Why Successful Physicians Still Feel Like Frauds (and What to Do About It)

I have been independently practicing pediatric critical care exclusively for just over a decade. And what did I say when I went off service a couple of weeks ago?

“These kids need an attendier attending.”

Borrowed from the meme with the tiny kitten that circulates every July 1 in academic medicine, I deeply believed my patients needed somebody smarter, more thoughtful, and more well-read: the mythical Attendier Attending. It wasn’t the kids’ fault they weren’t getting better; it was mine.

Objectively, I know the truth. It has been over 12 years, and I haven’t been fired yet. I have been “successfully attending.” (Cue the kitten GIF again.) But I still handed off that service feeling like a failure. Not knowledgeable enough. Not dedicated enough. Not brave enough to move the patients forward.

And as sure as I was that I was failing, I was equally certain that my colleague inheriting the service would succeed. She would figure it out. She would have the patients hemodynamically stable and extubated by the end of the week, their families glowing and submitting rave reviews to Press Ganey. And she would see the mistakes I made. She would notice where I could have pushed harder, and where I pushed too far, too fast. She would debrief with one of my other colleagues. And then another. And it would be known: I was the weak link. I had flown under the radar all this time, and I was finally going to be found out.

I was an impostor.

What Exactly Is Impostor Syndrome?

Impostor syndrome is the persistent belief that one’s success is undeserved or due to luck, timing, or deception rather than genuine ability, even when there is clear evidence of competence. People experiencing it often fear being “found out” as a fraud despite objective accomplishments.

Psychologists Pauline Clance and Suzanne Imes first described this pattern in 1978. Importantly, many now prefer the term impostor phenomenon since it is not a psychiatric diagnosis but a common experience across high-achieving fields, particularly medicine and academia.

The prevalence is sobering. In 2022, Shanafelt and colleagues found that up to 10 percent of physicians endorsed impostor themes, such as feeling like a fake, attributing success to luck, or downplaying achievements, as “very true” for them. Physicians were also more likely than workers in other fields to feel disappointment in their accomplishments. Unsurprisingly, impostor experiences were associated with higher burnout, more suicidal ideation, and lower professional fulfillment.

Quick Gut-Check: Do These Sound Familiar?

You might be in impostor territory if you catch yourself saying or thinking:

• I just lucked out

• If I can do it, anybody can

• I had a lot of help

• They’re just being nice

• I had connections

• I just made it up as I went

• I’m pretty sure, I kind of think, or, Does that make sense?

Of course, any of these might also reflect humility. That is part of the trouble: the line between modesty and self-erasure can be razor-thin.

Why It’s a Problem

If everyone feels it sometimes, and if some of its tells overlap with trying not to be a raging jerk, why does it matter?

Because it comes at a cost.

• Self-underappreciation. When you cannot internalize your wins, you miss out on the satisfaction, confidence, and energy that come from owning your hard work.

• Wasted mental energy. Instead of resting or innovating, you spend your cognitive bandwidth rehearsing failures, doubting yourself, or anxiously scanning for evidence that you do not belong.

• Professional consequences. Research links impostor phenomenon with increased burnout, stalled career progression, and leaving medicine altogether.

The Many Faces of Feeling Like a Fraud

Not all impostors look the same. Psychologists describe five common subtypes that may resonate with physicians:

1. The Perfectionist: Success equals 100 percent. Anything less feels like failure.

2. The Expert: There are never enough degrees, certifications, or PubMed articles read.

3. The Soloist: If you didn’t do it alone, it doesn’t count.

4. The Natural Genius: If it wasn’t effortless, you must not be cut out for it.

5. The Superhuman: You must excel in every role: clinician, teacher, researcher, parent, partner.

Most of us toggle between several. Recognizing your subtype can help you name the script you are running and begin to rewrite it.

Shifting from Fixed to Growth Mindset

One reason impostor phenomenon feels so heavy is that many of us, especially in medicine, were trained with a fixed mindset. A fixed mindset whispers: “You are either smart or you are not. You either have the skill or you don’t. If you stumble, it proves you never really belonged here.”

That framework makes every missed diagnosis and every patient who does not improve feel like definitive proof of inadequacy. It sets up a zero-sum game: if my colleague is thriving, it must mean I am failing.

A growth mindset reframes the story. Challenges, mistakes, and even failures are not verdicts on our worth. They are evidence that we are still learning, still practicing, and still showing up to the work. A growth mindset sounds more like: “We are all still learning. Every shift, every patient, every conversation is another opportunity to grow.”

When you shift from fixed to growth, the equation changes. It is no longer “I am a fraud and they are all winners.” It becomes “We are all works in progress, figuring this out together.” That does not erase self-doubt, but it softens its sting and makes space for curiosity, humility, and resilience.

What To Do About It

There is no single cure, but there are powerful shifts that help. All of them are strengthened by adopting a growth mindset.

• Name it. Identifying impostor thoughts for what they are reduces their power. Instead of “I am a failure,” you can reframe it to “I am learning.”

• Document reality. Keep a “done list” or a “praise file” of thank-you notes, saved comments, and patient stories. Revisit them when your brain insists you are failing. This helps anchor your perspective in facts rather than fears.

• Reframe mistakes. A fixed mindset sees errors as evidence that you do not belong. A growth mindset reframes them as data points in a lifelong learning curve.

• Talk about it. Impostor feelings thrive in secrecy. Sharing them with colleagues often reveals that others, even those you admire most, have the same worries. Naming them aloud makes them less shameful.

• Celebrate progress. Perfection and omniscience are impossible standards. Growth comes in increments, and competence combined with compassion is more than enough.

The Takeaway

If you have ever thought, “I am not good enough to be doing this,” you are in good company. Impostor phenomenon does not mean you are broken; it means you are human, working in a field that demands more than any single person can give at all times.

The real trick is not eliminating self-doubt altogether, but learning to carry it without letting it define you. A growth mindset offers one way forward. The goal is not to become the Attendier Attending. It is to recognize that you already belong, and that your patients, colleagues, and community are better for the work you do, exactly as you are.