Imposter syndrome in medical and graduate students: Strategies to expose the real imposter

A message from the senior associate dean for diversity, equity and inclusion

As our School of Medicine settles into this new academic year, I cannot help but think how impressive our new medical and graduate students are, how persistent and focused they must be. After all, they have persevered through a pandemic, national social unrest, financial uncertainty and not to mention the grueling process of applying to medical / graduate school. It also occurred to me that some of these high-achieving, highly talented aspiring physicians and scientists will likely question themselves and their abilities. Whether it be following an exceptionally tough exam or their first encounter with a world-renowned physician or researcher. Yes, some of our new students will face yet one more formidable challenger – imposter syndrome.

Imposter syndrome, or imposter phenomenon, is a feeling some individuals have that they don’t belong and are essentially a fraud in spite of demonstrated accomplishments in their career or their personal life. Imposter syndrome shows up as an inner voice that is harshly critical, self-sabotaging and unforgiving. Jennifer Hunt, M.D., one of the keynote speakers at the VCU Women in Science, Dentistry and Medicine (WISDM) annual leadership conference this past spring, compares it to experiencing a “high tide, a full moon and a storm” occurring all at once – a feeling that is not all together unfamiliar to me.

While attending the WISDM conference, which focused on “Imposter Syndrome: What Is it, How to Recognize It and How to Overcome It,” I vividly recalled a conversation I had with a faculty member during my doctoral program:

“Some of your interactions with your colleagues suggest you are struggling to prove you belong in the program when it’s clear by what you share that you do. You may want to look into imposter syndrome.”

While I consider myself rather confident in most situations and am very comfortable in my skin, I eventually came to the uncomfortable truth that I was in fact presenting with a classic case of imposter syndrome.

I, however, was not alone. It is reported that 70% of people in the U.S. have experienced imposter syndrome at some point in their lives. It is an equal opportunity phenomenon affecting people regardless of their background. However, research does indicate imposter syndrome is often exacerbated in underrepresented and marginalized populations such as women and minorities who often lack available role models and who also experience higher degrees of bias, stereotypes, microaggressions and structural discrimination.

Research further shows that some 22–60% of medical students experience imposter syndrome. The feelings of some medical students that they lack sufficient knowledge, particularly compared to their peers, is attributed to the larger identity transformation experienced by aspiring physicians. Other factors involved include the penchant of medical educations to attract high achievers and the stressful academic and clinical environments that can set expectations of perfectionism or foster low self-esteem as students are stretched with new knowledge and experiences.

The good news is there are steps we can take to dampen the effects of imposter syndrome. I can attest to the positive impact of becoming aware of this phenomenon. As Jack Canfield reminds us all: “We can’t fix what we don’t acknowledge.” With that in mind, I’d encourage you to take the Imposter Syndrome Assessment developed by Dr. Hunt. I took this assessment prior to attending the WISDM conference and continue to find the self-development part of the report quite useful.

Beyond that, consider the follow steps for addressing imposter syndrome:

  • Make intentional efforts to be nicer to yourself and show yourself some grace when you feel overwhelmed by volumes of new information or experiences.
  • Celebrate the progress you make and do not focus too much on the occasional missteps that will occur.
  • Create a supportive community of family, friends and classmates to get a broader perspective and to help break negative self-talk.

There are also things that organizations like ours can do to help mitigate the effects of imposter syndrome. The first is to foster increasing awareness of the real impact of imposter syndrome on individuals and on organizational performance. Events such as the WISDM conference are important vehicles of communication. In and between major events, departments can further awareness through periodic workshops, brown-bag lunches or encouraging colleagues who consistently down-play their contributions or accomplishments.

More specific steps to assist medical students can include implementing more “grade-free” systems in the pre-clinical years, strengthening mental health services, including more self-assessment and reflective exercises in the clinical setting and providing resources to strengthen our students’ psychosocial well-being and resilience.

As we settle into this new academic year, I would say to our newest learners: You enrich us with a diversity of backgrounds, experiences, interests, aspirations, gifts, talents and intellect. Over the coming years, each of you will demonstrate resilience in the midst of adversity, resolve in the midst of uncertainty and excellence in the midst of opportunity. Through your experiences, you will prove to yourself that you deserve to be here. And, in the end, you will expose imposter syndrome as the real “imposter.”

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