Residency is an incredible opportunity to grow into the pharmacist you want to become. It challenges us, stretches our knowledge, and constantly exposes areas where we can improve. But it can also magnify self-doubt and imposter syndrome. The persistent feeling that we are not enough, that everyone else is ahead, and that every mistake or knowledge gap confirms our inadequacy is something I have experienced all too often.

For me, the realization that I had been caught in this pattern came during a feedback session with my residency program director. She told me my self-directed feedback focused almost exclusively on areas I needed to improve. My initial reaction was confusion. I thought, Why waste time reflecting on things I am capable of? The purpose of residency is to learn and grow, not pat myself on the back. Then she added something that hit me. My self-reflections were harsher than what my preceptors had observed. Later that week, in a casual conversation, a co-resident told me I was being too hard on myself. Hearing it from 2 perspectives forced me to pause and consider that my single-minded focus on improvement might actually be holding me back. I was blind to the fact that celebrating progress and acknowledging strengths is a necessary part of growth.

This insight made me realize how much my self-critique was affecting me. It was limiting my confidence and enjoyment of work and shaping how I approached learning. I would take any gap in my knowledge as proof that my imposter thoughts were correct. At the same time, I worried that pausing, reflecting on my strengths, or acknowledging progress would somehow make me complacent. Over time, I realized that growth is not just about correcting mistakes. It is also about taking credit for what you have learned and recognizing that continued practice leads to improvement, even if that improvement is not always obvious.

I have been trying several approaches to manage these feelings, though none of them are perfect. One practice is simply awareness of thought patterns. When I notice that I am defaulting to self-critique or telling myself I am not enough, I pause and reflect on that thought. Acknowledging it without judgment is the first step in breaking the cycle. Another approach is intentionally highlighting my strengths. Even if I have already developed a skill, I allow myself to take credit for it. Each time I apply that skill successfully, it reinforces that I am capable and growing.

I also remind myself that not knowing something does not prove inadequacy. No one knows everything, and even experienced pharmacists often need to look things up or ask for help. Guidelines change, recommendations evolve, and medicine is constantly updating. Taking the time to verify information is not a sign of weakness. It is a demonstration of thoroughness and professionalism.

Talking with others has been another important practice. Sharing thoughts with co-residents, who are navigating the same challenges, helps me see how untrue some of my imposter feelings are. Sometimes, just voicing them aloud is enough to put them in perspective. It is also comforting to have someone understand and empathize without immediately offering reassurance or trying to fix the feeling. External reinforcement from mentors, program directors, and peers provides a check on my internal narrative and helps me recalibrate.

Residency is naturally a high-feedback environment. It emphasizes areas for improvement, which is critical for learning but can inadvertently reinforce imposter syndrome if it is not balanced with reflection on strengths and successes. I am learning that sustainable growth requires both internal and external support. It is not about eliminating self-doubt entirely, but about recognizing patterns, pausing to acknowledge progress, and seeking perspective from others.

This journey is ongoing. I still struggle with moments of self-doubt and a sense that I need to push myself constantly. But I am learning that being a competent and thoughtful pharmacist is not just about pushing yourself and correcting mistakes. It is about growth, reflection, and the recognition that progress matters as much as perfection. Celebrating what works, acknowledging what we do well, and leaning on peers and mentors for perspective are practices that allow us to navigate imposter syndrome without letting it dominate our experience.

For me, the lesson is clear. Residency is not only about improving skills but also about learning to give myself credit for the work I have already done. Imposter feelings are natural, but they do not define capability. By being aware of thought patterns, intentionally noting strengths, and seeking perspective from mentors and peers, I am learning to balance self-critique with recognition of growth. This balance will ultimately allow me to thrive, sustain enjoyment in the profession, and continue growing in residency and beyond.

Author:

Emma Covington, Pharm.D.

PGY1 Resident

UVA Health