COMMENTARY

From Resident to Faculty, Coping With Imposter Syndrome

Alexa M. Mieses, MD, MPH

Disclosures

September 06, 2019

I remember the first time I introduced myself to a patient as "Dr Mieses." I felt like I was playing dress-up in my brand new, starched, stark white coat. In that instant, 4 years of medical school evaporated from my mind. How did I get here?

Over the next 3 years of residency, I slipped into the role of physician. I learned to truly care for patients, beyond the textbooks and artificiality of the clinical years of medical school. Yet as residency drew to a close, I found myself feeling as though 3 years of residency wasn't enough time.

As I got close to graduation, 3 years of residency evaporated. Already an attending? Am I ready for the next step?

The Return of a Familiar Foe

This cycle of doubt is not uncommon. You probably experienced it yourself as you made a big professional transition. The term "imposter syndrome" was first used to describe these feelings back in 1978, when psychologists observed this phenomenon among a group of high-achieving women. In general, it refers to an inability to internalize accomplishments, or feeling like a fraud despite evidence of accomplishments.

In a published interview with the American Psychological Association, the two psychologists who coined the term (Pauline R. Clance, PhD, and Suzanne A. Imes, PhD) said that imposter syndrome is more common among individuals who grew up in families that emphasized achievement. They also explained that affected individuals may confuse achievement with self-worth, and that minorities may be at increased risk for imposter syndrome.

Thinking carefully, the first time I felt like an "imposter" was when I first started medical school. I think that had more to do with feeling like an outsider, rather than ignoring my accomplishments. Most people in my medical school class graduated from Ivy League undergraduate institutions. I went to a large, public, commuter university in the heart of New York City. Most people in my medical school class came from a long line of physicians. Neither of my parents graduated college. Most people in my medical school class were white. I am not.

My younger self allowed that to shake me a bit, despite various accolades. I quickly realized that remembering who I was as at my core made feeling "unworthy of medical school" irrelevant.

Feeling like a fraud and having self-doubts may stem from two separate, but related, processes. The first is a true imposter syndrome, which anyone can experience. In fact, approximately 70% of people experience it at some point in their lives. However, feeling like an outsider is a separate feeling, and one that undoubtedly makes imposter syndrome worse.

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