I
was quick on the heels of my co-resident as we marched down the sterile corridors of the hospital. When we arrived, we found the pediatric attending sitting with our patient’s parents. The trio glanced up as we entered.
The mother looked at us, and stated simply, “It’s the surgeon.”
She was referring to my colleague who had entered the room with me. He was one year my junior and about 10 inches taller than me. I looked down at our identical uniforms—deep-blue scrubs, stained white coats, and two separate pairs of dirtied, worn sneakers—and I couldn’t help but feel a little indignant and angry. Why don’t I look like a surgeon?
This wasn’t an isolated incident. It seems as though there isn’t a day that goes by during which a patient assumes I am a nurse, nurse aid, or other allied health care provider. Despite my best attempts to wear taller shoes, keep my white coat handy, and place my name badge in plain visible sight, no one seems to assume I am a doctor, let alone neurosurgeon.
To make matters worse, I am surrounded by male colleagues who all seem to have been born with that gene that makes a person confident and proud, and gives them the ability to command a room when needed. I often feel like a mouse next to them.
These fleeting moments, repeated literally hundreds of times over my years as a resident, added up and soon began to weigh heavily on my mind, but in a different form: imposter syndrome.
This syndrome was first described in the 1970s by two psychologists, Suzanne Imes and Pauline Rose Clance, as an issue commonly seen in high-achieving people who are unable to internalize and accept their success. They often attribute their accomplishments to luck rather than ability, and they fear others will eventually reveal them as frauds. This has predominantly been seen in women.
Women in medicine are particularly vulnerable to imposter syndrome. It’s little wonder that women feel less than others in their fields. Women doctors earn $19,879 less than their male counterparts, and women surgeons earn roughly $44,000 less. Being open about my imposter syndrome has been met with many other relieved women who tell me they’ve always felt this way and thought they were alone.
My turning point with imposter syndrome came once I realized these feelings were getting in the way of one extremely important thing: my patient care. Being timid and second-guessing oneself has the potential to influence medical decision-making, so to be the best doctor for my patients, I knew I had to let these feelings go.
This process has not been easy, and it’s very much still ongoing. There is a mindfulness exercise called “fact checking” that I’ve found to be particularly helpful. It involves repeatedly asking the question: Do my feelings match the facts of the situation? I would ask myself, “Am I a complete failure? Do I not belong? Do I lack the skills and the ability to be a neurosurgical resident?” The answer was, of course, “No!” The facts clearly provided evidence that I am right where I need to be. You don’t become a surgeon by accident, after all.
That doesn’t mean imposter syndrome has only been problematic. There have been some good things to come out of the experience. A little bit of self-doubt can actually be the driving force behind extra effort and collaboration. When an ambitious person doubts himself or herself, he or she is more likely to work harder to master that particular skill and to ask for help. Having too much confidence can actually be detrimental.
A 2017 study done by researchers at Sunnybrook Health Sciences Centre at the University of Toronto found that patients treated by female surgeons had a decrease in 30-day mortality than those treated by their male colleagues. The authors postulated that, among other factors, women’s willingness to collaborate might be a contributing cause.
With that said, there is no place for imposter syndrome in medicine—or in any other professional field. Too much self-doubt can be crippling and lead to decision-paralysis and poor outcomes. And with high rates of burnout and mental illness, imposter syndrome only serves to fuel those flames. But the good news is we can beat imposter syndrome. One strategy is to cut out sexism in the workplace, both subtle sexism and overt acts. We can also learn to be more open and mindful about our feelings and the feelings of others. Women who struggle with confidence issues should know that they aren’t alone. Many others feel the exact same way, no matter how successful they’ve been professionally.
With time and some important structural changes to our workplaces, we can beat imposter syndrome and make our workplaces better for everyone.