Dear MS1s,
Several weeks ago, my friend Martha sent me a Tweet that read, “Here’s the true story of how I overcame imposter syndrome: One day my phone auto corrected it to ‘I’m pasta syndrome’ and I could never take it seriously again.”
When we worked together at the NIH, Martha and I would exchange pep talks about pursuing medicine and neuroscience. Bolstering each other’s confidence in our abilities became routine in our friendship. As I wrapped up my first year of medical school, I found this Tweet to be both deeply relevant and laughably inapplicable. Relevant because I had a healthy dose of imposter syndrome; inapplicable because, unlike @ivanividivici, I probably needed a stronger antidote than autocorrect.
If you’ve ever wondered (perhaps after an SDN binge) how the heck you made it past admissions, you’re in good company. According to an article1 in the International Journal of Medical Education, about half of the surveyed female medical students and a quarter of the male medical students reported experiencing imposter syndrome. Imposter syndrome also disproportionately affects URM students2, often exacerbated by explicit discouragement in the forms of microaggressions and racism. Nevertheless, it’s hard to imagine my well-spoken, wildly accomplished classmates feeling even a modicum of insecurity. Some of my classmates might think likewise of me, but the truth is quite the contrary.
Although I was excited to study medicine, I was apprehensive about joining a class composed of premeds who I assumed were cream-of-the-crop gunners in college. I never took cell biology or physiology, didn’t boast a 4.0 (or a 3.9), and didn’t wield a pipette until senior year. Friends, family, and ex-boyfriends alike joked that they never saw me as the “MD/PhD type.” I knew extremely qualified applicants who were basically walking Nature papers, but who had gotten waitlisted at Penn while I had somehow gotten a golden ticket. I figured my classmates would be similarly accomplished, if not more.
And more they were. Over the past year, I have been absolutely floored by the talent in my class — I’m in awe of the classmate writing a book, the classmates teaching workshops on statistical programming, the etymologist, the classmates leading anti-racist initiatives, the competitive figure skater, the winners of fancy fellowships to study in the UK, the friend who took a class with a well-known writer whom I was too shy to approach in college, the eloquent daughter of said writer, and many others.
The hallmark of imposter syndrome is as its namesake suggests — a fear of being discovered as a fraud or imposter. I often felt that the perceptions that admissions committees had of me were derived purely from the narrative crafted in my application, rather than actual academic competence. My first year of medical school was punctuated with moments where I thought I’d finally be exposed for knowing nothing. Like the time I tried to convince my anatomy TA that I was sweaty because I just biked up South Street Bridge — not because I had no clue what Budd-Chiari syndrome was. Or the time a classmate casually mentioned DAPI in our MD/PhD journal club, a technique I had never heard of, while everyone else nodded knowingly. I spent the rest of the seminar musing about how DAPI sounded like dapper, which, hilariously, was the opposite of how I felt. Looking back, I can’t help but wonder: Why didn’t I consider that Div, my enthusiastic and brilliant TA, was trying to teach me new information rather than expose my ignorance? If I knew every answer, there wouldn’t be much to learn. Plus, I should have reminded myself that I didn’t know about cell staining techniques because my background was in cognitive neuroscience.
Imposter syndrome is hardly rational. It’s just a nagging feeling that I don’t belong. If you were to ask me what exactly I need to accomplish in order to feel satisfied, I wouldn’t have a clear answer. And perhaps the most toxic aspect of imposter syndrome is that it’s isolating. Do I want to confide in a classmate, only to find out that they also question my competence? Not really.
Ironically, one of the most helpful measures against imposter syndrome has been talking to peers about it. Over several conversations, I discovered that even the most outgoing and confident friends in my class second-guessed their abilities. It struck me that I should’ve initiated these kinds of conversations — like the ones I’d shared with Martha — earlier in the school year. So, my advice to you is this: If you’re feeling even a shadow of doubt about your competence or your rightful place in medical school, I encourage you to broach the subject with a friend in your class. I am confident that they will be eager to support you. More than being accomplished, my classmates are kind. From the encounters I’ve had with your incoming class, I’m heartened by the openness and empathy that I’ve seen. And just to be clear: You do belong.
My mom likes to quote this Chinese proverb: There are skies beyond skies. In other words, comparison is futile. It only steals joy. Beyond simply avoiding comparison, it is even more empowering to point out the good and admirable in others. In his book The Screwtape Letters, C.S. Lewis writes about the ability to gaze at the best cathedral in the world and rejoice over the accomplishment of its designer the way you would if you had designed it yourself. It might be idealistic to desire both freedom from insecurity and also the ability to wholly rejoice over a “neighbor’s talents,” but I do think there is something mutually encouraging about affirming others in a thoughtful way.
Lastly, I want to share my favorite piece of advice from an upperclassperson: Remember why you chose medicine. My classmates and I have vastly different reasons for pursuing medical school, and we have vastly different career goals. With most of my classmates, medical school will be the only leg of the journey that we run together. That’s all the more reason to make the most of our time together, rather than fretting about how I measure up. As I revisited my medical school application essays recently, I remembered the sense of having a calling. I remembered my desire to understand the brain — the organ with the strange power to shape our identities. I remembered writing in my personal statement that something would be amiss in my life if I weren’t in the clinic caring for patients and using my knowledge to treat disease someday. I remembered how my pull toward medicine was — and still is — tied to my faith. During the school year, as I sifted through Anki cards and shriveled from the feeling of being unprepared, it was so easy to forget all of my reasons for starting medical school.
As you begin your own journey in medicine, I hope that you can hold onto your own reasons for choosing this path. I also hope that you will build meaningful friendships with one another — friendships that leave little room for I’m pasta imposter syndrome.
Sincerely,
Audrey Luo
1. Villwock JA, Sobin LB, Koester LA, Harris TM. Impostor syndrome and burnout among American medical students: a pilot study. Int J Med Educ. 2016;7:364-369. doi:10.5116/ijme.5801.eac42. Chrousos GP, Mentis A-FA. Imposter syndrome threatens diversity. Sills J, ed. Science (80- ). 2020;367(6479):749 LP – 750. doi:10.1126/science.aba8039
2. Chrousos GP, Mentis A-FA. Imposter syndrome threatens diversity. Sills J, ed. Science (80- ). 2020;367(6479):749 LP – 750. doi:10.1126/science.aba8039
Audrey Luo is an MS2 at the Perelman School of Medicine. Audrey can be reached by email at [email protected].
