My heart sank as I quickly scanned the list of speakers at the conference. I recognized the names of faculty whom I respected and admired, many of whom are local, state, and national leaders in their fields. What business did I have speaking at such a conference? Surely one of them would attend my talk, detect a fatal error, and spread the word that I had advanced this far in my career by chance alone and didn’t deserve my merits. Does this story seem familiar to you? If so, you may be suffering from “perceived fraudulence,” otherwise known as “impostor syndrome.”
In 1978, psychologists Pauline Clance and Suzanne Imes1 described a syndrome where high-performing adults (women in their initial study) failed to internalize their success and were plagued by doubts that they would be unmasked and revealed to be “impostors.” Since their initial study, the findings have been replicated in men and women alike, in groups ranging from undergraduate students all the way to faculty – no one is immune. The word “impostor” comes from the Latin root “imponere,” meaning to “impose upon or deceive.” Individuals with impostor syndrome genuinely have difficulty recognizing their own accomplishments and constantly attribute their success to other factors, such as luck, charm, or effort.2 More recently, psychologists have developed “perceived fraudulence” scales to accurately quantify the magnitude of impostor syndrome.3
In academic medical centers, impostor syndrome is quite prevalent: one study found 43% of residents were affected, with a higher prevalence among foreign-trained residents, while another study showed that 49% of female medical students were affected.4,5 These feelings can be exacerbated even more in groups underrepresented in medicine, where issues of impostor syndrome and internalized racism may intersect.6
As successful medical educators, we often hold our impostor syndrome very closely to the heart, and even colleagues who know us well may be surprised when they learn about these seemingly irrational thoughts. How do we break free of the cycle of negative thinking and utilize our impostor syndromes to think of ourselves as leaders?
First off, repeat after me – I belong here. Believing in yourself and the worthiness of your accomplishments is easier said than done, but repetition and self-affirmations, although they may seem corny, can actually go a long way. Elite athletes repeat affirmations and visualize themselves succeeding at throwing the perfect basket,7 so similarly, visualize yourself excelling at that oral presentation, delivering an amazing lecture, or writing a brilliant article.
Second of all, recognize that impostor syndrome can serve as a motivator to work even harder! Many highly successful academics and leaders suffer from impostor syndrome and their fears encourage them to work even harder. Now that you know that this condition has a name, embrace it, and channel that energy into your next paper or presentation.
Third, don’t be afraid to discuss impostor syndrome with your colleagues and trainees. Many of the students and trainees who look up to you are experiencing these very same feelings, and sharing your experiences with them can help them shed their insecurities and enable them to succeed.
Finally, regularly update your CV or educators’ portfolio – not only will it save you time down the road each time you have to update it, but it forces you to visually confront and accept your own accomplishments. Take pride in what you have accomplished and remember to periodically reward yourself as well.
You belong here. You are a leader. You wouldn’t be here otherwise! Now go out there and turn that “perceived fraudulence” into excellence!
References:
1. Clance, P.R.; Imes, S.A. (1978). "The imposter phenomenon in high achieving women: dynamics and therapeutic intervention". Psychotherapy: Theory, Research and Practice. 15 (3): 241 247. doi:10.1037/h0086006.
2. Young V. The secret thoughts of successful women: Why capable people suffer from the impostor syndrome and how to thrive in spite of it. Crown Pub; 2011.
3. Kolligian Jr J, Sternberg RJ. Perceived Fraudulence in Young Adults: Is There an'Imposter Syndrome'?. Journal of personality assessment. 1991 Apr 1;56(2):308-26.
4. Legassie J, Zibrowski EM, Goldszmidt MA. Measuring resident well-being: impostorism and burnout syndrome in residency. Journal of general internal medicine. 2008 Jul 1;23(7):1090-4.
5. Villwock JA, Sobin LB, Koester LA, Harris TM. Impostor syndrome and burnout among American medical students: a pilot study. International Journal of Medical Education. 2016;7:364-369. doi:10.5116/ijme.5801.eac4.
6. Dancy, T. Elon, and Gaetane Jean-Marie. "Faculty of color in higher education: Exploring the intersections of identity, impostorship, and internalized racism." Mentoring & Tutoring: Partnership in Learning 22.4 (2014): 354-372.
7. Jones L, Stuth G. The uses of mental imagery in athletics: An overview. Applied and Preventive Psychology. 1997 Mar 1;6(2):101-15.
Lekshmi Santhosh, M.D.
Lekshmi Santhosh, MD (Educators, ’18) is a 3rd-year Pulmonary and Critical Care Medicine Clinical Fellow at the University of California-San Francisco (UCSF). She is a graduate of Yale College and Harvard Medical School, and completed her residency, chief residency, and fellowship training at UCSF. Her research interests focus on graduate medical education in the intensive care unit. She is still actively managing her own impostor syndrome! She can be followed on Twitter @LekshmiMD.