Imposter Syndrome and the Never-Ending Rat Race of Being Enough

I used to feel inadequate at various points in my educational experience, but those feelings have been effectively silenced, though it wasn’t easy. I didn’t attend the “top school,” but my family indeed had one hell of a tuition bill to pay. I didn’t consistently achieve “top grades or a perfect GPA,” but I gained a lot of helpful information that wasn’t necessarily on my exams but proved valuable in clinical practice. I remember when applying for the Match, people would ask me, “Why didn’t I apply to more glamorous programs or surgical residencies?”.

A surgery resident publicly told me in a busy ER, “You’re smart for a family medicine resident.” Countless times, I’ve heard, “You’re just a family doctor.” I’ve encountered many people with no qualms about passing judgment and asserting their superiority over me. These individuals were placed in my life to help me develop the thick skin I would need later.

I don’t aspire to be a surgeon or pursue a surgical specialty. After experiencing surgical rotations, serving as a “retractor woman” for hours, enduring grueling quizzes on the innervation and arterial supply of various organs while scrubbed into the OR, enduring late-night OR cases, and the never-ending rounds, well, I wasn’t sold. I enjoy learning, and I struggled to envision dedicating the remainder of my career to just one or two systems. I find satisfaction in family medicine and its breadth of knowledge, allowing me to delve deeply into subjects.

So, what exactly is imposter syndrome? Imposter syndrome is a psychological phenomenon where individuals doubt their accomplishments and persistently fear being accused of fraud despite evidence of their competence and success. When you have imposter syndrome, you regularly feel that you are not enough. Medical professionals experiencing imposter syndrome may feel inadequate or unworthy of their positions, even if they possess the necessary qualifications and experience. They may constantly worry about making mistakes or failing to meet the expectations of their peers and patients. This can lead to feelings of anxiety, stress, and burnout, negatively impacting job performance and well-being. Sadly, feelings of imposter syndrome are a natural byproduct of the prevailing culture of medical education. Fortunately, you don’t have to accept this. You are enough; your work positively impacts someone’s life, even if you’re not always recognized or appreciated. Countless degrees, board certifications, and accolades will not alleviate self-loathing unless we do the inner work.

I’m a family physician, and I’m content with my choice, though there were periods in my career where the impact of working in a dysfunctional system dampened my enthusiasm for the job. I appreciate primary care because it doesn’t confine me to a box. I’ve had the opportunity to treat patients with sarcoidosis, diagnose rare conditions, solve medical challenges that had stumped others for years, deliver babies, and ensure dignity in end-of-life care for my patients.

I am keenly aware that primary care is in a precarious state. In the United States, according to the National Association of Community Health Centers (NACHC), 30% of Americans don’t have a primary care doctor due to a shortage of providers. Moreover, the Association of American Medical Colleges projects that by 2034, the US will be short as many as 124,000 physicians, with more than a third of them being primary care providers.

In Canada, the situation is equally concerning. Amidst a widespread shortage of family doctors nationwide, a survey by the Angus Reid Institute and the Canadian Medical Association (CMA) reveals that half of Canadians either lack a primary care physician or struggle to schedule timely appointments with their current one. The survey found that one in five Canadians said they don’t have a family doctor.

These shortages have significant impacts on healthcare delivery. Patients without access to regular primary care often resort to emergency departments for issues that could have been addressed in a primary care setting. This leads to overcrowding in emergency rooms, longer wait times, and increased healthcare costs.

Furthermore, the shortage of family physicians exacerbates health disparities, particularly in rural and underserved areas where access to healthcare is already limited. With enough primary care providers, patients may be able to receive timely and comprehensive medical care, leading to better health outcomes. Therefore, addressing this shortage and ensuring adequate access to primary care for all individuals is crucial.

I also recognize that, as healthcare professionals, we must collaborate as a team. Let us foster collaboration for better patient outcomes. Let us also acknowledge that other professionals perhaps perform tasks you and I might prefer not to do. So, I salute you to my fellow obstetricians effectively managing shoulder dystocia, general surgeons performing bowel resections, orthopedic surgeons conducting total hip replacements, or pathologists analyzing specimens under a microscope. We all play crucial roles, and it’s time to eradicate this imposter syndrome.