The alchemy of doubt, praise, and progress

Maiedha Raza is a GP, GP Appraiser, speaker, and delivers lectures and training courses in communication skills with an interest in compassion

In medicine, perceptions can often shape careers as powerfully as performance does. Being underestimated can quietly become a source of resilience, sharpening clinical judgement, work ethic and adaptability. Trainees and early-career clinicians who are underestimated may develop strong intrinsic motivation, learning to rely on evidence, consistency and patient outcomes rather than external validation. Conversely, being overestimated can carry its own risks, creating unrealistic expectations, reduced support, and a reluctance to admit uncertainty. This is a potentially dangerous combination in a profession where patient safety depends on humility and teamwork.¹ Both experiences shape professional identity, but neither guarantees protection from burnout or self-doubt.

Career progression in medicine does not occur in a vacuum; it unfolds within complex academic and institutional hierarchies. Academia can be an unforgiving environment, highly competitive, metrics-driven, and often intolerant of vulnerability. Publication counts, grant success, and perceived ‘promise’ can overshadow quieter but equally vital contributions such as teaching excellence, mentoring, or compassionate clinical care.² Those who are underestimated may be overlooked for opportunities, while those who are overestimated may feel pressure to perform flawlessly, discouraging help-seeking and honest reflection. In both cases, the human cost can be significant.

I have noticed that leadership within medicine and academia therefore demands more than technical expertise or prestige; it requires compassionate awareness. Leaders who recognise how under- and overestimation affect confidence, risk-taking, and wellbeing can create environments where growth is supported rather than extracted. Compassionate leadership has been shown to improve staff engagement, reduce burnout, and enhance patient care outcomes.³ This involves normalising uncertainty, encouraging psychological safety, and recognising potential beyond traditional markers of success.

Ultimately, the power of being underestimated or overestimated lies not in the label itself, but in how institutions and leaders respond to it. Medicine thrives when its culture values learning over ego, and people over prestige. By leading with compassion, especially in the demanding world of academia, we allow individuals to develop authentically, take intellectual risks safely, and sustain long careers grounded in both excellence and humanity. In doing so, leaders can shape careers and safeguard the future of the profession itself.

References

1. Dweck, C.S. (2006) Mindset: The New Psychology of Success. New York: Random House.
2. Woolston, C. (2019) ‘PhDs: the tortuous truth’, Nature, 575(7782), pp. 403–406. https://doi.org/10.1038/d41586-019-03459-7
3. West, M., Eckert, R., Collins, B. and Chowla, R. (2017) Caring to Change: How Compassionate Leadership Can Stimulate Innovation in Health Care. London: The King’s Fund. https://www.kingsfund.org.uk/insight-and-analysis/reports/caring-change [accessed 16/1/26]

Featured Photo by Ashin K Suresh on Unsplash