Author: Holly Trippe
Medical Student, University of Birmingham
Hi, my names Holly and I am about to start my 3rd year if Medicine at the University of Birmingham. In my A-Levels I significantly missed my grade offer, but due to contextual data and extenuating circumstances was still given a place at Birmingham to study medicine. When I arrived at university I suffered hugely with Imposter Syndrome, but at this point I didn’t know what imposter syndrome was so struggled to verbalise what I was feeling and felt very isolated. Their is limited (if any) teaching on the concept, so hopefully this article will explain what it is, how to combat it, and some stats that show you are not alone in feeling like this.
What is Imposter Syndrome?
Imposter Syndrome can be defined as ‘a collection of feelings of inadequacy that persist despite evident success’. ‘Imposters’ experience chronic self doubt, a feeling of fraudulence and lack of confidence in their ability. If left un-addressed Imposter syndrome can cause:
- emotional exhaustion
It can also reduce a persons ability to take up new roles and responsibilities, in particular leadership roles, as they feel like are ‘not good enough’. This cartoon visually demonstrates some of the common thoughts and emotions seen in those with Imposter Syndrome.
It is a phenomenon that often makes an appearance as students start university and is particularly common on high intensity, competitive courses such as Medicine. A descriptive study of Imposter Syndrome in Medical Students (1) stated that 38.09% of the sampled medical students had moderate Imposter Syndrome and 54.49% had severe imposter syndrome. Both genders were of equal risk of developing Imposter Syndrome and concluded that ‘further discussion regarding medical educations paradigms’ were needed as a result of these statistics.
Do I have Imposter Syndrome?
I have linked a 3-minute quiz designed to assess the likelihood of yourself having Imposters Syndrome.
If you have more time to spare and would like to do a more in-depth test that takes slightly longer, but will provide a more in-depth insight this free test is also available:
The results of these ‘self assessment tests’ are not designed to give you a diagnosis, but more an insight into your own emotions and feelings surround Imposter Syndrome.
Techniques to Manage Imposter Syndrome
Later I will discuss how to tackle Imposter Syndrome in a sustainable and well evidenced manner however first I will give you some techniques that you can use right here and right now to help tackle Imposter Syndrome
- Separate feelings from fact → you may be feeling like a fraud, but you have earnt everything you have received.
- Celebrate your successes, make sure you reward yourself → my friend keeps both a success and a compliment log so when she’s struggling she can read back over them!
- Practice Positive Self-Talk → try saying some daily affirmations every morning e.g. I am smart and deserving of a place on my course, I deserve to receive constrictive criticism so I can grow as a person and improve, I am worthy of everything this world has to offer. Saying these may feel odd and bizarre at first but over time they will start to sink in.
- Accept mistakes, and reflect on how feedback can help you improve → by becoming more confident in giving criticisms to others, when the same criticisms are given to you you will be more able to separate the suggested improvements from your self worth.
- Establish a Support Network
- Rephrase your thoughts
I want to spend a minute discussing this last point as it can be quite a tricky one to master. Imagine you are in an exam hall, stressed and feeling like you are going to fail because you don’t deserve to be here. Whenever you are about to say to yourself ‘I don’t deserve to be here’ rephrase this and say ‘Right now I don’t think I deserve to be here, but this is a feeling not a fact’. By simply self-correcting our thoughts, we can start to create a positive mental space that will allow us to reach our maximum potential. This is the most challenging out of the ‘short-term’ fixes and takes some practice, but has a strong evidence base backing it as a technique conducive with sustained change.
There are several recognised techniques that can be used to tackle Imposters Syndrome, however I will primarily be discussion Acceptance and Commitment Therapy (ACT) as this has the strongest evidence base.
ACT is a form of therapy that combines mindfullness with the practice of self-acceptance, and requires the individual to confront and deal with their negative emotions rather than avoid them completely. There are 6 Core Processes in ACT:
- Acceptance → by acknowledging and accepting the negative experience/emotion, people can shift to an action taking mindset, where they hope to create change, rather than an avoidance mindset.
- Cognitive Diffusion → Changing how we react to out thoughts and emotions, primarily based on reducing our fixation on negative experiences
- Being Present → Being aware of what is happening in the here and now,
- Self as Context → The introduction of the idea that we as individuals are more than our experiences, thoughts and emotions have made us become, we have limitless potential.
- Committed Action → ACT is not a quick fix, it takes continued effort and engagement over a prolonged period of time
It can be summarised by equating Imposter Syndrome to being trapped in quick sand. When stuck in quicksand the more you struggle and try to push the sand away and dig yourself out, the more you sink. However, when you pause and accept where you are and stop struggling, you stop sinking. The same happens with emotions. ACT helps people to acknowledge, process and then overcome these negative emotions
The building of personal resilience is another evidence based technique to counter imposter syndrome. Resilience is the ability to ‘bounce back’, recover or rebound from adversity. It is an ongoing and dynamic process of coping.
A study by Safaryazdi on the ‘Relationship between Resiliency and Imposter Syndrome’ (2) showed there is a negative relationship between Resiliency and Imposter Syndrome. This means as we increase our personal resilience, we are less likely to experience Imposter Syndrome, highlighting the importance of resilience on our feelings of capability and belonging. Students can build resilience by:
- Having a growth mindset
- Becoming comfortable receiving and distributing constructive feedback
- Aiming high and getting involved.
This method works by countering the cycle of perceived inadequacy which is explained in the image below.
I hope this article has helped introduce you to the concepts of Imposter Syndrome, how to recognise it in yourself and some short and long term strategies to cope/manage the phenomenon. If you have any feedback on this article or further questions please get in touch on me via my instagram @miscellaneousmedic or my email email@example.com.
Have a lovely day and here’s a reminder to take a moment to unclench your jaw, drop your shoulders, take 5 deep breaths and smile! You’ve got this!!
- Maqsood, Hamza & Shakeel, Hassan Abdullah & Hussain, Humza & Khan, Ali & Ali, Basit & Ishaq, Asher & Shah, Syed. (2018). The descriptive study of imposter syndrome in medical students. International Journal of Research in Medical Sciences. 6. 3431. 10.18203/2320-6012.ijrms20184031.
- Safaryazdi, Niayesh. (2015). Surveying the Relationship between Resiliency and Imposter Syndrome. International Journal of Review in Life Sciences. 4. 36-42.