The Mentorship Paradox in Military Medical Education: A Comprehensive Mixed-methods Evaluation

Introduction: This study provides the first systematic evaluation of the mentorship program at Myanmar's Defence Services Medical Academy (DSMA). It assesses mentorship’s role in cadet development and examines how systemic challenges constrain its effectiveness in a dual academic–military setting. 
Methods: A mixed-methods (MM) sequential explanatory design was employed. A cross-sectional quantitative survey was conducted, followed by qualitative semi-structured interviews to explore cadets’ experiences and perceptions of mentorship. 
Results: Cadets valued mentorship highly (career guidance: 79.5%; personal development: 81.0%). However, significant challenges emerged, including balancing dual academic–military duties (66.1%), communication barriers (65.2%), and lack of mentor availability (58.2%). Analysis of variance (ANOVA) showed significant differences across academic years in career guidance, personal development, communication barriers, balancing dual roles, and mentor availability (all p≤.022; η²=.05–.09). Effects across years were small-to-moderate (η² ≈ .05–.09). Male cadets reported greater difficulty balancing roles than female cadets (t(249)=2.16, p=.032, d=0.34). Qualitative interviews confirmed that hierarchical structures and limited mentor access were the most pervasive barriers. 
Conclusion: The DSMA mentorship program is highly valued but constrained by structural and cultural barriers. Effective mentorship in dual-role contexts must integrate academic guidance with robust psychosocial support while addressing issues of mentor availability, hierarchical communication, and gender sensitivity. Tailored, evidence-based mentorship models are needed to strengthen resilience and professional development in future military physicians.