Simon Tobin has has been a GP in Southport for 33 years
It’s rare for me to carry out an appraisal without an appraisee confessing to a degree of imposter syndrome. This sentiment seems ubiquitous amongst my colleagues.
The term imposter syndrome was coined in 1978 by clinical psychologists Pauline Clance and Suzanne Imes. Interestingly, it does not appear as a diagnosis in the DSM-5 or ICD-11 but psychologists define it as a persistent internalised fear of being exposed as a fraud, despite objective evidence of competence, success, or achievement.1 Whilst not a medical diagnosis, it has real emotional consequences.
I cannot recall a GP ever mentioning they consider themselves an “expert generalist”.
I suspect that most GPs regard themselves as “jacks of all trades” and inevitably internalise that they are therefore “masters of none”. I cannot recall a GP ever mentioning they consider themselves an “expert generalist”. These thoughts may be driven by the very nature of generalism itself. GPs do not suffer impostor syndrome because they lack expertise, but because their expertise lies in generalism — a form of mastery that is harder to define, problematic to measure and easier to undervalue. When expertise is defined narrowly, those trained to work broadly are left feeling fraudulent. GPs may be paying the emotional price of that mismatch.
Does it matter that feelings of imposter syndrome are so common in GPs? I think it does. Left unchecked, it’s easy to see how feeling fearful of being “found out” as incompetent can lead to chronic self-doubt. We know that experiencing these emotions is a risk factor for burnout. I suspect they contribute to the high rates of alcoholism and depression in GPs.
I wonder whether feeling a degree of imposter syndrome is actually the hallmark of a conscientious professional.
This makes me wonder what might help GPs who are struggling with feelings of imposter syndrome. A good start might be to normalise it as something that most of us experience. Normalising removes the erroneous belief that you are suffering in isolation. There’s comfort in numbers. We would be better to regard imposter syndrome as “something that most primary care doctors feel”. Medical Leaders, educators and appraisers could help by role-modelling uncertainty and openly admitting that they often think this way too. The clinicians in my practice meet for coffee daily to discuss cases and to ask others for advice. Between us we have accumulated more than two centuries of shared expertise in making mistakes and not knowing.
Secondly, I wonder whether feeling a degree of imposter syndrome is actually the hallmark of a conscientious professional. Perhaps we need to rebrand it in a more positive way? A good GP will be constantly peer referencing, identifying areas for improvement and setting themselves high standards – but it’s important not to allow it to get out of control.
If feelings of impostor syndrome were normalised — and reframed — they might become less a source of shame and more a marker of thoughtful practice. Maybe we could remove the unhelpful “syndrome” label and rebrand it as “imposter feelings”. In a profession that demands embracing uncertainty, self-reflection and humility, a degree of self-doubt should not be seen as a flaw but as an occupational necessity. The danger lies not in feeling like an impostor, but in believing that feeling makes you unfit to be a GP.
Reference:
- Mak KKL, Kleitman S, Abbott MJ. Impostor Phenomenon Measurement Scales: A Systematic Review. Front Psychol. 2019 Apr 5;10:671. doi: 10.3389/fpsyg.2019.00671. PMID: 31024375; PMCID: PMC6463809.
Featured image by Iulia Mihailov on Unsplash
