A 24 year old Asian female presents with a two week history of confusion and out-of-body experiences. She also reports associated symptoms of fatigue. The patient admits she has been experiencing some life stressors, such as starting medical school. Physical exam is normal. What is the most likely diagnosis?
You guessed it: this is a CLASSIC presentation of imposter syndrome! It often occurs in the setting of graduate school and the professional field. It is the feeling that you don’t belong and that someone is going to expose you for a fraud.
What is the etiology of this syndrome?
- harboring lifelong feelings of inadequacy and then suddenly being surrounded by exceptional, intelligent individuals
- finally achieving a goal that you have been struggling to reach for so long
- going from being the smartest kid in the room, to not
- entering an environment you are not accustomed to
The etiology is different for everyone, but for me, it was number 1 and 2. I felt like an imposter the first few weeks of med school, that I was going to be found out. I couldn’t believe I was here! I grew up in a household of seven: my grandpa, grandma, aunt, uncle, my two cousins, and me. We all lived together and money was tight for most of my childhood. Granted, being an Asian boss mom, my aunt knew how to save and we were still able to afford summer vacations and small luxuries like that. I think those trips were for their mental health, as they worked so hard. But anyway, on top of that, nobody in my family had gone to college before. As you may know, education and income are closely related in America. Generally, the more educated you are, the more income you can potentially make. I am in no way trying to seek your sympathy or pity, but my point is, as a high school kid, I didn’t think I could attend a good college, like a four-year university, much less medical school! Lastly, nobody in my family was in the health care field, although we did have family friends who were pharmacists. Financial constraints and lack of mentorship is a common barrier for first-generation college students/graduates.
In high school, I knew I wanted to become a physician, but I felt like that was too ambitious of a dream. That’s why I decided on pharmacy in college, since I could have the mentorship of my family friends who were pharmacists. This was my path for the majority of college, until a month before graduating I had a sudden change of heart while trying to brainstorm for my pharmacy school personal statement. I decided to apply to medical school instead. I knew the path was going to be tough. My GPA was awful for a pre-med and despite studying hard for the MCAT, it was still below average for most medical schools. I still applied, but focused on MD schools that were primary care oriented and DO schools because that’s what I was interested in (and still am). When I received my acceptance to VCU, an MD program, I just couldn’t believe it. I kept telling my boyfriend there must have been a mistake. He kept telling me I was crazy! I was in denial, literally up until my first weeks of medical school. I couldn’t accept it until I passed my first medical school exam. The imposter syndrome was so REAL.
What is the treatment for it?
- Above all else, surround yourself with a strong support system. The people who love you most. I can’t emphasize this enough! This might seem like a no-brainer, but the unfortunate byproduct of medical school is that your family and friends start becoming less of a priority, whether you intended for it to happen or not. It’s not because you don’t love or care about them, it’s just the med school life. It becomes easy to drift away or isolate yourself and sometimes you don’t notice. If you have imposter syndrome, chances are it will be tough for you to talk yourself down from it. I know it was for me. But if you have people in your life who have always believed in you, supported you, and cheered you on, these are the people who can talk you down from negative thoughts and HYPE YOU UP! Keep them around as much as you can because they know what you are truly capable of! We know too, but sometimes we forget. Your support system will remind you.
- Link up with other students who might feel the same way as you. I was surprised to find that a couple of my friends were experiencing the same thing. Yes, you DO have time for friends in med school and surviving it is about the pack, not the lone wolf. It’s okay to lean on each other! It’s not a sign of weakness. It’s a great opportunity to form friendships that you will need throughout school. But also don’t try to force it and accept that not everyone can relate to you.
- Read your medical school application, personal statement and secondary essays to remind yourself of your achievements! Many of our most passionate moments so far in medicine manifest in our personal statement. Revisiting it can help renew your drive. Every time I read mine, I’m invigorated!
- Write a letter to yourself ahead of time, if you can, when your passion is at its peak (similar to writing your personal statement). When I embarked on this journey, I was excited. It felt SO right. I made a list of all the reasons why I wanted to pursue medicine and all the encouraging things people said about my potential. I read it right before my first exam because I was nervous and didn’t know if I’d pass.
If symptoms persist or worsen, please follow-up with your primary care physician. Kidding!
I hope you found this relatable. Congrats on medical school! Believe that you are destined for greatness <3
With lobe,
Kelly
