Two dozen students from a variety of School of Medicine programs gathered via Zoom for an Imperfection Session on the topic of "The Imposter Syndrome." Explained by moderator and expert on shame competence Dr. Will Bynum as "the persistent inability to recognize your success is deserved or achieved despite evidence to the contrary," the term "imposter syndrome" has become a hot one. While recognizing that the term "imposter syndrome" is near-ubiquitous and gives a name to something we are all prone to feeling, Dr. Bynum recognized that sharing authentically about this very human experience is rare.
An interprofessional panel of esteemed faculty generously offered their own experiences and answered questions first from Dr. Bynum, who also shared anecdotes, and then from the larger group. Panelists were Drs. Tiffany Hilton, Dr. Elizabeth Malinzak and Dr. Len White. Hilton, an Associate Professor in Orthopaedic Surgery and Program Director for the Doctor of Physical Therapy Program, is a physical therapist who engages in peer-reviewed research and has notched a variety of accomplishments working to define adaptations and exercise training to improve quality and quantity of life for frail elderly patients. Malinzak is an Associate Dean for Student Affairs (also known as Advisory Dean) for the MD program and also an Associate Professor of Anesthesiology and distinguished, nationally-recognized educator and advocate. White is a neuroscientist and educator who has earned local and national acclaim. He has held and continues to hold numerous leadership roles on the university side as well as in the School of Medicine.
Participants gained a sense of community in the recognition that feeling less than adequate is a human experience, as is making comparisons (and self-assessing as “falling short”) and seeking validation from external forces such as test scores or other accomplishments. Additionally, identity characteristics, family background, generational trauma, internal and external expectations, and medical or behavioral health concerns can all contribute to self-assessment and self-worth. In addition to panelists’ reinforcement of the importance of connecting with our own core values and worth, Bynum discussed the importance of separating "self" from "behavior" with a memorable quote: "You are still worthy even if you suck at this right now."
As the evening progressed, some themes emerged.
- Times of transition or career advancement are ripe for feelings of inadequacy.
- The balance between "imposter syndrome" and necessary humility (e.g., accurately recognizing knowledge and skill deficits) is important, particularly in high-stakes professions that involve others' lives, such as patient-facing health professions.
- Lack of confidence shows up differently in different people. For some, constant self-doubt causes an inward retreat and constant rumination about whether or not to contribute to a discussion. For others, nervous energy may manifest in loud contributions to the discussion.
- It is not possible to know someone's inner experience by observing the outside.
- Even though it's normal human behavior, comparison can easily become “the thief of joy."
- One way to counteract self-doubt and the more destructive elements of the almost universal phenomenon of "imposterism" is to find meaning and value in each struggle. Another is to identify those professional activities that promote a feeling of full engagement or "flow" as a method of informing future career choices.
- Finding allies, mentors and sponsors in the professional space can be valuable when self-assessing in the midst of numerical assessments, which are part of medical and health professional education but may not give the full picture of an individual's clinical acumen, competence, and—critically—their overall worthiness. Work ethic, humility, and authentic caring for other human beings are harder to measure but contribute greatly to our ability to serve our patients.
Recommendations from panelists included attention to North Carolina mottos and famous Duke exhortations - To be rather than to seem (NC state motto) and to pursue outrageous ambitions (Duke exhortation by outgoing president Terry Sanford) - as well as care to prioritize patient safety in any moment of doubt.
Le Well is grateful for partnership with the MD Program Wellness Committee.
Special thanks to Drs. Bynum, Hilton, Malinzak and White for sharing authentically, compassionately, and meaningfully during a memorable Imperfection Session.
