How to conquer imposter syndrome in medical school and beyond

Dr. Nancy Yen Shipley, an orthopaedic surgeon and public speaker, has written that when she was in medical school, she was haunted by a voice in her head that would tell her, “They are going to find you out. You are a fraud.”

This kind of self-doubt, known as imposter syndrome, can stay with people long after they have finished their studies. Regardless of their many accomplishments, those with imposter syndrome feel they really aren’t that bright — and somehow they’ve managed to fool those who think otherwise. 

“Even when I got out into practice, taking care of patients, I had that fear,” Dr. Yen Shipley recently wrote in her blog. Even today, she is sometimes surprised when people thank her for her mentorship.

While imposter syndrome can affect professionals in just about any industry, those in medicine could be particularly susceptible to it, perhaps because the necessity to excel as a physician is literally seen as a matter of life and death.

According to a 2018 Canadian study published in the journal Academic Medicine, imposter syndrome is an “inaccurate self-assessment” that becomes a problem when it begins to affect physicians’ receptivity to real feedback. Even if a physician is completely qualified and performing well, ill-founded self-doubt can de-motivate them and hamper their productivity.

Women and minority groups are more prone to this syndrome

The concept of imposter syndrome originated with a 1978 study that first identified what was then labelled “the impostor phenomenon” in women. Psychologists Pauline Clance and Suzanne Imes studied “self-perceived intellectual phoniness” among high-achieving women and found that “certain early family dynamics and later introjection of societal sex-role stereotyping appear to contribute significantly to the development of the impostor phenomenon.”

A lot has changed in the 40 years since, but there is still evidence that imposter syndrome affects women and minority groups more than it affects men.

Dr. Suzanne Koven, a primary-care doctor and writer in residence at Massachusetts General Hospital, identified the phenomenon as a female one in The New England Journal of Medicine in an article called “Letter to a Young Female Physician.”

In a letter telling her younger self what she wished she had known at the time, Dr. Koven wrote: “I believe that women’s fear of fraudulence is similar to men’s, but with an added feature: not only do we tend to perseverate over our inadequacies, we also often denigrate our strengths.”

There are effective ways to counteract it

Whether you’re a woman or a man suffering from imposter syndrome, you can mitigate its effects — but you have to work at it. As with learning any new skill, practice makes progress.

Remind yourself what you’ve done well. In Dr. Koven’s letter to her younger self, for example, she wrote that she should have spent less time worrying about being a fraud and more time appreciating herself and acknowledging what her patients appreciated about her.

Look through the eyes of others. Dr. Yen Shipley suggests asking yourself how others would describe you — or asking them directly. She writes: “What do you do well that others struggle with? What do people seek you out for advice on? When you see these in front of you … you have a tool to combat the internal voice that can hold you back.”

Talk to others. You will discover that many people around you feel the same way you do. You can also seek support from your professors (while you’re still in training) and mentors (when you’re new in practice).  

Learn to reframe. If you really do slip up, try to reframe those failures as learning experiences that help with your professional development.

When all else fails, remember Dr. Koven’s letter to her younger self: “My dear young colleague, you are not a fraud. You are a flawed and unique human being, with excellent training and an admirable sense of purpose. Your training and sense of purpose will serve you well. Your humanity will serve your patients even better.”

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