How to identify and overcome imposter syndrome among doctors

Feeling like a fraud despite your accomplishments? You’re not alone. Many doctors experience imposter syndrome, a psychological phenomenon that can negatively impact mental and emotional well-being.

In the challenging and dynamic world of medicine, where excellence is not just desired but required, it's paradoxical to think that many healthcare professionals grapple with a pervasive psychological phenomenon: imposter syndrome. Commonly known as impostor syndrome, this mental pattern involves individuals doubting their accomplishments and fearing being exposed as a "fraud."

While it might seem counterintuitive, imposter syndrome frequently targets the most competent and dedicated individuals in a field. The world of medicine, with its intense pressures, high stakes, and hierarchical structures, can become a hotbed for these feelings of self-doubt.

Medical professionals who experience imposter syndrome feel a deep-seated fear that they will be exposed as inadequate or ill-prepared, despite evidence to the contrary. This syndrome doesn't discriminate based on experience or stature; it affects medical students, seasoned physicians, and everyone in between.

Let’s take a closer look at imposter syndrome, how it affects doctors and what can be done to overcome it.

What is imposter syndrome?

Imposter syndrome is a psychological phenomenon in which an individual experiences feelings of inadequacy, self-doubt, and fraudulence despite having accomplished significant achievements. It is particularly prevalent in medical students, junior doctors, and high-achieving or successful women.

One of the hallmarks of this syndrome is the feeling that one's achievements are the result of luck, rather than ability or hard work. Another classic trait is the idea that one has deceived others into thinking they are more competent than they believe themselves to be. Such feelings can manifest as a constant fear of being 'found out' or exposed, which can, in turn, lead to burnout, anxiety, and other mental disorders.

It can affect anyone, regardless of their level of education, experience, or profession. It is more prevalent among women, people from marginalised communities, and people who are perfectionists or high achievers.

It can have negative effects on one's mental and emotional wellbeing, as well as one's career and personal life. It can lead to anxiety, stress, and depression, as well as a reluctance to take on new challenges or opportunities. It can also lead to procrastination, perfectionism, and burnout.

How does imposter syndrome affect doctors?

Imposter syndrome in doctors is highly common due to the high-pressure and high-stakes nature of the medical profession. A study in the Medical Education journal discovered that for many physicians, the origin of their imposter syndrome was medical school. The fast-paced and competitive nature of medical school kickstarts stress, comparison and other factors that breed imposter syndrome.

Doctors are expected to be experts in their field and make life-or-death decisions on a regular basis. This high level of responsibility can lead to feelings of pressure and stress, which can exacerbate imposter syndrome symptoms. Additionally, doctors are often surrounded by colleagues who are highly accomplished and successful, which can make them feel like they don’t measure up.

Doctors are also required to continuously update their knowledge and skills, which can make them feel like they are never fully prepared for the next challenge. They may fear that they will make a mistake or fail to diagnose a patient correctly, leading to feelings of fraudulence.

Combined with all of this, doctors in training are often judged by their supervisors and mentors, which can lead to feelings of insecurity and self-doubt. This can be further exacerbated by the competitive nature of the medical profession, which can make it difficult for doctors to acknowledge their own successes and feel worthy of their achievements.

It is important to note, as written in Academic Medicine, that these feelings do not discriminate on level, medical professionals across their careers may experience this imposter phenomenon.

How do I tell if I have imposter syndrome?

Imposter syndrome is characterised by feelings of self-doubt and inadequacy despite having accomplished significant achievements. Everyone experiences self-doubt to a certain extent, when it starts to affect your daily life and wellbeing is when it becomes a bigger problem to be dealt with.

Some key indicators include:

• Attributing success to external factors rather than personal abilities and skills.
• Lack of ability to celebrate or accept one’s professional successes
• Fear of being exposed as a “fake” or “fraud” and being deemed inadequate or unqualified.
• Constant self-doubt and a lack of confidence in one’s own abilities.
• Difficulty accepting praise and recognition for accomplishments
• Avoiding taking on new challenges or opportunities out of fear of failure
• Setting unrealistic expectations of oneself and striving for perfectionism
• Fixating on mistakes as opposed to celebrating accomplishments
• Procrastination and difficulty completing tasks due to fear of not being good enough

Imposter syndrome in medical students

Imposter syndrome is often experienced by medical students, particularly during their early years of study. In the case of medical students, they may feel like they don't belong, that they're not smart enough, or that they're not capable of becoming competent physicians. The pressure to succeed in medical school, combined with the rigorous academic demands and clinical responsibilities, can exacerbate the condition.

Recognising the signs of imposter syndrome and seeking support from peers, mentors, or mental health professionals can help medical students overcome these feelings and succeed in their studies and future medical practice.

Gender analysis: a closer look at how women are affected

Evidence suggests that women, particularly in professional environments, may experience imposter syndrome with greater frequency and intensity. The intersection of imposter syndrome and gender is influenced by various sociocultural factors. Society often sets unrealistic standards of perfection, specifically towards women. For instance, they are expected to excel in their careers while also being perfect mothers and partners. This can lead to a constant fear of not measuring up to these expectations, triggering feelings of imposter syndrome.

Also, gender bias in the workplace, which often subtly, but persistently, undermines women's achievements and potential, contributes significantly to the development of this syndrome. Women's accomplishments are frequently downplayed or attributed to luck rather than skill, perpetuating feelings of fraudulence. The pervasive glass ceiling phenomenon, where women are less likely to ascend to leadership roles, reinforces their feelings of inadequacy and bolsters the imposter syndrome.

Moreover, the underrepresentation of women in various fields, particularly STEM, exacerbates the syndrome. Women in these fields often face the pressure of representing their entire gender, causing them to feel that any failure would negatively reflect on all women, thus increasing their stress levels and feelings of being an imposter.

In combating imposter syndrome in women, it is crucial to address the broader societal norms that perpetuate these feelings. This involves encouraging a shift in the narrative to recognise and affirm women's accomplishments and abilities, promoting gender equity in all sectors, and offering support mechanisms like mentoring and counseling to help women navigate these challenges. Understanding and acknowledging the interplay of imposter syndrome and gender is a critical step towards creating a more equitable and inclusive environment for all.

A multicultural perspective

Culture plays a significant role in shaping our identities and, consequently, our perceptions of success and failure. In certain cultures, there may be a strong emphasis on success, achievement, and perfection. For practitioners originating from such backgrounds, the pressure to live up to these high standards can amplify feelings of fraudulence and contribute to imposter syndrome. Furthermore, cultures that traditionally value humility may unintentionally discourage self-affirmation, making individuals more prone to underplaying their achievements and increasing their susceptibility to imposter syndrome.

In the context of medicine, multicultural healthcare professionals, particularly those in minority groups, often face additional challenges. They may feel a heightened sense of isolation and a greater need to prove their capabilities. For instance, foreign-trained doctors may face stereotyping and bias, leading them to question their competence and further perpetuating their imposter syndrome.

The cultural diversity among patients also has implications. Medical practitioners may grapple with self-doubt when dealing with culturally unfamiliar patients, fearing their inability to understand the patient's unique cultural context might compromise the quality of care provided.

In addressing the cultural implications of imposter syndrome in medicine, it's essential to foster an inclusive and supportive environment. Cultural competence training can help medical professionals navigate multicultural interactions with greater confidence. Additionally, mentorship and peer-support networks can provide a safe space for individuals to express their fears and doubts.

Understanding imposter syndrome through a multicultural lens is not only crucial for the well-being of medical professionals but also for enhancing the quality of care they provide. By acknowledging and addressing the cultural nuances of this syndrome, we can work towards a medical profession that truly values and supports its diverse workforce.

High achievers

High achievers in medicine, such as top clinicians, researchers, or medical academics, are often expected to exhibit exceptional competency and consistent perfection. However, the inherent uncertainty and complexity of the medical profession can make these expectations difficult to meet. Even when high achievers do meet these expectations, they may attribute their success to luck, timing, or a perception that they've managed to deceive others about their abilities, rather than recognising their skill and hard work. This is the essence of imposter syndrome.

In medicine, the stakes are incredibly high – lives hang in the balance – which further exacerbates the pressure these high achievers face. Any mistake, no matter how minor, may trigger feelings of self-doubt, with individuals questioning their entire professional competency based on isolated incidents.

Ironically, the very traits that make one a high achiever in medicine – ambition, perfectionism, and a robust work ethic – may feed into imposter syndrome. The desire to be the best can result in an unhealthy comparison with peers, further fueling feelings of inadequacy.

Addressing imposter syndrome among high achievers in medicine requires a shift in perspective. Encouraging self-compassion, a healthy understanding of failure as part of the learning process, and an accurate attribution of success to one's abilities can be beneficial. It is equally important to cultivate a supportive professional culture, where open conversations about self-doubt and vulnerability are welcomed and normalised.

Ultimately, acknowledging imposter syndrome as an unseen hurdle among high achievers in medicine is a critical step in fostering their mental well-being, enhancing their job satisfaction, and, ultimately, improving the care they deliver.

Why high achieving women are more susceptible

Research has shown that high achieving women are particularly prone to imposter syndrome. This susceptibility may stem from societal norms and stereotypes about gender roles, combined with the traditionally male-dominated nature of medicine. Women in medicine may sometimes feel they don’t belong in certain roles or specialties or might believe they have to work twice as hard to prove their competence, further fueling the feelings of being an impostor.

How to deal with imposter syndrome?

Awareness is the first step to addressing imposter syndrome. Recognising and naming these feelings can diminish their power. It's also beneficial to understand that such feelings are widespread, even among the most accomplished individuals in medicine.

Open discussions about imposter syndrome can help normalise these feelings. Mentorship plays a pivotal role in this context. Having a trusted senior physician or colleague who can share their experiences and feelings can provide invaluable reassurance.

Cognitive behavioral techniques can be useful in challenging and changing the destructive thought patterns associated with imposter syndrome. For those severely affected, seeking professional counseling can be beneficial.

Imposter syndrome is not a permanent condition and can be overcome with the right tools and strategies. All of the pathways to dealing with it can feel difficult as experiencing imposter syndrome is overwhelming, but it is possible.

Here are 5 key tools for you to use in order to tackle imposter syndrome:

1. Challenge negative self-talk by implementing daily affirmations.

Imposter syndrome is often fuelled by negative thoughts and self-talk. The more we are aware of these thoughts, the sooner we can challenge them. Take time each morning to identify your key strengths, they don’t necessarily need to relate to your medical role. Carry these strengths with you, visualise them, in time you’ll find that the more you focus on these positive attributes, the easier it will become to combat thoughts of self-doubt.

2. Develop a growth mindset by focusing on learning new things.

There is a never-ending amount of knowledge to be acquired in the medical field, which can make you feel like you’re always behind. Instead of getting stuck and focusing on the limitations of what you don’t know, focus on what you can learn and improve upon. Embrace the gaps as challenges and see them as opportunities to grow and develop new skills. This can even apply to using learning style assessments to understand your own personal strengths and how to work with others.

3. Boost your confidence by setting realistic goals and celebrating achievements.

Setting unrealistic goals can lead to feelings of inadequacy and failure. Instead, set achievable goals for yourself, and work towards them in small steps. Just as important as setting yourself a realistic goal every day, is making sure that focus on the success of achieving it. Celebrate these wins, even on tough days, to counteract negative experiences and build momentum. You can save positive feedback sent from patients or create a personal archive of moments you're proud of, to look back on your achievements down the line.

4. Practice self-compassion by treating yourself as you would a friend.

As best as you can, be kind and understanding towards yourself. Recognise that everyone makes mistakes and has moments of self-doubt. Learn to accept your own imperfections and treat yourself with the same kindness and compassion that you would offer to a friend. Acknowledge imposter syndrome as a normal reaction to your environment, and remind yourself that the feeling doesn’t mean you are underperforming.

5. Lean on others by surrounding yourself with people who support you.

Seek out support by surrounding yourself with people who believe in you and will help to put your skills and strengths into perspective. Our insecurities generally come from the desire to be a good doctor, which is why so often we are our own worst critics, seeking out mentors who will give us honest feedback on our strengths and areas for potential improvement. Asking for support does not signify incompetence – it instead shows a desire to grow. Remember that you’ve made it to this point in your medical career because you are highly skilled and hardworking, when you can’t remind yourself of these things, find social support to help you out.

Impacts on mental health

Imposter syndrome, especially among doctors, poses a unique threat to mental well-being. The medical profession already grapples with external pressures: long hours, life-or-death decisions, and a relentless pursuit of knowledge. When these external pressures merge with internalised feelings of being a fraud, it can exacerbate mental stress. For many doctors, the constant self-doubt associated with imposter syndrome amplifies the risk of anxiety and depression. The fear of making mistakes, given the high stakes of their profession, can lead to constant rumination and heightened stress. The isolating nature of these feelings makes it difficult for many to seek support. This silence can further intensify feelings of loneliness and alienation, creating an environment where mental health can easily deteriorate. As such, recognising and addressing imposter syndrome is not just about professional development, but also about safeguarding the mental health of our healthcare providers.

The chronic stress and anxiety that come with constantly feeling inadequate can lead to burnout, depression, and other mental health challenges. It can create a vicious cycle: as individuals with imposter syndrome become more anxious, they might start to avoid taking on new challenges or seeking help, fearing exposure. This avoidance can lead to missed opportunities and can stymie personal and professional growth.

In conclusion

Imposter syndrome, with its insidious self-doubt and fears of inadequacy, is a silent challenge faced by many in the medical field. While high achieving women might be more susceptible due to societal pressures and stereotypes, no one is immune. Acknowledging these feelings, fostering open discussions, seeking mentorship, and occasionally seeking professional help are all vital in ensuring that imposter syndrome doesn't impede the journey of dedicated professionals in medicine.

Imposter syndrome can lead to feelings of inadequacy and self-doubt, and is a risk factor for burnout. It is important for medical professionals to recognise and address these feelings in order to maintain their mental wellbeing and provide the best care for their patients. With the right tools and strategies, it’s possible to build self-confidence and develop a more balanced view of oneself. Keep in mind that it’s a journey, and it’s important to be patient and kind to yourself and those around you along the way.

If you are struggling with mental health or imposter syndrome you can find resources here.