Imposter Syndrome in the IMG Doctors

When I first joined the NHS, I was in constant fear that I am not good enough and someone will soon find out that I am totally incompetent. I felt anxious and my mind was filled with self-doubt. I will spend hours thinking about what I did in the hospital and my mind will ruminate on how I should have done thing. My mind will compare myself with other doctors working around me and I was getting the constant feeling that I am way behind everyone and will never be able to catch up.

This feeling of incompetence isn’t uncommon among young doctors and the new IMGs often feel they are not good enough. The psychological phenomena is called “Imposter syndrome” and if you are feeling like this, you are not alone.

What is Imposter Syndrome?

Imposter Syndrome refers to an Psychological experience of believing that you are fraud, not as competent as others perceive and got this position just by luck. Imposter Syndrome is not a mental illness.

The concept of Imposter Phenomenon/Syndrome was first studied by Pauline Rose Clance and Suzanne Imes, two female psychologists in 1978. They studied 150 highly successful women and found that despite their academic excellence (multiple PhD’s, scholastic honours, high achievement on standardised tests), they considered themselves to be “imposters.”

What does imposter syndrome feels like?

  • You may feel you are a fraud and people will soon find about you.
  • You may minimise your achievements and skills as a doctor so far and your mind may focus on the things you cant do yet.
  • You may feel you are not ready to take the next step in the career progression and hold yourself back from opportunities.
  • You may not ask questions or hold yourself back from conversations feeling that you may say something silly and

Why it may be more common in the new IMGs?

When the IMGs are new to the NHS, they have a lot to learn and during the initial days in the NHS they may feel completely out of their comfort zone.

The language barrier can add to the stress and IMGs may struggle to understand what is going around them.

IMGs come from different health systems and at times when they are fully clinically competent, they may not fully understand how the NHS work during the initial days and this can lead to stress, anxiety and self doubt

The new IMGs will take time to understand the new system, that’s not incompetence, that’s just adjustment. They should be supported during the initial weeks and months which will help them gain confidence.

How to over come this Imposter Syndrome?

Set yourself small goals and tasks:

When everything is looking overwhelming and unachievable, setting yourself small goals and short term tasks can help. This could be just as simple as surviving a weekend of on-call or performing a small procedure. It can give you sense of achievement.

A person with Imposter Syndrome often minimise their achievements feeling that was just part of their job, nothing special, and their brain may magnify their small setbacks as big failures.

It is therefore important to have a reflective approach to overcome this feeling. You can start identifying your small achievements, build upon them and start seeing your contribution to the wider team.

Seek feedback:

As junior doctors and new IMGs, you should seek feedback not just from your seniors but also by peers, nursing and other MDT staff.

A person with imposter syndrome may feel people are extra polite with me and just saying nice things to make me happy. It is important to overcome this feeling by getting feedback from multiple sources and making note of the positive things said about you alongside the areas of improvement.

It is often difficult to openly talk about your feelings when you have Imposter Syndrome but as Imposter Syndrome is a common phenomenon, other professionals and IMGs are able to relate with it and reassure you.

Reflect on your progress:

Sometimes I read my old CVs and reflect how far I have come. When our mind is constantly focusing on our deficiencies, we fail to acknowledge our success and we need to literally remind ourselves.  

You can make a personal development plan on how you will improve yourself in the coming months and year. Focus on one or a few things at a time. Putting things on paper or in writing can help clarify any doubts and plan next steps better.

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