By Joe Home

As an FY1, I was surprised by the relief and gratitude that patients showed me when I came to review them. When a patient listened attentively, or wrote down my advice, I felt a deep uncertainty in my knowledge and validity as a doctor; surely they weren’t relying on ME for medical advice?

Imposter syndrome is described as a feeling of inadequacy that persists despite evidence of success. This sensation of chronic self-doubt can feel both undermining and isolating with individuals describing sensations of fraudulence, which over a prolonged period can act as a significant contributor to burnout. Evidence suggests that imposter syndrome is common amongst high performing professional groups such as doctors, with increased prevalence in people from ethnic minority backgrounds. Doctors at all levels describe experiencing imposter syndrome to different degrees throughout their working lives.

After foundation training, I began to move away from clinical medicine, initially with a role in the leadership team at my local trust before taking a national leadership fellowship. Frequent questions such as – ‘why is a junior doctor here and not providing clinical services?’, drove deep feelings of inadequacy and a need to prove myself. This led me to consistently work above my contracted hours and contributed to me experiencing burnout in my F3 year.

As junior doctors we are often thrust into new environments surrounded by people who appear to have the credentials, confidence and knowledge to perform – leading us to question our own capabilities. This isn’t helped by the mainstream media portrayal of doctors as high achievers, and the deeply ingrained personal and professional identity associated with being a clinician.

I’m fortunate to have supportive mentors, one of whom gave me advice that ‘imposter syndrome is a reflection of your environment and not yourself’. Shifting the blame burden was crucial in understanding my own perspective and valuing the contribution I could make.

In my F4 year in my national role, I had the opportunity to put the question to several leaders in UK healthcare. To my surprise, many openly discussed experiencing imposter syndrome at all stages of their careers, even while holding some of the most senior medical positions in the country. This reassured me imposter syndrome is shared by many, and does not signify an inability to do a role.

My advice to tackle imposter syndrome:

Embrace the imposter.

Imposter syndrome can be worsened by the guilt that accompanies the fraudulent feeling. Acknowledge this feeling as a normal reaction to a situation or setting; it does not mean you are underperforming.

Speak to colleagues.

Reassurance that this feeling is felt by others can make a huge difference, not only to you but others around you. Open discussion often reveals that many members of the team experience imposter syndrome, even those who appear confident.

Recognise that imposter syndrome can affect people disproportionately.

It’s even more isolating if there is no one else on your team from your background or with a similar life experience. Research suggests women from ethnic minority backgrounds can be more likely to experience imposter syndrome. An ‘out of place’ feeling can be exacerbated by other workplace factors, such as interactions with staff or service users who wrongly assume an individual’s role or seniority.

Consider the context.

Everyone has experienced times when they felt out of their depth; self-doubt is a normal reaction in this circumstance. In some settings I have felt confident in my own skills and experience, only to walk into a different room with different people and feel like an imposter. Neither feeling is necessarily wrong and no one can excel at everything; there is a reason we have separate specialties for neurosurgery and cardiology!

Seek support.

Even the most senior of our consultant or GP colleagues once walked into work for the first time with no experience. Asking for support does not signify incompetence – it can suggest there are many opportunities for learning and development. At times like this, a supportive mentor, particularly someone who knows who you are beyond work, can be invaluable. In my experience, showing vulnerability in this way can be powerful in developing relationships with senior colleagues, as well as indicating in which areas you would benefit from more support.

Be kind to yourself.

Whether you are new to a job or an old hand, everyone makes mistakes and feels anxious sometimes. This is okay – mistakes don’t define you.