The first time many physicians seriously consider professional coaching is when something already feels off.
Burnout. An unexpected leadership conflict. A career that looks successful from the outside but feels adrift from the inside.
As program directors, we recognize this pattern. Fellows and early-career gastroenterologists are skilled at pushing through discomfort — medicine selects for it. Endurance and productivity are rewarded. Reflection rarely makes the schedule. And if we are being honest, we have been guilty of the same. We held the same assumptions about coaching. We waited longer than we should have.
This misconception is worth addressing directly: coaching is not for when things fall apart, and it is not reserved for advanced-career physician leaders. In reality, it may be most valuable before a physician reaches those inflection points. The earlier physicians develop genuine insight into their values, leadership style, and definitions of success, the more deliberately they can shape what comes next.
This is particularly relevant in gastroenterology, where clinical productivity, procedural volume, research, teaching, leadership, national engagement, and personal responsibilities all compete for the same finite capacity, often simultaneously. The cost of operating without that clarity compounds.
One of my favorite reads on this topic (Dr. Naveed here) is Atul Gawande's 2011 New Yorker essay "Personal Best."¹ It genuinely changed how I thought about the role of coaching in a physician's life. He asks a deceptively simple question: Why do elite performers in every other field rely on coaches, while physicians rarely do? His answer has stayed with me — even highly accomplished professionals have blind spots, and an outside perspective, what he called an "outside ear," is often the only way to see them.
Setting the record straight
Coaching is not therapy, and it is not remediation. Coaching is forward-focused and goal-directed. While mentorship transfers the benefit of someone else's experience, coaching builds your own capacity to find answers. Sponsorship opens doors; coaching helps you decide which ones to walk through. As physicians and leaders, we are trained to solve problems. Coaching cultivates something different — the discipline to slow down, sit with the question, and resist reaching for an answer before you fully understand what you are dealing with. That shift is uncomfortable. It is also where the growth happens.
Table 1 shows how these three roles differ and why conflating them means underutilizing all three.1
| Mentorship | Sponsorship | Coaching |
|---|---|---|---|
Primary function | Guidance based on experience | Advocacy and opportunity creation | Facilitation of self-discovery |
Key message | "Here's what I would do." | "I will open doors for you." | "What do you want, and how will you get there?" |
Relationship | Directional | Influential | Reflective |
Table 1. Mentorship, sponsorship, and coaching compared.
Why now, not later
The transition from fellow to attending is one of the highest-stakes windows in a physician's career. High-impact decisions get made quickly — practice model, subspecialty focus, leadership opportunities, work-life structure — and most of them happen under time pressure with limited protected space for reflection. Coaching protects against reactive decision-making and intentionally creates space for choices that are mission-aligned.
This matters during training, too. Working with a coach early helps answer the questions that rarely come up in case conference: What kind of practice do I actually want? What am I building my career around? That clarity guides more intentional decisions about a first job, a first leadership role, and the first real career crossroads. Waiting until you are "established" often means waiting until the habits are already set and the patterns are harder to shift.
The evidence is particularly striking for women trainees. A randomized clinical trial of group coaching in women physician trainees demonstrated significant reductions in burnout, impostor syndrome, and moral injury, alongside meaningful improvements in flourishing and self-compassion.2 Women physicians face disproportionately higher rates of burnout, with disparities that begin during training. Group coaching, in particular, offers a structure that addresses those vulnerabilities before they compound.
What coaching looks like in practice
Not all coaching is the same. Career coaching is typically the natural entry point for early-career GIs — addressing trajectory, transitions, and the question of what you are trying to build professionally. Leadership coaching becomes relevant as physicians step into roles such as program director, section chief, or committee leader, often before formal development in communication, conflict navigation, or building institutional influence has been offered. Physician-specific coaches, many with clinical backgrounds, accelerate that work because the culture and constraints of medicine require no translation.
Where you find a coach matters too. Internal coaches are often offered as a faculty benefit and offer advantages such as lower cost, faster trust-building, and organizational familiarity. The trade-off is that confidentiality can feel uncertain and independence more limited. External coaches offer full objectivity, which is often where the most candid work happens. For anyone navigating something politically sensitive within their institution, that distinction is meaningful.
Table 2 outlines the key differences between internal and external coaching.
Internal: Advantages | Internal: Limitations | External: Advantages | External: Limitations |
|---|---|---|---|
Cost often covered | Potential bias | Unbiased perspective | Higher cost |
Knows organizational culture | Confidentiality risk | Full confidentiality | Unfamiliar with culture |
Flexible scheduling | Role conflict risk | Deeper specialization | Scheduling challenges |
Table 2. Internal vs. external coaching: key trade-offs.
Two perspectives
We came to coaching from different places. What follows is what we found.
"I held the same misconceptions I am writing about here. I did not pursue coaching until recently, and it took navigating a challenging period at work to get there. What I found changed how I approach almost everything. The most important lesson was about curiosity: walking into a hard conversation not to prove my perspective, but to understand the other person's. The second was about culture. There is a reason people say culture eats strategy for breakfast. I had to first understand the institution's culture, its goals, and what it was actually trying to protect, before I could figure out how to navigate toward outcomes that worked for both of us. Coaching gave me the framework to do that. I wish I had found it sooner."
— Mariam Naveed, MD, FACG
"My first experience with coaching came through the Scrubs & Heels Matrix Mentorship program, an unexpected gift that genuinely changed my career trajectory. Coaching gave me clarity and a strategic roadmap that is values-focused and mission-aligned. It also gave me permission to say no. Before coaching, I was on more committees than I could count. Since 2022, I have continued working with a coach — both group and individual — though I have had to seek it out proactively. It has never been offered as part of my annual evaluation. I consider it a lifetime investment, because the returns are both personal and professional."
— Kathryn E. Hutchins, MD, FACG
How to start
Start with your institution. Many academic medical centers and health systems offer coaching as a faculty development benefit — ask your GME office, faculty affairs, or HR. Specialty societies are also a resource; AGA, ACG, and ASGE offer professional development programming for early-career members, and those networks often connect physicians with coaches who understand the culture of medicine. Women-focused leadership initiatives in GI are increasingly building coaching access into their programming. Organizations such as Women in Endoscopy and events such as Scrubs & Heels are among those creating this kind of structured support, alongside others doing similar work across the field. When vetting an external coach, look for International Coaching Federation credentialing as a reasonable baseline standard.3
Request a complimentary session before committing. Chemistry matters more than credentials — the coaching relationship is the primary vehicle for the work. If the fit is not right, that is not a failure of coaching; it is useful information. Try a different coach or a group format. Like any meaningful professional relationship, the right match sometimes takes more than one attempt.
If you are a trainee and your program does not currently offer coaching access, ask. Not because something is wrong. Because you are worth the proactive investment, and your entire career is still in front of you.
Conclusion
The culture of medicine has long treated help-seeking as a liability and deferred self-investment until it is earned. That framing is costly — for physicians, for the people they lead and train, and for the patients downstream. Coaching does not wait for the right moment. It creates one. The fellows in your program today and the early-career attendings who just left training are in the window where this matters most — while the habits are still forming, the identity is still taking shape, and the trajectory is still genuinely flexible.
Seeking guidance is not an indication of inadequacy. It is a deliberate investment in clarity, accountability, and the kind of career worth building.
We waited longer than we should have. You do not have to.
References
Gawande A. Personal Best. The New Yorker. October 3, 2011.
Mann A, Shah AN, Thibodeau PS, et al. Online well-being group coaching program for women physician trainees: a randomized clinical trial. JAMA Netw Open. 2023;6(10):e2335541.
International Coaching Federation. ICF credential programs. https://coachingfederation.org. Accessed May 2026.