It’s the lingering thought that you don’t belong when sitting in a meeting, surrounded by accomplished colleagues.

The hesitation before answering a question on ward rounds, afraid of being wrong in front of your supervisor.  The unease when you are given a leadership opportunity and wonder if you truly deserve it. The hesitation of a newly appointed consultant, wondering if they truly deserve the role after years of training. The self-doubt that lingers after a patient files a complaint about a treatment outcome, even when every step was taken with care and professionalism.

What is Imposter Syndrome?

Imposter syndrome is also known as Impostor Syndrome and Imposter Phenomenon. It is the experience whereby individuals feel that they do not deserve their successes despite objective evidence to the contrary and therefore they feel they will eventually be exposed as an imposter. It was first described in 1978 by psychologists Pauline Clance and Suzanne Imes. Though originally studied in high-achieving women, we now know it affects professionals of all genders, especially in high-pressure environments.  Imposter syndrome isn’t just occasional self-doubt; it’s a persistent belief that success is undeserved, despite clear achievements. Those affected often attribute accomplishments to luck or external factors rather than recognising their own competence.

While it overlaps with anxiety and depression, imposter syndrome is not classified as a clinical disorder in the DSM-5. This phenomenon is widely recognised, making it a popular topic in discussions on workplace psychology and professional development. The term resonates because it captures the deep-seated self-doubt many high-achievers in high-pressure environments experience, even when there is clear evidence of their competence. Medicine, with its relentless demands, hierarchical structures, and culture of perfectionism, is a breeding ground for imposter feelings.

Understanding the Pressures That Drive Imposter Syndrome in Medicine

Why Does Imposter Syndrome Develop?

Several factors contribute to imposter feelings:

• Perfectionism – The pressure to perform flawlessly, common in medicine, reinforces feelings of inadequacy.
• Early family messaging – Childhood expectations, like being labelled ‘the smart one,’ can create a fear of failing to meet high standards.
• Societal biases – Women, minorities, and high-achievers often experience imposter syndrome more frequently due to systemic pressures and underrepresentation in leadership roles.
• Medical culture – The demanding nature of training, hierarchical structures, and an emphasis on knowledge retention over growth can fuel imposter feelings.

Consider medical training: The gruelling hours, the constant assessments, the expectation to retain an overwhelming volume of knowledge, and the pressures of working within a rigid hierarchical structure where questioning authority can feel risky. From day one, students are thrown into a system where excellence is assumed, mistakes are punished, and showing vulnerability is often seen as weakness. It’s no surprise that imposter syndrome starts early. Studies suggest that up to 49% of female medical students and 24% of male medical students experience significant impostor feelings.

For practising doctors, the stakes are even higher. A recent survey published in Mayo Clinic Proceedings found that one in four doctors experiences frequent or intense imposter feelings. Although physicians have higher levels of personal resilience than workers in other fields, they have lower levels of self-valuation. This factor translates into many physicians being empathetic with others but self-critical and perfectionistic with themselves. This mindset, when combined with the professional norms previously discussed and a highly accomplished peer group, results in many physicians believing that their personal accomplishments are inadequate.

Women and early-career doctors are particularly vulnerable. Doctors report that poor patient outcomes, patient complaints, and negative teaching evaluations often contribute to self-doubt, even after residency.

How Imposter Syndrome Manifests in Medical Professionals

The Imposter Cycle

Imposter syndrome often follows a predictable pattern known as the Imposter Cycle:

1. Trigger Event – A new challenge, evaluation, or high-pressure situation arises (e.g., a new role, patient feedback, or a presentation).
2. Response Mechanism – The individual either overprepares excessively or procrastinates to cope with self-doubt.
3. Short-Term Success – The task is completed, often successfully, but the relief is only temporary.
4. Attribution of Success – Instead of recognising their skill, the individual credits luck, external help, or sheer effort rather than ability.
5. Reinforcement of Self-Doubt – Because the success is not internalised, the cycle repeats with the next challenge, reinforcing imposter feelings.

The 5 Imposter Personas

Dr Valerie Young identified five common imposter personas that professionals may identify with:

1. The Perfectionist – Feels like a failure if they make a mistake, even if the overall outcome is successful. Struggles to accept anything less than perfection.
2. The Expert – Believes they must know everything before they can contribute. Feels inadequate if they don’t have all the answers.
3. The Soloist – Prefers to accomplish tasks alone and sees asking for help as a sign of incompetence.
4. The Natural Genius – Expects to excel effortlessly. Feels like an imposter if they struggle to master something immediately.
5. The Superhuman – Feels the need to excel in every area of life (career, family, fitness, social life) and sees any shortcoming as failure.

Doctors and medical students with imposter syndrome often exhibit behaviours that paradoxically reinforce their self-doubt:

• Overcompensation: They work excessive hours, triple-check everything, and avoid delegating. While this may seem beneficial in medicine, it leads to exhaustion and inefficiency.
• Avoidance of Challenges: Some hesitate to take on leadership roles, apply for promotions, or teach juniors for fear of exposing their ‘incompetence.’
• Attributing Success to External Factors: They chalk up their achievements to luck, timing, or the support of colleagues rather than their own skill and effort.
• Fear of Asking for Help: In a culture where competence is equated with confidence, many hesitate to admit uncertainty, even when patient safety would benefit from a second opinion.

The Real-World Consequences

Imposter syndrome in medicine isn’t just a personal struggle—it has professional and systemic repercussions:

• Burnout and Mental Health Decline: Studies consistently show a link between imposter syndrome, anxiety, depression, and physician burnout. Medical students and doctors who feel like frauds are at increased risk of emotional exhaustion and even suicidal ideation.
• Compromised Patient Care: A doctor or student paralysed by self-doubt may hesitate in decision-making, avoid difficult cases, or fail to advocate for a patient because they don’t trust their own judgment.
• Workforce Attrition: Talented individuals may leave medicine altogether, believing they are not ‘cut out’ for it. This is especially concerning in an era of healthcare worker shortages.

There is also good news, you can work on beating your imposter syndrome:

Because imposter syndrome is deeply rooted in thought patterns and external pressures, effective strategies involve both individual mindset shifts and systemic workplace changes. Cognitive-behavioural approaches, mentorship, and creating supportive professional environments are all key to helping medical professionals overcome these feelings and build confidence in their abilities.

Vitae Wellbeing& Leadership has developed a practical 10- step guide to help you overcome your imposter syndrome: 

📥 Download the Free Guide: Get a structured, printable version of these steps to keep as a reference. 

 1️⃣ Normalise It

Imposter syndrome is extremely common, especially among high achievers. It thrives in the dark, feeding on silence and self-doubt. Recognising that you are not alone and bringing these feelings into the light—through awareness and open conversation—is the first step toward overcoming them.

2️⃣ Talk About It

Open up to mentors, colleagues, or trusted friends. You’ll likely find that they’ve felt the same way. Discussing imposter feelings can help normalise them and provide perspective.

3️⃣ Name and Challenge Your Inner Critic

When you catch yourself thinking, “I’m not good enough” or “I don’t belong here,” acknowledge that voice as the Imposter Voice. Challenge these thoughts by asking yourself: What skills, effort, and preparation led to this success? Focus on facts, not feelings.

4️⃣ Identify and Manage Triggers

Notice when imposter thoughts arise—after feedback, during presentations, or when working with senior colleagues. Recognising patterns can help you develop strategies to counteract them.

5️⃣ Acknowledge Your Achievements

Own your accomplishments rather than dismissing them as luck. Keep a ‘Success Journal’ where you document positive feedback, milestones, and challenges you’ve overcome.

6️⃣ Stop Comparing Yourself to Others

Everyone has a unique path. Rather than measuring your progress against colleagues, focus on your own growth and learning.

7️⃣ Focus on Progress, Not Perfection

Perfectionism fuels imposter syndrome. Shift your mindset to continuous improvement rather than flawlessness. Mistakes are part of learning and growth.

8️⃣ Create a Confidence File

Keep a folder with positive feedback, thank-you notes, and examples of work you’re proud of. Reviewing these reminders can boost confidence during moments of doubt.

9️⃣ Practice Self-Compassion

Treat yourself with the same kindness you would offer a friend. Swap harsh self-criticism for supportive and constructive self-talk.

🔟 Take Action Anyway

Confidence grows through action. Don’t wait until you feel fully ready—apply for that opportunity, speak up in meetings, and take on challenges. Growth happens outside your comfort zone.

Coaching and Support:

If you’re struggling with imposter syndrome and want to address your personal risk factors, Vitae Wellbeing & Leadership can support you with evidence-based strategies tailored to your needs. Click here to schedule a complementary 15-minute Introductory Call with Dr Ira van der Steenstraten, or click here to schedule a coaching session. 

Conclusion: You Are Not Alone

Imposter syndrome thrives in silence, but it diminishes in the light of awareness and community. If you feel like a fraud, remember: You are not the only one.

Your training has prepared you more than you realise. Competence is not the absence of doubt—it’s the ability to keep learning, adapting, and showing up, even when you’re uncertain.

So the next time you feel like an imposter in your own career or medical education, pause. Acknowledge the feeling, but don’t let it define you. Because you belong here.