Within our healthcare system teaching very often continues to play but a marginal role in educational centres, where care and, to a lesser extent, research predominate. This results in an upset in the -theoretically- acknowledged and necessary balance among care, research and teaching as the set of basic functions of healthcare institutions and their professionals.

The mentor is a key figure in the learning process of trainee medical specialists, acting as both a referent and a model and, therefore, must have a series of characteristics that ensure his or her duties will be carried out in the most effective manner. In addition to the professional and academic requirements, mentors must also possess a number of qualities, one of the most important being the capacity to interact and communicate with patients and those around them, as well as with the professionals at the institution. It is also very important that mentors have a sufficient degree of motivation and willingness to fulfil the mentoring tasks adequately, with special emphasis on teaching activities. The figure of mentor exists in most countries, although sometimes under another name, such as 'supervisor' or 'tutor', and their mission goes beyond that of direct teaching to focus on a role providing supervision and guidance throughout the whole learning process.

The accreditation and re-accreditation of mentors will only be possible and effective when the opportunity to be appointed as such offers enough incentives and is deemed to be sufficiently appealing, both personally and professionally, to generate a certain degree of competitiveness among those interested in accessing this situation. It is an essential element and an indispensable condition for the implementation of a system for accrediting mentors. We cannot demand more of mentors or hold them accountable for their teaching activity if they are not given adequate recognition and incentives.

As I outlined in different media some years ago, the main areas in which mentoring should be explicitly recognised are the following:

In view of the foregoing considerations, it is clear that the processes of accreditation and re-accreditation of mentors cannot develop along lines that are not linked to those of recognising and encouraging mentoring itself. Nevertheless, many politicians, managers and directors of centres and services do not seem to accept that if they want to have a sufficient number of mentors with the best possible training and motivation, they must address these two areas together and with a broad forward-looking vision.

In recent times we have witnessed a certain proliferation of training initiatives aimed at present or future postgraduate mentors promoted by a variety of institutions, including the Spanish Organisation of Medical Associations (in Spanish, OMC). Specific mentor subcommittees are also being set up in different medical associations. These projects are to be welcomed as a means to help highlight the needs of this vitally important group in postgraduate teaching. That said, it cannot and should not be forgotten that these and other proposals would be far more coherent and effective if they were properly contextualised with the framework of a state proposal for accreditation and recognition of mentoring.

In the design and implementation of this state initiative, the lead role should be played jointly by the Spanish National Council of Health Science Specialties and its commissions, the different medical and nursing professional organisations, and the mentors and resident physicians themselves. The proposal should focus on those aspects of the accreditation and recognition processes that are mandatory throughout all the national health system, without going into the details of those included within the competencies transferred to the health services of the different autonomous communities.

It is obvious that it is not possible to address each and every one of the components of the state proposal in detail in an editorial, but we can point out some of its core elements.

In the field of accreditation and re-accreditation of mentors, it is important to clearly establish the requirements and mechanisms to be able to access this condition: qualification(s); clinical, teaching and research professional profiles; previous, overall and specific professional experience in the teaching field, and so forth. It is also necessary to establish a precise definition of the motives and mechanisms by which this condition may be lost, as well as the periodicity with which accreditation has to be renewed. The processes of accrediting and re-accrediting mentors and their concrete results should be part of the documentation required for teaching institutions, units or services to apply for initial accreditation or its renewal. One element to be taken into consideration in this regard could be the Mentoring Accreditation Diploma that the Sub-Directorate General of Professional Regulation has already submitted to the Human Resources Commission of the Spanish National Health System.

In the field of the recognition of mentoring, all the areas mentioned above must be addressed, granting each of them the same degree of importance. Developing them only partially, leaving one or more of them to one side, as some autonomous communities have done, is a mistake that may make it more difficult to solve the problem and will in no way help make it easier.

The low level of priority given to teaching by many policymakers and health managers results in the partial and insufficient recognition of mentoring, usually focused on little more than documentary matters. The importance of addressing all the areas, including the economic aspects, must be stressed at all levels. In order to achieve this inalienable goal, it is essential that the state proposal be taken on board by the different stakeholders with the same level of conviction regarding the benefits of its proposals and the responsibility of monitoring its development.