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    You Have What It Takes

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    Ruth D. Williams, MD

    By Ruth D. Williams, MD, Chief Medical Editor, EyeNet

    Three residents approached me after the L.E.A.P. Forward program, an annual leadership forum for ophthalmology residents that is held during the Mid-Year Forum in Washington, D.C. One of them asked, “Have you ever had Imposter Syndrome?”

    The question gave me pause, and I’ve been thinking about it since. When I was a resident and a young ophthalmologist in clinical practice, very few things we experienced were described as a syndrome, and it was even less likely that we would talk about our feelings. It was work, after all. But thankfully, things have changed.

    Imposter Syndrome and Beyond

    In this supplemental podcast, three ophthalmic leaders discuss Imposter Syndrome, the value that young ophthalmologists bring to the field, and lessons that they’ve learned about leadership. Ruth D. Williams, MD, hosts a conversation with Kathryn A. Colby, MD, PhD, and Tamara Fountain, MD.

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    So, what is Imposter Syndrome? First described in 1978, Imposter Syndrome is a psychological pattern in which a person doubts his or her accomplishments and has an internalized fear of being discovered as a fraud.Although it is commonly experienced by high-achieving women and minorities, most people—up to 70%—will experience it at some point in their careers, especially during times of stress, anxiety, or depression.

    Kathryn Colby, MD, PhD, gave a talk on Imposter Syndrome at last year’s Women in Ophthalmology clinical meeting, so I asked her about it. Kathy is an ophthalmology superstar. Among other accomplishments, she is chair of the Department of Ophthalmology at the University of Chicago and president-elect of the Cornea Society.

    Kathy pointed out that moments of self-doubt are ubiq­uitous among successful people, and she acknowledged that she has dealt with them herself. For instance, last year, Kathy gave an invited talk on ocular surface tumors in children at the 2018 World Ophthalmology Congress. Looking out at the audience, she spotted four experts on the topic, several of whom she was referencing. Her inner voice said, “OMG, how can I be standing up here?” But her well-trained second reaction was to identify the thought as a manifestation of Imposter Syndrome. She chuckled internally and gave a terrific talk.

    Her advice for dealing with these episodes: “The most important thing is to recognize these feelings when they arise.” Then, she said, the thoughts can be redirected, thus allowing the person to visualize a successful outcome. Kathy pointed out that perfectionism is the enemy of professional development, while a growth mindset is its greatest friend. Acquiring new professional skills requires us to step outside of comfort zones. “One of the most important projects for professional (and personal) growth is coming to terms with one’s imperfections and using failures as the fuel for learning and change,” Kathy said. She cited the burgeoning body of work that supports the concept of neuroplasticity and sug­gested that ophthalmologists consciously work on rewriting their inner scripts.

    When I think about this process, I remember a night when my husband and I had the kitchen table at Charlie Trotter’s, a famous Chicago restaurant. Midway through our remarkable meal of complex and artistically prepared food, the room took on an electric feel when Char­lie walked in. When he stopped by our table, I commented that he must be a perfectionist. He responded, “No, I’m an excellentist.”

    I think this is how to tran­scend Imposter Syndrome. My ophthalmology col­leagues, we are excellentists. Each of us isn’t perfect, isn’t the only expert, and doesn’t have all the answers. But we each have the courage to take on professional challenges, the ability to learn new skills, and the capacity to be leaders.

    So, to the residents who asked about Imposter Syndrome: It’s normal. It has a name, but it need not have any power. You’re excellentists. You have what it takes.


    1 Clance PR, Imes SA. Accessed April 30, 2019.

    Voices of Experience

    As Dr. Colby noted in the podcast above, feelings related to Imposter Syndrome are shared by many successful people.

    I’ve written 11 books, but each time I think, “Uh oh, they’re going to find out now. I’ve run a game on everybody. And they’re going to find me out.” —Maya Angelou

    No matter who we are, no matter what we’ve done, there comes a point where you think “How did I get here, and am I going to be able to continue this? When are they going to discover that I am, in fact, a fraud and take everything away from me?” It’s a high-wire act that we all walk. —Tom Hanks

    Some years ago, I was lucky enough to be invited to a gathering of great and good people: artists and scientists, writers and discoverers of things. And I felt that at any moment they would realize that I didn’t qualify to be there, among these people who had really done things.

    On my second or third night there, I was standing at the back of the hall, while a musical entertainment happened, and I started talking to a very nice, polite, elderly gentleman about several things, including our shared first name. And then he pointed to the hall of people, and said words to the effect of, “I just look at all these people, and I think, what the heck am I doing here? They’ve made amazing things. I just went where I was sent.”

    And I said, “Yes. But you were the first man on the moon. I think that counts for something.”

    And I felt a bit better. Because if Neil Armstrong felt like an imposter, maybe everyone did. Maybe there weren’t any grownups, only people who had worked hard and also got lucky and were slightly out of their depth, all of us doing the best job we could, which is all we can really hope for. —Neil Gaiman