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Ways to Overcome Feeling Like a Fraud in Medicine

Rosy Thachil, MD

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October 28, 2021

As an immigrant woman of color with a youthful appearance and who stands five feet tall (on a good day), I've become fairly comfortable looking and being "different," in both professional and personal settings.

However, when I transitioned to practice and attendinghood, I started experiencing a new phenomenon. I noticed myself frequently wondering whether I had faked my entire training, whether I had somehow gotten to where I was because of sheer luck, and whether I really belonged. Intersect this with "not looking like a cardiologist," and I quickly realized that these patterns of thinking were ones that I needed to overcome/learn to manage in order to grow and move forward.

For a while, I was reluctant to share these sentiments at all. Medical culture is not always conducive to open discussion surrounding these sorts of challenges, and speaking of your lived experience could potentially be seen as a sign of weakness or misinterpreted as vulnerability. I was also cognizant of the fact that I had chosen a medical specialty that is 85% male, and perhaps this is just how it was "supposed to be."

But eventually I learned that there is a term for this phenomenon: impostor syndrome. And perhaps more important, that many others experience it as well. I had never heard of it in training or schooling, nor did there seem to be much open discussion surrounding it until relatively recently.

Impostor syndrome, according to the Harvard Business Review, is a collection of feelings of inadequacy that persist despite evident success. Interestingly enough, it is not tied to self-esteem or self-confidence, and even CEOs, Nobel laureates, and other seemingly high achievers experience it. In fact, it is estimated that 70% of people will experience impostor syndrome at some point in their lives.

While this is an "individual" phenomenon and can certainly be experienced by anyone, observationally and within my professional networks, I have noticed that women, individuals of color, and those in underrepresented groups seem to experience it at a higher rate. And the literature does provide some suggestion that within academic settings, women (and particularly women of certain racial and ethnic groups) may be at higher risk for impostor syndrome. Intersectionality can amplify this phenomenon.

This is not surprising given the unique obstacles that women and other underrepresented groups may face in a professional workplace. Systemic biases can influence the experience of impostor syndrome. For example, if leadership emphasizes traditionally "masculine" traits, a woman who leads with empathy and compassion (often societally characterized as "feminine" traits) may feel like an impostor.

While systemic and cultural change may take time, on the individual level, we can learn to manage impostor syndrome.

If left unchecked, it can lead to unhealthy degrees of perfectionism, constant self-criticism, holding oneself to unattainable standards, poor boundaries, and a persistent feeling of "others always know more than me."

While I certainly still experience it from time to time, these are a few mental hacks that have helped me mitigate impostor syndrome:

  1. Recognize it. As they say, awareness is the first step. Make note of it when you find yourself attributing success/wins to "luck" or external circumstances.

  2. Internalize your success. Accept that your achievements were a result of hard work, intelligence, time spent, etc. This does not make you arrogant.

  3. Realize that it is okay to be wrong, to not know something, or to fail. Having a gap in knowledge or skill does not automatically make you a fraud. It is okay to learn and develop. Forgive yourself for mistakes; don't perseverate. At the end of the day, we learn more from our failures (or perceived failures) than we do from our successes.

  4. Talk about it. Discuss it with a trusted friend, colleague, family member, or community. You'd be surprised at how many people have experienced it.

  5. Let go of perfectionism. Are you ruminating over details that may not have long-term impact? In some contexts, a healthy perfectionism is necessary (ie, patient care), but in other situations, just a viable product may be sufficient.

Have you ever felt like an "impostor"? Comment below.

Disclaimer: The above article is intended for informational purposes only. It is not professional medical advice. If you believe you may have a medical emergency, immediately call your physician or 911.

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About Dr Rosy Thachil
Rosy Thachil, MD, is a noninvasive cardiologist and assistant professor of medicine at Albert Einstein College of Medicine. She is a graduate of Jefferson Medical College and completed cardiology training at Mount Sinai Hospital. She is a fellow of the American College of Cardiology.

Dr Thachil's clinical interests including acute cardiovascular care, cardiac critical care, and health disparities. Her nonclinical interests include personal development, blogging, and writing (at thachilmd.com).

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