Imposter syndrome is a problem that affects a large number of people–including many premeds, medical students, and residents. But what is imposter syndrome? Why are aspiring doctors more likely to suffer from it? And what can you do about it?
Imposter syndrome is the persistent belief that you don’t deserve your success. You believe that you got to where you are in life, not because of your own efforts, skills, or ability, but because of luck.
As a result, individuals with imposter syndrome can often experience difficulty celebrating their successes or accepting praise. They can also feel like frauds and internalize their mistakes over their accomplishments. These feelings can then lead to more serious issues such as burnout, anxiety, and depression–all of which can significantly impact one’s emotional, psychological, and physical well-being.
Although imposter syndrome is not categorized as a psychiatric disorder by the American Psychiatric Association, there is a growing body of literature examining this phenomenon and its prevalence among medical students, residents, and physicians.
According to research, about 25% of medical students and residents and nearly 30% of doctors will experience imposter syndrome. Doctors are also approximately 30% more likely to suffer from imposter syndrome compared to similarly-aged individuals in other career fields.
Let’s explore the various causes of imposter syndrome, why it seems to disproportionately affect doctors, and how you can mitigate it in your own life.
Causes of Imposter Syndrome
According to the literature, various factors may increase your chances of developing imposter syndrome.
To start, family upbringing has been linked to imposter syndrome.
Research has shown that children who grew up with parents who were controlling or overprotective may be more susceptible. These children often receive a great deal of criticism during their childhood which can lead to feelings of inadequacy and imposter syndrome.
This may offer one explanation for why there is a high prevalence of imposter syndrome among doctors. Familial and cultural pressures can have a significant impact on one’s decision to pursue a career in medicine. This pressure to live up to expectations can lead many students to feel like any academic setback or failure will ruin their chances of getting into medical school and make them a disappointment in the eyes of their families.
Certain personality traits have also been associated with the development of imposter syndrome.
People who have perfectionistic tendencies are more likely to develop imposter syndrome. These individuals often set unattainable standards for themselves and are incredibly self-critical when they don’t meet them. Even seemingly minor mistakes can cause significant distress. Much like with familial upbringing, this constant feeling of “never being good enough” can lead to imposter syndrome.
Neuroticism, which is the tendency toward anxiety, depression, self-doubt, and other negative feelings, has also been associated with a higher incidence of imposter syndrome.
Perfectionism and neuroticism are common personality traits among doctors at all levels of training. This makes sense given the competitive nature of medical school and residency admissions as well as the level of responsibility that physicians have over their patients.
To get into medical school or match into your desired residency program, it can often feel like you have to be perfect. You need to have a high GPA, high MCAT and step scores, strong extracurriculars, and glowing letters of recommendation. If any piece of that puzzle is off, it’s common to experience stress and anxiety about your future career.
In addition, once you become an attending physician, even seemingly minor mistakes can have serious effects on patient outcomes, so the mentality that you should be perfect and never make mistakes is further reinforced.
Life Transition Points
Important life transitions have also been associated with imposter syndrome. These are times of great change and learning that can make one question their life decisions.
Future physicians go through many of these transitional phases during their training–each one with its own level of uncertainty.
College is a huge transition point. While you may have done well in high school, college is a completely different experience with its own unique challenges. This is further compounded for premeds as getting into medical school requires consistently going the extra mile to stand out from your peers.
If we fast-forward to medical school, you’ll be surrounded by a cohort of academically-gifted individuals and have to do even more to stand out amongst the crowd. This competitive environment can make it easy to feel like your peers are always doing more than you. These feelings are further heightened towards the end of medical school when you apply to residency and have to contend with the uncertainty of matching into your desired program.
Residency is yet another transition point for future physicians. It is during this time that they gain increasing levels of responsibility and autonomy–which comes with additional psychological stress. In addition, over two-thirds of residents work greater than 50 hours per week and nearly a quarter work more than 70 hours per week. The workload during those hours is often challenging as well with nearly a quarter of residents spending 11-20 hours of their week on unskilled or “scut” work.
The combination of high stress, long hours, and heavy workloads can easily break you down and cause you to blame yourself for perceived inadequacies.
Once you complete residency and become an attending physician, however, the feelings of inadequacy don’t necessarily end. Now you’re suddenly the decision-maker and everyone is looking to you for the final say in what to do. Your choices will now have long-lasting effects on the health of your patients and the fear of making wrong decisions can be crippling.
How to Address Imposter Syndrome
Now that we’ve explored some of the causes of imposter syndrome and why it may disproportionately affect physicians, here’s what you can do about it.
Talk About It
The first step in dealing with imposter syndrome is to talk about it with people you trust. Aspiring doctors often bottle up their feelings and have a paralyzing fear of talking about their struggles due to the stigma associated with mental health; however, this is a mistake. Ignoring your negative emotions is not an effective strategy to resolve them.
Although it may be tempting to only talk to your peers in medical school or residency about these feelings, you should try talking to other people as well. Friends and family outside of medicine can offer different perspectives, which can be incredibly refreshing.
Aspiring doctors often forget that getting into medical school, matching into residency, and becoming a doctor are impressive in their own right. It’s only when they compare themselves to other high-achieving individuals that it can feel like it’s not a feat worth celebrating.
Limit Comparing Yourself to Others
Next, you should limit comparing yourself to others.
Although some competition can be a good thing and push you to become a better version of yourself, fixating too much on what other people are doing can negatively affect your perception of yourself. There’s a trade-off between the two. On the one hand, surrounding yourself with top performers can elevate your own game and teach you things that you wouldn’t learn otherwise; however, consistently being around top performers can also highlight your own shortcomings.
As Naval Ravikant once said, “If you want to be successful, surround yourself with people who are more successful than you are, but if you want to be happy, surround yourself with people who are less successful than you are.”
The trick is to find the balance between the two.
Surround yourself with individuals that push you to grow, but don’t forget about your own accomplishments and how far you’ve come along your journey.
If you find yourself comparing yourself to others too frequently, one effective strategy is to avoid social media. Social media often propagates a false sense of perfection. You’re only seeing what people want you to see and not all of the struggles they may be dealing with behind the scenes. As such, limiting your social media usage can help decrease feelings of inadequacy and imposter syndrome.
Another effective strategy for coping with imposter syndrome is to practice acceptance. Accept the fact that it is not uncommon to feel this way during your medical training and it’s okay that you’re experiencing it. You don’t need to try to make it go away overnight. Instead, it’s something that you can give yourself the time and space to work through.
I have found that the harder I resist something, the more it grows in magnitude. By trying to fight something, I am implicitly validating its existence and giving it more strength.
It may sound paradoxical, but by learning to accept it and not fighting tooth and nail to fix it, I’ve found that I worry about it far less and the magnitude decreases much more rapidly.
Meditation and Mindfulness
It sounds cliche, but mindfulness and meditation can be another effective strategy to help control your internal dialogue. Ultimately, imposter syndrome is a story that you tell yourself. It isn’t a real, physical phenomenon.
When it comes to these kinds of things, meditation and mindfulness give you greater insight into your mind’s inner workings. They allow you to observe your own physical sensations and emotions from an almost third-person perspective, which can give you more control over your own feelings and actions.
They allow you to put yourself back in the driver’s seat and not just be a passenger to the constant chatter. And that level of mental clarity can have profound effects on your life and your happiness in addition to helping with imposter syndrome.
If you enjoyed this article, be sure to check out Doctors and Mental Health Stigma.