COE Helps us fight imposter syndrome in ourselves and future trainees.

Emily Jane Kivlehan, MD

Fellow in Pediatric Rehabilitation Medicine

Spaulding Rehabilitation Hospital 

PGY 5

11/13/2020

Emily Jane Kivlehan, M.D. 

Imposter syndrome is the sense of self-doubt and fear of being discovered as an intellectual fraud despite objective professional success¹. Initially found in groups of professional women, it has more recently been discovered to have a high prevalence throughout medical trainees^2,3.  In my personal experience, imposter syndrome “flares” especially in a new setting. Recently joining Harvard Medical School as a PGY-5 fellow in pediatric rehabilitation medicine, there have been new colleagues to meet, hospital cultures to adjust to and the ever-present struggle of finding the bathroom in a new building. Because of my passion for medical education, I signed up for the Center of Expertise Clinical Teaching Skills Course (and as above, of course thought maybe I wouldn’t be accepted and might be out of place if accepted). Upon a workshop session of reviewing the barriers trainees face to teaching, I noted “I don’t know enough” was common.

Trainees are sandwiched between engrossing ourselves in the learning environment to work toward our own autonomous practice and being responsible for adding to the medical education of trainees and medical students. As such, it may not be shocking that we wonder how we can teach others when we are not yet the experts. However, in our own word cloud, the most common listed qualities to describe our best teacher included “engaging,” “approachable,” “feedback,” “learning,” “supportive,” “patient” and “knowledgeable”. Despite our own self-doubts, the knowledge of our own teacher only listed ones out of the top 7 qualities.

I hope recognizing that we are not alone in our doubts – even those of us dedicated to signing up for an extra course on education – will be a first step toward fighting this component of imposter syndrome. Other tangible ways our group considered to combat this are to pick “bite-size” topics that we have prepared. This allows for flow into the busy workday and helps us build our own confidence by repeating certain topics. As we learn more, we can prepare more of these small topics. Second, if learners ask questions we do not immediately have an answer to, we can normalize the fact that we don’t all know it all quite yet. Beyond teaching clinical items, this helps us teach that we are not expected to know everything, hopefully fighting halting the development of imposter syndrome for those learners in the future!

1.         Clance PI, S. The imposter phenomenon in high achieving women: dynamics and therapeutic intervention. Psychotherapy: Theory, Research, and Practice. 1978;15(3):241-247.

2.         Legassie J, Zibrowski EM, Goldszmidt MA. Measuring resident well-being: impostorism and burnout syndrome in residency. J Gen Intern Med. 2008;23(7):1090-1094.

3.         Brown DW, Binney G, Gauthier Z, Blume ED. Fears and Stressors of Trainees Starting Fellowship in Pediatric Cardiology. Pediatr Cardiol. 2020;41(4):677-682.