Overcoming impostor syndrome: Guidance for physicians and medical students

Impostor syndrome is an issue among osteopathic medical students, residents and practicing physicians that deserves more attention. A 2022 study estimates that impostor syndrome can affect more than 70% of people

First identified in the late 1970s, impostor syndrome represents a psychological state in which individuals consistently doubt their abilities despite evidence of success. There are likely several catalysts for, and mediators of, impostor syndrome among physicians. In this article, I will shed light on this phenomenon and offer hope to osteopathic physicians and medical students who battle it.

Impostor syndrome can develop during medical school and residency, when trainees are exposed to competitive academic standards, long hours of studying and frequent assessments. Many physicians compare themselves to peers who appear more knowledgeable or confident, leading them to question their own competence despite their achievements.

What to look out for

Imposter syndrome is often marked by these five signs:

1. Perfectionism: Placing unrealistic or extreme standards on yourself to achieve a goal.
2. Fear of failure: The fear of not living up to an expectation (seen as “failure”) can contribute to anxiety or unease, and in some cases this can be severe.
3. Super-heroism: Expecting yourself to excel in all areas, at all things. Attaching a deep moral obligation to carrying out tasks that can lead to further challenges when it comes to balance, moral controversies and realizing limitations.
4. Denial of competence: This often involves internalizing failures and externalizing successes and can include discounting or not accepting one’s own abilities.
5. Fear of success: This paradoxical fear of achieving success can limit the pursuit of successes. You may associate success with further workloads, expectations or standing out.   

The Clance Impostor Phenomenon Scale (CIPS) was developed by Pauline Rose Clance, PhD, and is a self-administered questionnaire that contains 20 scenarios in statement form. Participants are asked to mark an answer to each scenario; responses to each scenario involve the five-point Likert scale ranging from a score of one (not at all true) to five (very true).

Along with recognizing the above symptoms, the CIPS is one of several ways to stratify and recognize impostor syndrome and its severity. Importantly, impostor syndrome can vary in severity, and it can be a chronic, relapsing issue over time.

Impostor syndrome among physicians

One unique aspect of impostor syndrome in physicians is the conflict between professional expectations and personal vulnerability. Society often views doctors as highly capable, decisive and emotionally resilient individuals. As a result, physicians may feel pressure to hide uncertainty or emotional distress to maintain professional credibility. This culture of perfectionism can discourage open discussion about self-doubt and mental health challenges, causing many physicians to suffer in silence.

Another distinguishing factor is the relationship between impostor syndrome and burnout in medicine. Physicians frequently experience emotional exhaustion, sleep deprivation and overwhelming workloads. These stressors may reinforce impostor syndrome and may compound it with anxiety, depression, reduced job satisfaction and professional burnout.

The hierarchical structure of healthcare systems can intensify impostor feelings. Physicians are continuously evaluated by senior doctors, colleagues, patients and institutions, creating an environment where mistakes are highly visible and success may feel insufficient.

Unlike many other professions, physicians carry direct responsibility for human lives, making self-doubt more emotionally and ethically significant. In fact, persistent self-doubt may affect communication, confidence in clinical decision-making, leadership development and overall quality of patient care.

Therefore, there is an increased need for supportive work environments, mentorship programs, mental health resources and educational interventions aimed at promoting physician well-being.  Importantly, impostor syndrome, I believe, is not a physician weakness or something that would necessitate what some may call “resilience training.” 

Turning impostor syndrome into a strength

Those battling impostor syndrome do have a way out—it does not have to define you. For some, a step-wise approach to overcoming impostor syndrome may work well:

Step 1:  Recognize when impostor feelings occur.

Step 2:  Accept praise and recognize your accomplishments.

Step 3:  Learn from your mistakes; avoid thoughts of worst-case scenarios when mistakes happen.

Step 4:  Act despite possible risk (praise having the initiative to put thought into action).

Additionally, it can be helpful to talk through your imposter syndrome with a professional counselor or a trusted colleague, friend or family member.

Below are three additional tips that can help turn impostor syndrome into a strength born out of a vulnerability.

Know that no physician knows everything

No physician is perfect or a miracle worker. We all make mistakes. We can begin to normalize, in a thoughtful way, imperfections. We can work as teams to support each other’s strengths and weaknesses. Our patients may appreciate the authenticity when we share our own imperfections. 

Normalize discussing transitions honestly

Going from medical student to resident or from resident to attending can be challenging, as can other transitions such as joining a new practice or starting a practice of your own. We can normalize acknowledging and discussing the difficulties involved in these transition points. 

Validate someone else’s strengths or uniqueness

It can be important to tell someone how unique or special they are or where their talents lie. Helping others helps ourselves, and hearing from someone else where a physician might hold talent or a strength can be empowering and help push someone else past their feelings of impostor syndrome.

Looking within

Osteopathic physicians, along with osteopathic medical students and residents, are at increased risk for impostor syndrome. Recognizing feelings of impostor syndrome can be a challenge in itself, but early recognition can help mitigate risks associated with long-term sequelae. As a profession, we can do better to foster environments that support early recognition and offer help to those who may battle it. The next time you see someone who might be battling impostor syndrome, give this a try: Point out a strength of theirs with intention! Encouraging each other like this can go a long way.

Anyone battling or navigating feelings of impostor syndrome can contact me via email at [email protected].

Related reading:

How burnout taught me to listen to my body

The ironic tango of imposter syndrome and a growth mindset