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Aug 02, 2024

Feeling like a fraud? You’re not alone.

Impostor syndrome can affect you, your practice, and your patients.


This is a photo of two, female speakers at AAD's 2024 Innovation Academy meeting, Drs. Lucas and zmacDonald.
From left: Jennifer Lucas, MD, MHCM, FAAD, FACMS, and Amy MacDonald, PsyD

P001 – Leadership Institute: When Excellence Isn’t Enough: Imposter Syndrome, Comparison Culture, and the Quest for Authentic Identity in Medicine
10 a.m. – noon | Friday, Aug. 2
Room 617

If you’ve ever felt like you didn’t deserve the success you’ve achieved in your career, you are not alone. What you’re feeling could be impostor syndrome, which was first identified in 1978 as a private, often secret, psychological experience of feeling like a phony or a fraud despite evidence of success or high achievement.

A surprisingly high number of physicians struggle with imposter syndrome and unease about their accomplishments and performance as compared to their peers. Jennifer Lucas, MD, MHCM, FAAD, FACMS, director of derm surgery/Mohs and vice chair of the Medical Subspecialty Institute at Cleveland Clinic in Ohio, said the drive and expectations to be near perfect are things she has experienced in her own life, and reach back to when she was a child.

“A friend of mine once said, ‘would you treat anyone else the way you treat yourself or hold them to the standards you require of yourself?’ As I responded ‘no,’ and thought about all the times I’ve looked around a room and thought ‘how did I get here? Those people are the experts’ … the light bulb went off,” she said. “My ability for self-grace was dismal, and I had impostor syndrome.” 

Dr. Lucas will lead a frank discussion as the director of today’s Leadership Institute session, P001 –When Excellence Isn’t Enough: Imposter Syndrome, Comparison Culture, and the Quest for Authentic Identity in Medicine.

“This topic deserves attention and understanding as so many of us are affected by it,” she said.

The patient perspective

Session speaker Amy MacDonald, PsyD, a licensed clinical psychologist in Batavia, Illinois, is no stranger to impostor syndrome, having seen it in many of her patients.

“In my psychotherapy and coaching work with professionals, I find impostor syndrome to be widespread and common. We need to highlight how the medical world fosters impostor syndrome and normalize its presence in the lives of physicians,” she said. “Doctors’ training toward performance and assessment often shortchanges a focus on authentic identity and personal meaning planted in values. The focus on identity and values not only makes for a more fulfilling professional life but is also the foundation for strategies to fight impostor syndrome.”

Dr. MacDonald said impostor syndrome can lead to a lack of professional fulfillment in physicians and, in some cases, contribute to burnout. 

“All people have sometimes felt self-doubt, inadequacy, or fear of being in over their heads with a task,” she said. “Because imposterism involves the extra ‘emperor has no clothes’ element, it creates a weighty dread of inevitable discovery. This diverts needed professional energy into worry, vigilance, and self-protection. Consider how much less fulfilling professional life is when lived under such exhausting conditions. Higher degrees of impostor syndrome correlate with higher rates of burnout, lower job satisfaction, and poorer job performance.”

Change the conversation — with yourself

Fortunately, there are strategies for discouraging and overcoming impostor syndrome — even small changes can have a lot of impact for the better.

“Just shedding light onto the subject and recognizing this is an ‘us’ problem, not a ‘me’ problem helps,” said Dr. MacDonald. “Managing imposterism involves self-awareness, reframing assumptions, finding realistic solutions, and moving toward an authentic, values-based life, rather than one grounded in fear of loss, exposure, and comparison.”

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