When I was about to take my first quiz in medical school, I was convinced I would fail while everyone else felt prepared and would score perfectly. While I floundered to believe in my mastery of the material, my peers had seemed confident and secure. This couldn’t be farther from the truth: I was indeed prepared and ready to succeed in my academics as an M1, and many others were feeling the same sense of insufficiency as me. This experience of imposter syndrome, or chronically doubting your abilities and the fear of being discovered as a fraud, affects many people, including medical students, who find it difficult to accept their accomplishments and feel undeserving of praise or awards.

As medical school gets more difficult and residency spots become more competitive, the pressure of performing well on USMLE exams, getting publications, and scoring leadership positions can feel very overwhelming. The pressures surrounding medical school can kill the excitement, empathy, and hope that students enter with, leading to burnout and isolation even before they begin training. It has been reported that fourth-year medical students may feel imposter syndrome most acutely of any program year in response to the stress of matching, along with the thought of being called “doctor” in a few short months while they are still gaining confidence as a competent physician.

I wish I had been more open about my experience of imposter syndrome right from the beginning of M1 because talking about this sense of not being enough is one of the best ways to combat those emotions. Imposter syndrome cannot be ignored. It causes increased suffering, psychological distress, and burnout.

Here are some ways you can help combat imposter syndrome in medical school:

1. Talk about it. Share your experiences of feeling like an imposter with your friends and classmates: They may feel the same way. This can help everyone feel less isolated and more supported.

2. Remember you are a student. You are not expected to know everything the physicians and residents know. You are here to learn.

3. Acknowledge your success. Do not minimize your success. Embrace it; you earned it.

4. Seek out help, and seek it out early. Mental illness is an epidemic in medical school. Remember that struggling is not something to be ashamed of, and seek out help if you need it.

5. Discourage shame-based learning and “pimping.” Clerkships can be difficult when students are expected to learn and adapt quickly and perform excellently in new environments every day. On top of that, students can be asked questions by attendings in front of others, making them feel ashamed when they cannot answer. Stepping away from this type of learning, and towards a collaborative, conversational approach can help combat imposter syndrome.

6. Fake it till you make it. It is a skill. Don’t wait until you feel like an expert to take risks and feel confident.

You are becoming a doctor each and every day; it does not occur magically on graduation day. The transformation to physician evolves with every flashcard mastered, procedure observed, test taken (and perhaps retaken), and skill learned. Success in medical school is embracing the process of learning and getting better, which is why it is called the practice of medicine.

Margaret Hogan Smoot is a medical student.

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