Imposter Syndrome: You Are Not Alone in Your Thoughts – Q2 2023

Pamela C. Sullivan, MD, MBA, FACP, FCUCM, PT

Imposter Syndrome: When an individual doubts their own abilities and feels like a fraud. In other words, when one has the skills without the confidence. At first, I was amazed by how many physicians admit they experienced this phenomenon at some point in their careers. Now, I am amazed when I meet someone who has experienced these feelings and worse, felt isolated not realizing they are not alone. It is rarely discussed despite its commonality. I am reminded of how it was taboo to speak about mental illness in the past. If clinicians should discuss these feelings in themselves, they may be viewed as weak, and it could negatively impact their career. Hence, we brushed it under the rug for far too long.

It is often described as an issue with women, but it is clearly not isolated to women. Anyone who differs from the common “norm” of a given work culture is more likely to experience these feelings. Here are a few stories which may help you visualize this concept.

A female participates in a predominantly male board meeting, a resident physician whose primary language is not English or a physician who wears their native customary dress. It can be very difficult to find a mentor like you. You are viewed as different. This unconscious bias makes you not the first choice for the promotion or an opportunity. You question your self-worth. Was I too ambitious with my goals? Your self-doubt cripples you into not applying for a role you are quite capable of performing well. You strengthen your beliefs you are not deserving.

Recently someone so eloquently described how she questioned herself every time she received an accolade. Did they feel sorry for me because I moved to the U.S. alone and speak little English? Are they just being kind? Did I really deserve it? Was it said because it was the politically correct comment to tell me? For most of my life I could not say thank you without adding a “but” such as, “It was because I was in the right place at the right time.” I felt very justified adding my “but” until one day when a group of us were performing an executive coaching session for a colleague. We made it clear feedback was not just for him but a two-way street. This individual informed me I did not make him feel respected when I added a “but” after a thank you. I did not value his job well done comments. The light bulb went off in my head. It was so hard to say thank you followed by a period and not a “but” for the longest time as it made me feel uncomfortable.

I was being interviewed recently for a podcast as a female physician entrepreneur when this became the topic of discussion. I was asked if I ever moved past imposter syndrome. With belief in my words and confidence in myself, I was able to say yes. At age 58, I can confidently state for three years I do not live in the shadows of self-doubt.

How does one move past these beliefs? Resilience kept me going. I was going to find a way to be successful even if someone closed a door. Success does not mean one has confidence. Confidence does not mean one has competence. External facing confidence does not mean someone feels confident internally. Competence is gained from experience. One must be granted opportunities to gain experience. Confidence comes from being in the right culture feeling valued and supported. My emotional quotient (EQ) was terrible early in my career despite great intentions. I tried to find a mentor. The only mentors around were white males. I finally did something physicians did not do. I turned to our outwardly appearing confident female CNO for mentorship only to learn she was in the same situation. I finally landed in a great culture where I was supported and allowed to make mistakes without fear. I had a positive mentor surrounded by a company with a positive culture. Take the dichotomy of this situation: A resident performs poorly on Part 2 of the boards. One resident, who has never been a test taker but does very well clinically, was called into a room and asked if medicine was the right career path. Another with the same situation was called into a room and advised “we” have a problem to solve. Let’s come up with a plan to get you over this hurdle. Same situation for both of us. One with a negative mentor and one with a positive mentor. Which one was beaten down and which one believed she would succeed?

I have many stories I can share about my journey, and I bet many of you can as well. It is in our nature to help others. I ask each of you to speak openly about your experiences, so others do not feel isolated. Be the role model you wish you had or the one that helped you gain confidence affording you to grow your skills and competencies. Provide opportunities. I am hopeful the times are changing toward more inclusivity. We have many young physicians who may differ from yourself in one way or another. I challenge you to be that positive mentor for them.