Impostor Syndrome: Let’s Talk About It

By: Hannah Calvelli

I remember sitting at orientation with my white coat on for the first time, a stethoscope draped awkwardly around my neck. I shifted uncomfortably in my seat, fearing that I was being cast into a role I was unfit to play. As I looked around, everyone else seemed so confident about this new journey we were about to embark upon.

Diagnosis

The start of medical school was a whirlwind. Objectively, all was well. I learned a lot, passed my classes, joined clubs, and made friends. Medical school kept my mind busy but not busy enough. Despite my best efforts to focus on school, there were moments when I found myself overcome by a sinking feeling that I would never be good enough. It progressed quickly, bringing any confidence I had to a screeching halt. The feeling would pass with time, but it remained latent, waiting for the next moment of uncertainty, the first inkling of self-doubt to surface. By now I have diagnosed this feeling as impostor syndrome: a phenomenon that occurs when high-achieving individuals who, despite their objective successes, fail to internalize their accomplishments and have persistent self-doubt and fear of being exposed as an impostor [1]. While it is a term that many in the medical field are familiar with, it remains largely a private matter.

Talking about impostor syndrome is difficult. It is an acknowledgment of our own vulnerabilities in a field that self-selects for high-achievers. Imposter syndrome is pervasive, and susceptibility is unfortunately not limited to first-year medical students like myself. Perfection is unattainable and failure is inevitable regardless of how much knowledge, training, and experience someone has acquired. This is a tough pill to swallow. As healthcare providers, we want perfect outcomes, cures for diseases, healing for patients. We will never be good enough by medicine’s standards. 

“Perfection does not exist. To understand this is the triumph of human intelligence; to expect to possess it, is the most dangerous kind of madness.”

– Alfred de Musset

Comorbidities

The inability to achieve perfection and avoid failure, however, does not mean we should succumb to impostor syndrome. Acknowledging and addressing impostor syndrome is important in managing its comorbidities. These include anxiety and depression, linked to feelings of isolation. Those experiencing impostor syndrome often perceive themselves to be alone in their struggles, contributing to a self-perpetuating cycle of isolation. Further manifestations of imposter syndrome include increased burnout, decreased job satisfaction, and decreased job performance [1].

Treatment

Fortunately, impostor syndrome is treatable. Approaches are catered to the individual and can require a significant amount of time to take full effect. Below are some recommendations.

Self-reflection: Taking time for reflection provides an opportunity to slow down and assess the validity of any negative self-talk. This can include documenting positive feedback you have received along with your doubts about its authenticity [2]. Another method is to imagine telling your peers, superiors, etc. why you believe you are an imposter to better recognize how unreasonable this would sound [2].

A shift in mindset: I am a defensive pessimist at heart. In managing impostor syndrome, it is important for me to shift away from this mindset as my default. Optimism lends itself to a growth mindset, which thrives on challenges and views failure not as evidence of inadequacy but as a tool for growth and stretching your existing abilities. Shifting your mindset is no easy feat, but it can have profound long-term effects. Embracing a growth mindset requires recognizing that you are good enough and will continue to become better with every step you take.

Group therapy: Interacting with others is recommended because those experiencing imposter syndrome often feel isolated from their peers [1]. Creating dialogue about this topic is an important step in recognizing how ubiquitous impostor syndrome is. Addressing fears of failure with others can help validate your doubts and feelings while providing crucial social support.

While impostor syndrome has been part of my medical school experience, I can feel its impact steadily waning. Self-doubt and feelings of inadequacy are often chronic sentiments, but they can be alleviated by addressing impostor syndrome head-on. It is my hope that by engaging in conversations about impostor syndrome and working to support each other, we can begin to normalize the mental health challenges those in the medical field are facing.

References

[1] Bravata, D. M., Watts, S. A., Keefer, A. L., Madhusudhan, D. K., Taylor, K. T., Clark, D. M., Nelson, R. S., Cokley, K. O., & Hagg, H. K. (2020). Prevalence, Predictors, and Treatment of Impostor Syndrome: A Systematic Review. Journal of General Internal Medicine, 35(4), 1252-1275.
[2] Prata, J., & Gietzen, J.W. (2007). The Imposter Phenomenon in Physician Assistant Graduates. The Journal of Physician Assistant Education, 18, 33-36.

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Hannah Calvelli is a future physician working towards a combined degree in medicine (MD) and a Master’s in Urban Bioethics (MAUB) at Temple University’s Lewis Katz School of Medicine. She is passionate about advocating for mental health and dismantling the stigma surrounding mental illness.

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Posted on February 1st, 2021. Follow us on Instagram at (@medical.minds.matter).

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