For medical students taking the first steps on their journey toward a career as a physician, the path can seem daunting. In many instances, the start of medical school can come with impostor phenomenon—the feeling that you don’t truly belong or deserve your success, despite clear evidence that you are capable and qualified.
How does impostor phenomenon, also called imposter syndrome, manifest for first-year medical students? What can they do to normalize their feelings and stay on track? Read on for some insights that shed light on those questions.
Know that you are not alone
For a 2024 qualitative study published in the journal Medical Education, researchers examined the prevalence, sources and experience of impostor phenomenon among first-year medical students by analyzing reflective essays from cohorts at two medical schools.
The researchers used thematic analysis to identify themes showing where students felt misaligned with their image of a doctor. The results indicated that a majority (52%) of first-year medical students in this study described experiencing some level of impostor feelings.
Wayne Bond Lau, MD, is a dean for student affairs and professor of emergency medicine at Thomas Jefferson University's Sidney Kimmel Medical College in Philadelphia. He frequently works with applicants throughout the Match process.
“I see impostor syndrome very frequently in my students of all levels,” said Dr. Lau, an AMA member.
“I try to normalize it, by emphasizing to students that even residents and attendings often feel that same way.”
“I don’t have qualms in sharing with students that other members of the class who seem overtly confident and are publicly vocal often harbor the same self-doubt internally,” he said. “If you believe your feelings of self-doubt will dissolve magically after getting your MD, and everything will be suddenly perfect in residency and beyond, nothing could be further from the truth.”
Jefferson Health, which is the home of Sidney Kimmel Medical College, is part of the AMA Health System Member Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Why impostor phenomenon happens to medical students
The study found that most students compared themselves to what they believed the ideal version of a medical student or physician was. Medical students experiencing impostor phenomenon often thought they fell short in intelligence, confidence, background or personality.
As natural as it is, comparisons are often counterproductive, Dr. Lau said.
“Students see other members of their class achieving highly in realms deemed admirable, but may be outside of personal interest, and they automatically compare themselves,” he said. “For example, some students are very avid researchers because that’s sincerely what they want to do with their career. And that makes some students feel sensitive about having a dearth of research projects, and internally believe ‘I’m not going to be a great physician for my patients.’ This is not true, and students need to speak to trusted mentors to reset expectations.”
Another source of comparison that medical students can get caught up in is having a defined career path.
“I see students that anguish when they hear other students discuss confidently how they wish to be cardiothoracic surgeons or pediatric oncologists,” Dr. Lau said. “Such dialogue may trigger imposter syndrome additionally in a student struggling to find a career path, who may be managing other stressors in the academic sphere. It can be a painful thought cycle, feeling unworthy because an entire medical school plan is not set out, a residency plan is not set out, and a fellowship plan is not set out.”
It’s also worth noting that even those first-year medical students who seem to have their specialty path all figured out are likely to change their mind.
Combating feelings of impostor phenomenon
In examining the prevalence of impostor phenomenon, the study’s authors noted that for first-year medical students “this phenomenon is likely a state that fluctuates with new roles, expectations and experiences.” Generally, the feelings are dynamic and temporary.
The study’s authors recommended activities that minimize the feelings such as journaling and reflecting, speaking about your feelings with trusted classmates or mentors, and valuing a student’s unique contributions to the field of medicine.
Dr. Lau encourages students to stay connected to the reasons they are pursuing a career in medicine. One tactic he recommends is keeping a copy of the personal statement a medical student authored as part of their medical school application.
“The passion with which they wrote that statement should always ring true and it should remind them about how much they wanted to be in the spot they currently occupy,” he said. “That’s really important.”
He also encourages medical students to maintain their relationships outside of their institution.
“When medical students get together, ideas and themes of negativity can foment, and the common discourse about all things currently happening in school doesn’t need to be discussed 24 hours a day, seven days a week,” Dr. Lau said. “It’s nice to have supportive friends that are not at all tied to the medical field. Connecting with such people can be very liberating. While being a physician is a wonderful thing, and embarking on this path of medicine is a very noble craft, it doesn’t need to consume every aspect of your life all the time. It’s not healthy.”
As far as what medical students should do in the academic realm, Dr. Lau offered a piece of time-honored advice: Be yourself.
“Do not engage in an activity for which you don’t feel sincere love and true passion,” he said. “If you end up doing those types of activities, you’re only going to be in a place where you’re comparing yourself with others.”
“Instead, if you look for sincerity, look for honesty in the activities that you choose, you naturally will achieve well there because you’ve already had those skills your whole entire life. Don’t try to be something that you’re not.”
