
Medical residency programmes
Internal Medicine	11	61.1
General Surgery	7	38.9
Paid work outside residency
Yes	8	44.4
No	10	55.6
Total	18	100

• Source: Prepared by the authors.

In 72.2% of cases, the mentor was from an area other than the resident’s speciality. Communication was predominantly face-to-face (83.3%). For 61.1% of residents, mentoring should take place on an individual basis.

With regard to the number of meetings, frequency and last meeting with the mentor, the data is shown in Table 2.

Table 2
Distribution of the number of meetings, frequency and last meeting with the mentor, according to residents who joined in 2024.

Variable	N	%
Number of meetings with the mentor in the past year
One	11	61.1
Two	1	5.6
Three	3	16.7
Four	2	11.1
Five	1	5.6
Frequency of meetings with the mentor
Monthly	1	5.6
Quarterly	2	11.1
Annual	1	5.6
Does not meet regularly	14	77.8
The last meeting with the mentor occurred
Last two weeks	1	5.6
Last two months	2	11.1
Six months ago	15	83.3
Total	18	100

• Source: Prepared by the authors.

In an open question, residents were asked why they did not have meetings with mentors. Based on the thematic analysis of the answers, recording units were identified from which four categories emerged:

• Lack of communication (lack or interruption of contact with the mentor).

• Scheduling incompatibility

• Lack of perceived need for mentoring for the continuity of the meetings and

• Operational problems such as hospital complications arising from the residency practice itself.

Only 56.6% felt that their mentors provided a good network. Among the topics discussed were residency routine, technical skills, mental health, interpersonal relationships, the labour market and career planning.

As for satisfaction, 56% reported being satisfied and 11.1% very satisfied with the programme. For 72.2%, mentoring provided educational support. However, there was a limited impact on the change in professional conduct and the choice of speciality (Table 3).

Table 3
Data on behaviour change and future career choices of residents entering in 2024.

Variable	N	%
Mentoring changed your professional behaviour
Yes	4	22.2
No	14	77.8
The mentor helped with future career choices
Yes	3	16.7
No	15	83.3
Total	18	100

• Source: Prepared by the authors.

Suggestions for improvement included better structuring of the programme, improved training for mentors, better accessibility, alignment between the speciality of the mentor and the resident, and an integrated approach to technical and human aspects.

The residents also indicated the topics they would like to see discussed at the meetings:

• Residence routine and its difficulties;

• Mental health: burnout and quality of life;

• Interpersonal relationships: communication, leadership and conflict resolution;

• Scientific research and study;

• Career and professional future.

DISCUSSION

The findings of this study reflect demographic patterns observed in recent national surveys, which point to a predominance of women and white people among residents^15),(16. This trend reaffirms the scenario observed in Brazilian medical education in recent decades, in which female enrolment has grown, but ethnic-racial diversity remains limited.

The predominant age group (25 to 29) is also in line with studies on the profile of trainee doctors¹⁵. Parallel paid work reinforces the overload faced by residents, which can negatively influence adherence to mentoring activities¹⁷.

Most of the mentors were from a different speciality to the resident. Although this can make it difficult to establish an initial bond, it also drives the formation of interdisciplinary networks⁷. However, authors point out that affinity between areas and the structured training of the mentor are determining factors for the success of mentoring, indicating that this configuration can favour the creation of interdisciplinary networks and collaborations between different areas^18),(19.

The main barriers reported - communication issues and incompatible schedules - have been identified in previous studies^20),(21. The topics covered, such as mental health, interpersonal relationships and career planning, are recurrent in mentoring programmes and are associated with mitigating burnout and promoting well-being^5),(22. Overall satisfaction with the programme is consistent with national and international findings^23),(24. However, the limited impact on changes in behaviour indicates the need for more regular and structured mentoring, as pointed out in studies on successful programmes^20),(25. In addition, evidence indicates that the ongoing training of mentors and institutional support are essential pillars for the effectiveness of programmes^13),(21.

The residents in this study also highlighted the importance of the mentor as a guide for future decisions, which confirms the influence of mentoring on the choice of subspecialities and career paths^22),(25. However, challenges such as the lack of structure, absence of a timetable and insufficient training of mentors were pointed out as critical aspects, reinforcing the need for institutional planning^13),(21.

As suggestions for improvements to the mentoring programme, the residents indicated the need for greater structuring of the programme, regular frequency of meetings and improved mentor training. Significantly, before setting up a mentoring programme, planning is necessary, especially with regard to the size of the residency and the choice of mentors²¹. There is also a need to plan the programme assessments, which should be performed on an ongoing basis, in line with the mentor’s and mentee’s workloads at all times²².

A very important aspect is the choice of mentor. In a scoping study, mentor training is a relevant aspect of the mentoring process, with the objectives of personal and professional development, building humanistic characteristics and improving professional and interprofessional skills¹³. Good mentors have important relationship characteristics, such as accessibility, even when the mentoring is delivered remotely, for which, other resources, such as e-mail or telephone²⁴ are used. This is supported by one of programme improvements suggested by residents in this study.

Finally, the literature converges on some fundamental points for the success of mentoring programmes in medical residency: a clear and flexible structure; ongoing training for mentors; evaluation with process and impact indicators; and attention to gender, race and origin equity^13),(26. These principles should guide the reformulation and sustainability of national programmes.

Like all empirical research, this study has limitations that deserve to be recognised. The fact that it was carried out in a single educational institution limits the applicability of the results to other realities, especially in a country with such a diversity of educational contexts as Brazil. In addition, the number of participants was relatively small (n = 18), which may have restricted the diversity of experiences and perceptions captured. Nevertheless, the data obtained offers important indications about the role of mentoring in medical residency and points to key avenues for future studies with greater scope and representativeness.

FINAL CONSIDERATIONS

Mentoring is an essential tool for the holistic development of residents, supporting technical, emotional and professional growth. The effectiveness of the programmes depends on an organised structure, ongoing training for mentors, a schedule of meetings and systematic evaluation.

Residents perceived mentoring as a positive experience, although structural limitations compromised its formative potential. Improving the programme requires robust institutional planning in line with training and care needs.

Investing in structured, continuously evaluated and inclusive mentoring programmes contributes to the training of more competent, humane doctors committed to social transformation, consolidating mentoring as a fundamental pillar of medical residency in Brazil.

References

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• 9
  Evaluated by double blind review process.
• FUNDING
  We declare that there is no funding.

• Editora-chefe: Rosiane Viana Zuza Diniz.

• Editora associada: Denise Herdy.

Data availability statement

• STATEMENT OF DATA AVAILABILITY
  Research data is available in the body of the document

Data availability

Publication Dates

• Publication in this collection
  25 May 2026
• Date of issue
  2026

History

• Received
  08 Oct 2025
• Accepted
  23 Feb 2026