I have a very vivid memory of sitting in the large lecture hall at my medical school in 2005. I remember looking around at all of my new classmates with a mix of awe and utter fear. I was not scared of my classmates, per se. Rather, I was petrified that my peers would find me out.
I was not like them.
Why was I different? These folks were CLEARLY smarter than me. Better than me. They had done AMAZING things, obviously. I didn’t know them yet, but no doubt, they belonged here, and I did not. I would be found out quickly
There was no evidence to prove this theory of mine. I just KNEW, deep down in my gut, that I didn’t belong. However, I thrived and did well in medical school for 4 years, and even managed to plan a wedding by myself, get married, and take a year off to pursue another degree. I graduated, matched into my number 1 residency choice at a premier children’s hospital that is ranked #2 in the nation, and received an amazing award at recognizing my dedication to children and the field of pediatrics at graduation.
Then came residency. You would think that my relative success in medical school would have gotten me out of my own head and into believing that I belong and can be just as successful as my peers.
I don’t remember the first time that someone called me “doctor”, but I do recall having to call myself “doctor” for the first time. Spoiler alert: I didn’t do it! I introduced myself this way: “Hi! I’m Kim Reynolds, the pediatric resident.” I couldn’t do it! I didn’t feel like a doctor. I felt like an absolute FRAUD. I recall going home one day and saying to my husband “one day, these people are going to find me out.”
I knew it wasn’t good to consider myself a fraud, but I did not know how damaging the negative self-talk in my mind was contributing to my happiness, or lack thereof. Don’t get me wrong…I was HAPPY. I was finally living out my dream. But…I was anxious, and didn’t know it. It manifested as insomnia. I couldn’t fall asleep, or, if I woke up, it was difficult to go back to sleep. I would also procrastinate- procrastination is simply a manifestation of anxiety. Furthermore, how could I truly connect with my patients and have them believe in me if I didn’t believe in me?!
The defining moment was 6 months into my intern (or first) year of residency. I was going along day by day, full of anxiety and fear, but hoping that I was masking it all, and playing the role of a doctor well.
Spoiler alert: I wasn’t!
My attendings (or supervising physicians) were barely tolerating me (I am somewhat likable, which is the only reason that I think I didn’t get fired in the first 6 months!). I was stressed out, behind on everything, scared to speak up and answer questions, afraid to ask questions, tired, lonely (sooo thankful for my amazing hubby!), and basically failing at life at that point. It was definitely a low point for me.
It all came to a head when post call (the morning after a 30 hour hospital shift) and EXHAUSTED from a busy night on service, one of my attending physicians sat me down and gave me “feedback”. This consisted of him ripping me to shreds (this is not an exaggeration-he uttered the words “I am not calling you stupid, but…”). I left that day dejected, defeated, and wondering for the first time in my life if I had made the wrong career move by going into medicine. I remember sitting on the couch of our little apartment in Cincinnati with Adrian and crying my eyes out.
The next thing that I did was what ultimately altered the course of my trajectory in medicine, and by extension, in my life. I sat down with one of the senior residents on the team. “I need help” I said, with tears in my eyes. I needed to know how other people viewed me, and needed some actionable tips to help change my actions so that I could improve my performance. To this day I am grateful for this resident. She was kind, yet firm: exactly what I needed. She told me exactly what I didn’t want to hear and needed desperately to hear: I came across as incompetent, unsure of myself, and like I didn’t know what was going on.
It was worse than I thought. “What do I do?” I asked. How can I change and improve? I wanted to be better for my patients, and I didn’t want to develop a negative reputation that stayed with me throughout training. My senior resident then gave me the most profound and best professional advice that I have ever received.
She told me that she knows that I feel like I don’t belong or that I am an imposter. She felt the same way just the year before, when she herself was an intern. The best was that she has been able to conquer her imposter syndrome and to change the course of her training has been to: FAKE IT UNTIL YOU MAKE IT.
I looked at her blankly.
Look, she said. If you aren’t confident with your knowledge, your patients will not have confidence in you; your co-residents will not have confidence in you; your attendings will not have confidence in you. But, most importantly, YOU will not have confidence in YOU. And then, it becomes a vicious cycle. She explained that the only way to break the imposter syndrome cycle is to fake it. When you are asked a question, answer with conviction. If you do not know, say what you DO know about the subject, then state what your knowledge deficit is, and your plan of action to gain the knowledge. Don’t beat yourself up or have any negative self-talk. Just-do it. Look it up. Gain the knowledge. And continue with your day.
I was skeptical. But what did I have to lose? What I was doing was definitely not working, so I was willing to try something new. My next rotation was in the emergency room, which is an imposter’s worst nightmare. It is fast-paced and busy, and what you know or don’t know will be put to the test. She told me to try out the new method in the ER. She told me that I would either sink or swim in the emergency room, and that the time to start was now.
I could barely eat the morning before my first ER shift. I was sick to my stomach with dread.
This was it. This rotation would change everything for me, for better or for worse. I kept her words in my mind when I walked in- be confident. You are a physician who is here to learn. You can do this. I also kept my favorite scripture in mind: Philippians 4:13-I can do all things through Christ who strengthens me.
I don’t remember everything that happened that day, but I do remember this: I thoroughly enjoyed the emergency room! It was fast-paced and somewhat scary, but I actually grew to love the adrenaline rush and the fact that every patient that I saw was a different.
But, here’s the most important thing: I was receiving amazing feedback from my attendings! I found that they often treated me like a colleague more than simply as a learner. I bounced ideas off of them and discussed treatment plans. In the beginning my plans were totally incorrect and I had no clue what was going on half of the time. However, rather than beat myself up or get dejected I simply filed away all of the learning points and treatment plans so that I could remember them next time I saw a patient with similar complaints. With time, I became more and more confident. My senior resident was right-I was no different than I was a month prior, but my confidence in myself metastasized and spread, and allowed others to become more confident in me. Which led to me learning more, presenting better plans, and getting even more confident. Throughout that rotation and subsequent ER blocks I even became FRIENDS with some of my attendings, and maintain those friendships to this day. The confidence carried over into other rotations, and pretty soon I fell into the swing of things in residency. I will not claim to be the best resident in my class, but I was learning, taking care of my patients, and enjoying myself. I still had some hard days self-doubt, and feelings of insecurity, but my senior’s words continued to echo with me when I felt down.
I am now a Pediatric Hospitalist at a busy hospital in Miami, and an Assistant Professor of Pediatrics. I am often told that I am confident and self-assured. This is not always true, but here’s one thing I know to be true: The more confident you ACT the more confident you’ll BECOME. You will start to exude a quiet confidence that inspires the trust of others. Do not get me wrong: cockiness is never a pleasing trait in medicine or any other field for that matter, and I am not advocating for that. However, people also don’t want a doctor who is unsure of themselves. Also, please don’t let my call for confidence dissuade you from speaking and saying you don’t know or are unsure. Quite the opposite: confident people are able to say what they don’t know. Only the ignorant are entirely self-assured.
Reading this story makes it seem so easy. Trust me, it was not at all. And while I have more or less mastered my confidence when it comes to clinical medicine, there are many (MANY!) areas of my life where it eludes me. I am writing this blog post to encourage you, but also to encourage myself to implement this tactic in other areas of my life. Self-help books that attempt to teach me to change my mindset and then see how it changes my life are ever-present and well-meaning, but simply do not work for me. Every day I strive to change my life and in order to see how it changes my mindset. It has worked without fail every time.
Want practical strategies on how to take action in your life in order to see outcomes? Stay tuned for part 2 on how to tackle imposter syndrome head on! Also, check out my blog post on the 5 second rule (link to post) which is basically a foolproof way of implementing this strategy. To check out the book, click on this link!
Peace and love,