Imposter Syndrome: A Personal Perspective Through The Lens of A Medical Student
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Melissa’s perspectiveImposter syndrome, for me, started in college. It is easy to feel that you do not belong if you are pursuing something that no one in your family has done before. I come from a long line of hardworking grocery workers, and it’s a lot easier to walk on an existing path than it is to create the path, level the ground, and remove the weeds.
As a first-generation college student, I felt that I did not belong in college. I commuted to school and worked almost full-time. I did not tell many classmates that I wanted to be a doctor. What if I didn’t get accepted? What if they looked at me and thought, “yikes, she wants to be a doctor?”To make matters worse, my MCAT scores were less than impressive. I applied to medical school three times – each time with a new score. With every rejection, I felt my self-worth drop, and the voices in the back of my mind echoed that I wasn’t smart enough or hardworking enough to be a doctor.Finally, I was accepted to medical school. As one would expect, with very few exceptions, everyone in medical school is going to be a doctor – which means everyone is really, really smart. I spent the first week of medical school unable to sleep; most of the time I thought I was in way over my head. I told myself that it wasn’t too late to turn around and drive back home to Colorado. I thought attending medical school was a mistake and that I was depriving someone else of an opportunity that they were meant for.Thanks to my boyfriend and the help of strangers on Reddit, I stuck it out. The feeling became less intense, but it certainly has not gone away over the past four years. I found friends who struggled with many of the same feelings, and there is comfort in knowing you are not alone. Now, I have learned to live with it. It is a reminder of the gravity of being a doctor and caring for patients, but it is no longer an impediment to that care.Ashley’s perspectiveI come from a very loving, hardworking family. My mother and father, an aesthetician and blackjack dealer respectively, have truly shown me what hard work and sacrifice looks like. The day I told my father I was considering becoming a doctor, as wonderful and loving as he is, his first words were, “That’s really hard, you will probably change your mind.”This was my initiation into the premedical world. Little did I realize, my feelings of self-doubt and inadequacy were only about to grow worse. Along my path towards becoming a doctor, I have had the privilege of meeting some of the brightest, most hardworking individuals. I was even luckier to call these people my friends and colleagues. The only problem was, even though nobody liked talking about it, we were all going after the exact same thing: admission into medical school. Even though I was doing well in my courses and balancing multiple leadership opportunities, I still felt that I would never be able to outcompete these amazing individuals who had the same dream.My fears and self-doubt appeared to be further confirmed when I was never able to achieve the “perfect MCAT score”. 
The MCAT is the examination required to apply to medical school. Everyone around me seemingly achieved their goals effortlessly, while no matter how hard I worked, my score remained stagnant. I kept telling myself that a score does not define who I am or what I have to offer, but my mind kept telling me “you are not smart enough and you are only fooling yourself in thinking so”. These feelings of worthlessness were even further solidified when many of my colleagues had gotten into my dream school, and I did not.After applying three times to medical school, I was finally admitted! I had finally made it! Those moments of self-doubt, fear and deluding myself for all of these years into thinking I was worthy of being a doctor had finally absolved, right? Wrong. I’ve heard rumors that medical school is a very family-oriented and teamwork based environment, as everyone works together to achieve their goals. As true as this may be in some sense, the further along we got in school, the more clear it became that we are all in competition for the same job. The pressures I felt to be the best helped push me to be my best. Even though I was doing well in all of my courses and never failed a course, I always had this underlying feeling that I had passed “by chance or luck” and that one day, this luck would run out. In addition, any feelings of accomplishment or pride I may have felt were almost immediately annihilated when I found out someone had done better. The feeling of defeat had become a familiar companion of mine at that point.Over the past 4 years, these feelings of being a fraud or subpar have absolutely improved, but have never gone completely away. Having a support network has really helped diminish my feelings of inadequacy and defeat. I was blessed to have many cheerleaders in my life, which include my partner, family and a few lifelong friends I met along my journey. As Melissa eloquently pointed out, becoming a doctor is more than just the accomplishment of making it through this rigorous journey, but about the strength and utmost importance of caring for patients. As I have risen and fallen and fumbled in between, I choose to begin recognizing imposter syndrome as a way to always remember where I came from, and to stay humble throughout the entire process.
As defined by D. Bravata in Journal of General Internal Medicine, ‘Imposter Syndrome’ (also known as imposter phenomenon or fraud syndrome) is characterized as high achieving individuals who, regardless of their objective successes, fail to recognize their accomplishments and continue to have persistent self-doubt about their abilities, with fear of being exposed as fraudulent. Individuals with imposter syndrome have an internal battle within themselves to attribute their performances to their actual competence, and rather attribute any success or accomplishments to external factors, such as luck, and attribute any setback or perceived failure as evidence of their professional inadequacy. Many articles that sought to explore the comorbid conditions that are often found to co-exist with imposter syndrome include depression, anxiety and low self-esteem.As I do find solace in the fact that I am not alone in feeling like an “imposter”, the question I often pose to myself is, “why does this seemingly harmful, self-degrading phenomenon exist in the first place? How did we get to the point that any of our successes are not our own and are simply a product of luck or
chance?” Upon reflection, I look back and think about how our society, especially the premedical/medical culture, has become more about competition and less about teamwork. Ever since I can remember, any “minor success” I thought I had was immediately squashed and deemed not good enough in comparison the moment I saw someone else’s. Melissa and I agree that the education system has become more of a “competition”, which creates a culture where we are no longer able to recognize our successes because we are frantically trying to keep up with the rest of our “competitors”.What can be done to squash this phenomenon once and for all? Melissa brilliantly states, like with any form of trauma, the more we discuss it and create awareness, the 
less powerful it becomes. If the next generation of doctors feel confident in being transparent about the fact that they feel vulnerable and are concerned about not being good enough, then the idea of being an imposter begins to dissolve in on itself. Another thought is hoping that humility and awareness might permeate in places it might be lacking. Someone’s disappointment and “worst academic performance of their life” might be someone’s dream come true. Nobody’s disappointment should be diminished, but knowing your audience and recognizing that your strength is someone’s weakness, might avoid making someone feel worthless. Even today, I still find myself struggling with feelings of inadequacy. However, I have found the resolve to now recognize my strengths and to remember how far I have come from the woman who first had thoughts about becoming a doctor, the first in my family, with many other amazing individuals being the first in theirs. The courage, the drive and the determination it took to get here, is no accomplishment worth diminishing.
Co-authors: Ashley Maestas, OMS IV & Melissa Mahoney, OMS IV
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