Q: What is imposter syndrome and how do I overcome it?
When I first received this question, I immediately thought: Am I qualified to write about this when I haven’t done research in this field? What if an expert reads this and points out mistakes? As I gave it more thought, I began to laugh at the irony of my reactions. This was a well-timed example of the imposter phenomenon!
Imposter phenomenon, or more commonly referred to as imposter syndrome, was first defined in 1978 to characterize an internal experience of intellectual fraud where persons develop feelings of self-doubt despite their accomplishments.1 Those who experience this may think people have mistakenly overinflated their abilities and fear being discovered as an imposter. Frequent feelings of imposter syndrome can result in reduced self-confidence and job satisfaction as well as lead to burnout.2,3
Some of these examples may seem familiar:
-They said I did a good job, but they’re just being nice.
-It only seemed like I knew what I was talking about because no one asked difficult questions.
-I probably got the job offer because their first choice turned them down.
-They asked me to lead the project and I’m interested, but shouldn’t they ask someone more qualified?
-I hope they don’t find out that I only fooled them into thinking that I know what I’m doing.
If any of these thoughts resonate with you, you’re not alone. Imposter syndrome can be experienced by people of any gender, age, profession, and stage of career, and it is quite common across students and trainees from different health sciences, including pharmacy.4,5 One study that surveyed pharmacy students and faculty found that over 57% of respondents had frequent or intense feelings of being imposters.6 Furthermore, these levels were similar between students and faculty, suggesting that imposter syndrome does not necessarily lessen with career advancement.6
Why is imposter syndrome so common in pharmacy? Well, pharmacists are high achievers with perfectionist tendencies. If they fail to exceed expectations, they may begin to doubt their abilities. The same drive for lifelong learning and improvement may result in a deepened sense of inadequacy if left unchecked. Pharmacists are also constantly being evaluated, and even when positive feedback is given, it is usually followed by areas for improvement. When working under such scrutiny, it makes sense why pharmacists may fear the exposure of their inadequacies. Furthermore, frequent professional transitions, such as from student to resident or to clinician, may result in sudden increases in responsibility and challenges that lead to self-doubt.7
Here are some steps you can take to overcome imposter syndrome:
1. Recognize imposter syndrome – Pay close attention to how you respond to recognition, and listen for thoughts of self-doubt or negativity. If you are unsure what this might look like, consider completing the Clance Imposter Phenomenon Scale – a 20-item test developed to determine the presence and extent of imposter phenomenon.8 The items in this self-assessment can help you recognize signs of imposter syndrome.
2. Focus on facts – Having self-awareness means identifying not only weaknesses, but also strengths. Create and continue to add to a list of your strengths and accomplishments, and refer back to it when you feel uncertain about whether you deserve to be where you are. Keep your focus on your own achievements without comparing them with those of other people.
3. Celebrate your successes – Those with imposter syndrome may dismiss validation. But when people go out of their way to give you positive feedback, accept it gracefully instead of brushing it off. Trust in the sincerity of your colleagues. Take it a step further and acknowledge your own successes as well. Verbalize to yourself: “I did well” or “I am qualified to be here.”
4. Develop an appropriate response to “failure” – Although pharmacists are experts, they are not expected to be walking databases of knowledge. Someone may ask you a question you didn’t plan for. And unfortunately, there will be times when you’re not adequately prepared. It is important to practice healthy responses for when you don’t meet or exceed your own expectations. Treat these as learning opportunities, and take pride in discovering how you rise to the challenge.
5. Foster an environment of support and mentorship – According to survey results, more than half of your colleagues likely experience imposter syndrome, even those who have been working longer than you. Create a safe space to help each other recognize the signs. Be generous with providing positive feedback and encouragement to others. This will also increase your willingness to accept compliments.
Overcoming imposter syndrome will require both intrinsic and extrinsic motivation, but you need not endure it alone. Be wary of negative critique that isn’t constructive, especially if it originates from yourself. Increase your acceptance of positive recognition, and continue to put in your best efforts to achieve your goals.
Tiffany Tsai, Pharm.D., BCACP
Assistant Professor, Department of Pharmacy Practice and Administration
University of Saint Joseph School of Pharmacy and Physician Assistant Studies
West Hartford, Connecticut
References
1. Clance PR, Imes SA. The imposter phenomenon in high achieving women: dynamics and therapeutic intervention. Psychother Theory Res Pract 1978;15:241-7. doi:10.1037/h0086006
2. Villwock JA, Sobin LB, Koester LA, et al. Impostor syndrome and burnout among American medical students: a pilot study. Int J Med Educ 2016;7:364-9. doi:10.5116/ijme.5801.eac4
3. Macias-Moriarity LZ, Sinclair SM, Walker D, et al. Impostor phenomenon and grit as predictors of job satisfaction in female pharmacy faculty. Pharm Res 2023;40:2271-80. doi:10.1007/s11095-023-03518-9
4. Henning K, Ey S, Shaw D. Perfectionism, the imposter phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students. Med Educ 1998;32:456-64. doi:10.1046/j.1365-2923.1998.00234.x
5. Sullivan JB, Ryba NL. Prevalence of impostor phenomenon and assessment of well-being in pharmacy residents. Am J Health Syst Pharm 2020;77:690-6. doi:10.1093/ajhp/zxaa041
6. Boyle J, Malcom DR, Barker A, et al. Assessment of impostor phenomenon in student pharmacists and faculty at two doctor of pharmacy programs. Am J Pharm Educ 2022;86:8474. doi:10.5688/ajpe8474
7. Bell CM, Vest TA, White SJ. Dealing with doubt: overcoming impostor syndrome in new practitioners. Am J Health Syst Pharm 2022;79:421-3. doi:10.1093/ajhp/zxab425
8. Clance PR. The Imposter Phenomenon: When Success Makes You Feel Like a Fake. Bantam Books, 1985:20-2.