If you’ve felt this anytime in your life, know that it affects 70% of the population. From CEOs to famous artists to your average high school students. I wanted to touch more on how this affects medical students and what tips could help them deal with the ‘Imposter Phenomenon’.
‘Impostor syndrome (also known as impostor phenomenon, impostors, fraud syndrome or the impostor experience) is a psychological pattern in which an individual doubts their skills, talents or accomplishments and has a persistent internalized fear of being exposed as a "fraud".’ (1)
For medical students, the crippling feeling of not being smart enough for this demanding career is a dominant theme. The thought of ‘I’m not meant to be here in med school’ is an example. This is because medical students struggle to navigate themselves around the academic workload, the competitiveness around them, and the expectations of this career. Often, students compare their experiences, and attach it to their identity. A situation that makes them feel dumb becomes “I’m dumb”. However, it’s impractical to expect perfection at all times. The unfortunate truth is that burnout is very common among medical students. This is especially due to the level of perfectionism, or highly expectant culture. For example, to save a spot on a residency is much more competitive now than ever before. Students fight the race to get a high score on step 1, write over 50 publications, and simultaneously continue academics and extracurricular (volunteer) work along with this – all to match a preferred residency program. The competitive nature of medicine has put an extra burden on students that not only have to be great doctors now, but also exceptional exam takers, researchers, and community members. No wonder, burnout is common. This is not to say these qualities are not necessary for doctors to be equipped with, but clinical importance, and thirst for knowledge has lost its value over the years. In this vast world of medicine, students are made out to feel small as they compare themselves to their exceptional peers (who are also dealing with the same inferiority complex). Medicine will always remind you how much you don’t know. Every step of the process (whether med school, residency, or fellowship) feels like you’ve started brand new. The inexperienced students, interns, and new doctors feel this on a day-to-day basis as they realize their lack of expertise further fueling their self-doubt.
So how does it really work, and what can we do about it?
Imposter phenomenon was first discovered by Pauline Rose Clance and Suzanne Imes in 1978 in their paper in which they theorized that women were uniquely affected by the imposter phenomenon. Although, future studies have identified that anyone is susceptible to this whether a computer genius, an artist, or a business owner. It doesn’t matter. It can uniquely effect anyone at some point in their lives.
Valerie Young, author of, The Secret Thoughts of Successful Women: Why Capable People Suffer from Impostor Syndrome and How to Thrive in Spite of It, describes the importance of thinking like a non-imposter in order to walk yourself down these feelings of imposter syndrome. In her TED Talk, she talks about an essential component of this syndrome, which is, that you can’t overcome it. You can’t walk into a room and expect to walk out feeling none of these thoughts. What many victims of this syndrome want is to feel different, which unfortunately, doesn’t work like that. On the contrary, many suggest talking about these feelings, and yes that’s a good start, however it leaves you in the same state of mind. Talking about how fat you are won’t make you any thinner, Young mentions in her TED Talk. Fortunately, the solution is to think like a non-imposter. Young calls it “reframing”. Instead of saying, “I’m stupid”, why not, “that felt stupid”. Non-imposters don’t attribute their feelings to their identity or who they are. Feelings are independent, contextual, and variable.
Studies have linked this with family relations and attachment of certain terms to children like “sensitive”, or “smart”. See imposters aren’t just overachievers or workaholics, they can also be those who have found success at every first try, the talented folks who never fail to get a straight A, and perhaps may not be as hardworking. It’s a spectrum of personalities that can experience this, and there’s no doubt that it’s normal. However, it also has serious consequences, whether that’s for an artist, a business, or personal growth. Imposters struggle to attempt challenging tasks in fear that they will fail to prove themselves, because the goal has always been to PROVE THEMSELEVES in EVERYTHING. On another note, there are those independent imposters who hesitate to ask for help because they always feel the need to do all the work themselves to prove their worth.
Imposters feel like they’re frauds, soon to be discovered for their little play. There’s constant pressure to never fail. They believe their success if any to be a result of mere LUCK. Why? Because imposter phenomenon engages people in a thought process that encourages them to try to be good at everything. That’s not possible. The first step is to accept that one individual can’t be good at everything, and that’s okay. There’s also a tendency to downplay success being ‘easy’. It is of necessity for those with imposter syndrome to understand context. Just because a situation makes us feel ‘dumb’ does not mean that is a trait to attach ourselves to. This is where reframing comes into play, simply saying: “the fact that I feel useless right now does not mean that I really am”. There is a need for an alteration in the thought process, not the feelings. None of us can get rid of how we feel, but we can think about it differently. Another characteristic to assess is constructive criticism which is often taken personally. It’s NOT a personal comment. If someone offers you this sort of criticism, it is because they think you’re capable of using it. It’s not a measure of your worth, or success. And yes, all of this takes time. It’s not a day night thing. But the point I’m emphasizing is to consider the thought process behind the imposter phenomenon. What fuels these feelings, and when do they emerge? STOP in those moments, and think, how can I reframe this? Bring a second opinion to the context. Psychologist Audrey Ervin dives deeper into the internalized feelings of childhood memories and how these leave lasting impacts: “that in order to be loved or be lovable, ‘I need to achieve’”. Achievement is equated to self-worth, and lack of it to self-doubt and failure to be lovable. Multiple factors are involved in this including anxiety, environment, and childhood familial experiences. Ervin advises his clients to ask themselves this question, “‘Does that thought help or hinder me?’”.
Walking yourself down these thoughts won’t make imposter phenomenon disappear but it will take the ‘syndrome’ away from it. Young clarifies that people will “still have an impostor moment, but not an impostor life.”.
Young identifies five different imposter personalities, I wanted to dig a bit deeper into each of these:
1. Perfectionist: Setting extremely high expectations for themselves and allowing small mistakes to question their competence. They want 100% achievement every time to feel satisfied.
2. Expert: These are the folks who hesitate to apply for a job when they don’t meet every single criterion. Their aim is to know every piece of information and take every new training/certification to make themselves feel knowledgeable/competent.
3. Natural Genius: Having always found success to be at reach, these are the kids labelled ‘smart’ in their childhood years. However, when they must work harder towards achieving something, they start to question their abilities.
4. Soloist: Asking for help means that they’re a failure. These individuals are independent, and often complete tasks on their own, even when working with others.
5. Supermen/Superwomen: These individuals are the hustlers, the hard workers. They will push themselves to work more to prove they’re NOT imposters. They work their way to mask the feelings, often bearing more than is needed for their role.
Closing it off, I want to end on a positive note. The growth in our development is not focused on removing imposter phenomenon, but to accept it, and normalize it. Our focus should be directed towards thinking differently and being aware of emerging imposter thoughts instead of allowing it to take over our lives.
References:
Sakulku, J. “The Impostor Phenomenon”. The Journal of Behavioral Science, Vol. 6, no. 1, 1, pp. 75-97, doi:10.14456/ijbs.2011.6.
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