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  • I Really Can Do This: 4 Steps to Conquer Impostor Syndrome

    I sat down at the head of the surgical bed. The patient was prepped and draped, with an eye exposed and ready for surgery.

    The preoperative safety pause was complete. Now it was my turn. No attending surgeon to start out. No other eye surgeon even in the building. This was all on me. And my thoughts swirled through my head: Am I good enough? Am I qualified? Like my patients had asked before — am I even old enough to be a doctor? I took a deep breath, exhaled slowly and asked for the surgical forceps. I trusted my hands to follow the same steps I had done so many times before and started the surgery. 

    Although having some nerves prior to a big surgery day, a full clinic or an academic presentation is common. This so-called “impostor” syndrome — or the feeling of being not good enough, not qualified or inadequate for the job — is more common among physicians than other U.S. workers. 

    According to a 2022 study by the Mayo Clinic, one in four physicians experiences frequent or intense symptoms of impostor syndrome. Despite undergoing years of training, studying and preparing, there is still a sense of inferiority that physicians have a hard time shedding once in practice. Moreover, the experience was more severe among younger physicians, women physicians, physicians practicing in the Veterans Health Administration or in academic practice settings.

    As a young ophthalmologist, how do you deal with impostor syndrome? I polled a number of practicing ophthalmologists and mentors and summarized their recommendations below.  

    1. Talk to someone you trust.

    One of the falsehoods that we often tell ourselves is that we are alone in our feelings of inadequacy. The reality is that everyone has at some point felt similarly. Whether you are struggling to see the fundus with a 20-diopter lens as a new resident or you are trying to manage a complicated surgical patient years into practice, your peers and mentors have been through similar situations and are a great source of support. 

    Find someone that you can trust, who will empathize with you and build you up. A group message with your co-residents, lunch with a peer or phone call with a mentor are all good ways of connecting and finding support.  

    2. Put time into preparation.

    Preparation is the best building block for confidence. One of my residency mentors taught me the power of visualization. Prior to a challenging surgery, I often find a quiet place, close my eyes and visualize each step of the surgery. I then repeat the process with complications at each major step and how I would address them. 

    Watching surgical videos, reading up about a challenging situation or presenting challenging cases to a group of peers or on a listserv (which many subspecialty societies have available) are all ways to bolster preparation. Intentional preparation allows you to deal with unexpected circumstances with more confidence. 

    Sometimes we feel like kids in grown up clothes, are we really ready to be “the doctor”?

    3. Learn from challenging situations.

    Our first reaction to a challenging situation is to get out of it and avoid thinking or discussing it because we don’t want to experience the stress or pain that it induced in the moment. However, avoidance actually impedes learning.

    Although discussing complications can feel embarrassing at first, it is a crucial skill that allows you to learn from your experiences and benefits your patients moving forward. Sitting down at the end of the day and watching a surgical video or reviewing the steps in your mind will allow you to make more informed and confident decisions when faced with similar situations in the future. 

    4. Trust your training.

    Remind yourself of all of the countless hours of preparation that you have under your belt: studying, wet lab and simulator practice, proctored and independent surgeries and so on. There are few people in the world who have undergone the amount of prep for what you are doing. 

    Impostor syndrome is a real phenomenon and can challenge your ability to do your best work. Remember that you are not alone in these feelings and don’t let them keep you from jumping in and doing your best. Before you know it, you will be a couple of years into practice, in a good rhythm, with the confidence that should have been there all along. 

    Bradley S. Henriksen, MD About the author: Bradley S. Henriksen, MD, is a pediatric ophthalmologist at the Excel Eye Center in Provo, Utah. He joined the YO Info editorial board in 2022.