Imposter syndrome is something that many medical/dental students and early career professionals suffer from. And it can stand to reason. The profession you’re pursuing is fast paced, demanding and brings with it more risks and consequences than most other professions.
Although it’s understandable to suffer from imposter syndrome, it isn’t necessary. This is for two reasons. Number one, you’re not an imposter. Number two, this feeling can be managed.
To help you quieten these critical thoughts, we’ve asked practising dentist and positive psychologist Mahrukh Khwaja, AKA Mind Ninja, to help you unmask imposter syndrome and move forward with confidence.
What is imposter syndrome?
Do you ever feel that you’re not as bright, capable or qualified as your fellow students? Do you put your accomplishments down to luck, timing or connections? Do you agonise over the smallest flaws? Feel crushed by constructive criticism? And when you succeed, assumed you’ve fooled everyone?
If the answer to these questions is yes, chances are you’re experiencing imposter syndrome.
Defined as persistent self-doubt and fear of being exposed as a fraud, imposter syndrome occurs as a result of failing to internalise achievements. It often co-exists with depression, anxiety and low self-esteem.
Imposter syndrome is very common, with 70% of people experiencing at least one episode (Sakulku et al, 2011). We can think of it like a mask that we feel we need to put on to prevent others from finding out that we are a ‘fraud’.
My imposter syndrome journey
With 13 years of clinical dentistry under my belt, and shifting into a career in psychology, I can say I have had my fair share of imposter syndrome thoughts. The anxiety would often feel crippling every time I stood up in front of an audience to teach or deliver a workshop.
I had some fixed ideas of the type of person I was, my weaknesses and what I was able to do. And that can really set you up for buying into the story of imposter syndrome.
Using psychological tools was really transformational for me. I went from focusing on these unhelpful thoughts to looking outwards and recognising that I can support healthcare professionals in an honest and authentic way.
Imposter syndrome in healthcare
Imposter syndrome is prevalent in high achievers like medical and dental students. Research suggests that imposter syndrome is more common in female medical students, but it can be seen in male medical students too (Freeman and Peisah, 2021).
An online module for 120 first year dental students reported high incidences of imposter syndrome, associated with increased stress, burnout and decreased performance (Metz 2020). As part of this study, an intervention programme was created. Post-intervention, it was reported that high-achieving students were better able to cope with imposter syndrome.
Imposter syndrome also impacts career progression, leadership and mental health. Experienced doctors may question the validity of their achievements (LaDonna et al, 2018).
A closer look
Imposter syndrome thoughts centre around competency, as well as a fear of failure or being ‘found out’. For example:
- "I should get it right the first time"
- "I should excel in everything I do"
- "I should always know the answer"
- "I should always understand what I’m reading"
- "I should always feel confident"
- "I should never make a mistake"
- "I should never be confused"
- "I should never need help"
Emotions associated with these thoughts include low mood, anxiety, unease and dread.
In terms of the impact of imposter syndrome on our actions, it can often cause us to stay small, avoid stepping out of our comfort zones, prevent us from upskilling, make us feel like we’re not good enough, lead to overworking and overpreparing, stop us seeking help, increase procrastination and even result in self-sabotage.
Five types of imposter syndrome
Valerie Young describes five types of imposter syndrome:
- Perfectionist: Experiences high levels of anxiety, doubt and worry, especially when setting extreme goals that they are unable to achieve.
- Soloist: Prefers to work alone, fearing that asking for help will reveal incompetence.
- Expert: Will not be satisfied when finishing a task until they feel they know everything about the subject.
- Superhero: Often excel due to extreme effort – in other words, ‘workaholism’.
- Natural genius: Masters many new skills quickly and easily, and may feel ashamed and weak when faced with a goal that is too difficult.
Tools from the research
The good news is that psychological research has identified tools and strategies to help you navigate imposter syndrome thoughts with greater ease. I’ll be talking through the following three examples:
- Mindset: Developing a mindset to help you thrive whilst you learn as a student – compassionate and growth-oriented.
- Strengths: Spotting your strengths and using them to navigate challenges and build self-esteem.
- Cognitive Behavioural Therapy (CBT): Reframing unhelpful thoughts.
1. Mindset
We often hear the word mindset used, but do you know what it means?
Mindset refers to a pattern of thoughts and beliefs we hold about ourselves. Our mindset strongly influences our emotions, behaviours and perception of the world. The ideal mindset supports our psychological wellbeing and ability to thrive. It is one that is compassionate and growth-centred.
Compassionate mindset
A compassionate mindset is when we direct the same love and kindness to ourselves that we would a loved one or close friend.
Neff describes three components of self-compassion:
- Mindfulness: Paying attention to the present without getting swept away in the story of our thoughts. This involves an acceptance of the thoughts rather than an urge to reframe or change the thought.
- Common humanity: Reminding ourselves that we are all connected by the human experience of stress, unhelpful thoughts and so on.
- Self-kindness: Kind words and physical gestures.
When you notice an imposter syndrome thought (e.g., "I’m not good enough" whilst carrying out a dental or medical procedure), you can use self-compassion techniques to self-soothe and encourage a wave of positive emotions to provide a buffer against your inner critic.
This might be through validating your stress, or using phrases like: "I’m sorry you’re going through this. It’s not nice to hear. I have your back. How can I support you right now?"
The idea is to use words that you would say to comfort a close friend. You could also use gestures of kindness, like squeezing your arm.
Routes to increasing self-compassion
Compassion meditations can also be a great way to develop self-compassion – for example:
- How To Manifest Abundance With Self-love Meditation
- Self Compassion Meditation
- Loving Kindness Meditation
Journalling can also boost self-compassion – for example, reflecting on your self-talk, reminding yourself that perfection doesn’t exist and focusing on your progress instead.
Working on setting boundaries at university and home is an act of self-compassion. Say no when you have reached your full capacity.
Prioritising your rest, regular self-care and nutritious food is important. There’s no medical degree without you, so double down on building good habits now. This will help you to avoid burnout in the future.
We can also use self-compassion to help self-correct when we do make mistakes, rather than beating ourselves up for them. This approach focuses on the desire to improve, is forward-looking, given with kindness and encouragement, and focuses on hopes for success.
Growth mindset
Did you know that having a growth mindset is key when studying at university?
A growth mindset helps to prop us up when we face challenges and encourages us to gather feedback that will help us to develop.
Growth mindset refers to a belief that our intelligence and abilities can be developed through our own efforts at any age (Dweck, 2006).
When it comes to imposter syndrome, we can remind ourselves that no matter what our mind is telling us, each day we learn and develop further. We have the capacity to learn new skills and adapt to whatever comes our way.
2. Strengths
Another interesting tool from positive psychology is learning to lean into our strengths. Strengths are the positive parts about ourselves and areas that we are inherently, naturally good at. This could be a love of learning, creativity, empathy, leadership or justice.
Understanding what our strengths are can be really helpful in building positive self-esteem, as well as our sense of competence and self-confidence. Key strengths, such as making a patient feel at ease, can be useful in reminding ourselves that we have the capability to deal with many different scenarios.
If you find identifying your strengths difficult, you can try a free strengths assessment. You can also use my guided Strengths Meditation.
3. Cognitive Behavioural Therapy (CBT) (Beck, 1976)
CBT has traditionally been used to treat mental illness, but these tools can also be used to help shift your thoughts to a more realistic view. The aim of CBT is to reframe thoughts from unhelpful to helpful.
Try the 3 C’s approach when you notice an imposter syndrome thought:
- Catch the thought (notice the thought)
- Check to see if it’s helpful
- Change it to a more helpful way of thinking about the situation (or look for evidence against the thought)
You can also journal the above, recording your common thought traps. This can really help to highlight your go-to thought pattern and identify those that need to be reframed.
To help build your evidence against imposter syndrome thoughts you can create a compliment/progress folder collating positive feedback, exams that went well, procedures you’ve really improved on and so on. Aim to regularly review this, too.
Final thoughts
Every time you push yourself outside your comfort zone, you may notice your imposter syndrome chatter pop up. This is very natural. But over time, with the use of these tools, you’ll find that you don’t hook onto the thoughts in quite the same way.
You can notice them and let them be. That’s quite the superpower, and something I wish I’d worked on as a dental student. But the cool thing is, wherever you are on your journey, it’s never too late to start.
References
1. Young, V. (2022). The Imposter Syndrome Institute, The Imposter Syndrome Quiz.
2. Sakulku, J., & Alexander, J. (2011). The imposter phenomenon. International Journal of Behavioral Science, 6(1), 73-92.
3. Metz, C., Ballard, E., & Metz, M. (2020). The stress of success: An online module to help first-year dental students cope with the Impostor Phenomenon. Journal of Dental Education.
4. Bravata, D. M., Watts, S. A., Keefer, A. L., et al. (2020). Prevalence, predictors, and treatment of impostor syndrome: A systematic review. Journal of General Internal Medicine, 35(4), 1252-1275.
5. Young, V. (2011). The Secret Thoughts of Successful Women: Why Capable People Suffer from the Impostor Syndrome and How to Thrive in Spite of It.
6. Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York, NY: Meridian.
7. Neff, K. D. (2003). Self-Compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2, 85-102.