February 27, 2023

Dr Impostor Syndrome MD

As I’ve written elsewhere, there is still a part of me that believes I should never have gotten into medical school. Long story, but I think I was in a depressive episode during the entrance exams and I underperformed. Yet somehow I got in. And never having failed an exam from med school to fellowship, I still believe it was fluke. The facts don’t agree, but facts never got in the way of a good neurosis. Still, this doctor impostor syndrome is with me, and I am not alone.

What is Dr Impostor Syndrome?

Impostor syndrome is a common phenomenon among physicians, where we feel like we are frauds in our profession and that we don’t deserve our success. It is believed that this feeling is often triggered by the high level of responsibility and stress that comes with being a doctor. Impostor syndrome can also be considered a risk factor for burnout and psychological distress.

there is still a part of me that believes I should never have gotten into medical school... Yet somehow I got in. And never having failed an exam from med school to fellowship, I still believe it was fluke. The facts don’t agree, but facts never got in the way of a good neurosis. Still, this doctor impostor syndrome is with me, and I am not alone.

The Prevalence of Impostor Syndrome in Healthcare

Impostor syndrome is a common phenomenon in the healthcare industry, with a prevalence rate of around 30% among medical students and residents. Women and international medical graduates tend to have even higher rates of impostor syndrome.

The issue typically surfaces during transitions, such as starting new jobs, projects, or careers. Experienced physicians are not immune to impostor syndrome and may still struggle despite receiving positive feedback from our peers and patients.

Features of impostor syndrome include:

Inability to accept or internalize one’s success
Tendency to attribute one’s success to luck or chance rather than to one’s own ability
Difficulty accepting praise about one’s intelligence or accomplishments
A discrepancy between one’s self-evaluation and external evaluations
A fear of being revealed as a “fraud”
Tendency to recall mistakes over accomplishments
Disappointment with present accomplishments
Hesitancy taking on new challenges for fear of failure, despite previous success
Making frequent comparisons to others, believing others are more accomplished
A reluctance to disclose potential promotion until it is accomplished

Source: Clance PR. The impostor phenomenon: when success makes you feel like a fake (1985).

What causes medical impostor syndrome?

There are several underlying causes of impostor syndrome in physicians. Some of the most common include:

High expectations and pressure: Physicians face high expectations and pressure from both themselves and others. we are expected to be knowledgeable, competent, and confident in our work, and to provide the best possible care to our patients. This pressure can lead to feelings of self-doubt and insecurity, and make it difficult for physicians to recognize and acknowledge our successes.
Comparisons to others: Physicians are often surrounded by highly successful and accomplished colleagues, which can make them feel inadequate or like an impostor. The tendency to compare oneself to others can lead to feelings of self-doubt and insecurity, even when a physician is highly skilled and competent.
Lack of feedback: In the medical field, feedback is often given in a critical or negative manner, which can make it difficult for physicians to feel confident in our abilities. Additionally, the fast-paced nature of the medical field can make it challenging for physicians to receive regular feedback and recognition for our work, leading to feelings of self-doubt.
Perfectionism: Many physicians are perfectionists and hold themselves to high standards, which can make it difficult for them to recognize and acknowledge our successes. This can lead to feelings of self-doubt and insecurity, even when we are performing well in our work.
Burnout: The high stress and responsibility that comes with being a physician, combined with long hours and demanding workloads, can lead to burnout. This can result in physical and emotional exhaustion, decreased job performance, and a general sense of dissatisfaction with one’s work, all of which can contribute to impostor syndrome.

Conclusion: Physician Impostor Syndrome

In conclusion, impostor syndrome is a common issue among nearly a third of physicians, where we feel like we are frauds in our profession and that we don’t deserve our success.

Impostor syndrome in physicians is often the result of a combination of factors, including high expectations and pressure, comparisons to others, lack of feedback, perfectionism, and burnout. Understanding the underlying causes of impostor syndrome can help physicians better recognize and overcome the feelings of self-doubt and insecurity that can negatively impact their work and patient care.

In the next article – Overcoming Physician Impostor Syndrome, we will explore the impact on doctor and patients, and four steps to overcome it.

Dr Corrigan

A recovering physician who left medicine after burning out and more. Overachiever. Impostor syndrome. Addict. Had never heard of Corrigan's Secret Door* until it was too late. Co-founded Physicians Anonymous with intention to solve physician burnout, mental illness, and addiction. Hopes to prevent future medical career disasters through peer support, advocacy, policy change, and innovation. * https://physiciansanonymous.org/corrigans-secret-door-and-other-stories/

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