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  • Writer's pictureDr Sally Ayesa

I'm an imposter

You might not know this about me, but I'm an imposter. At least that's what have been telling myself in one way or another throughout my medical career. This might seem crazy, but stay with me.

Imposter syndrome is a feeling that your achievements aren't deserved, and it is only a matter of time before everyone finds out you are a fraud. It is irrational, usually unfounded, and (sadly) common in doctors. We are stereotyped as having god complexes, but often the opposite is true.

For some of us, celebrating how fabulous we really are requires bravery

My journey through radiology has been unique. There was no straight line, but sidesteps and detours. I changed sites, stopped and started again after my son was born and often felt that I was hurtling through my career without control.

This was made worse by a significant early career setback, which had me questioning not only the validity of my reports and assertions, but my place on the radiology program. Sadly, not a word anyone could say would convince me otherwise and I repressed the negative feelings - refusing to deal with things in a meaningful way until years later.

Radiology is one of the most humbling specialties going around, made even more humbling when you start out on shaking footings. If you have missed something, no matter how small, it will be there on the scan waiting for you when someone points it out. "Sally, I just want to show you something..." was the phrase that prompted my learning and growth, but learning only came by my mistakes. On a good day, empowering. On a bad day, crippling.

As the culture of education in imaging is based on learning by mistakes (small and large), it is sometimes hard to find the positive amongst the negative. On my worst and my desperate days after having ever scan corrected, I remember asking one of my consultants "Am I actually improving? I feel like I am getting worse at this." She was actually taken aback, not expecting me to be so beaten by her feedback. Quickly and almost dismissively, she told me "Of course you are. You are one of the best registrars we have." I heard her, but I couldn't believe her.

I have written before about the fresh hell that is part II exams, which I believe is in part due to the constant stream of feedback regarding ways you can improve. There is always something to tweak, rephrase, reconsider. I constantly found myself wanting to prove myself to certain consultants, showing them I could learn from my mistakes. This certainly played a part in driving me forward - but I am not sure how healthy this approach was.

So I sat exams, passed and tried to get on with my life. Relaxing was hard, as I was left with the weight of the expectation of 'what next?'. I was only one of two local graduates in NSW who got through first go and I felt immense guilt for my friends who were still going, as well as pressure to make the most of my privileged position. I was working part time but still came in on my days off to take multidisciplinary meetings and try and prove that I was worthy as a consultant. Worthy as a radiologist who had something to offer the medical community.

When I found out I won the medal for my exam year, I cried in disbelieve and shock. I had always strived for it and it was probably one of the proudest moments of my career. But why wasn't I overwhelmed by the happiness I had promised myself? Why were my reports still being edited within an inch of their life? Why did I still feel like I had so much to prove in my work life? And why was I feeling so down and defeated in my personal life?

At this stage I realised that I needed help. Objectively, I was at the top of my game - but I still felt like I wasn't worthy. Something was seriously wrong in the way I perceived myself. I reached out to a community of like minded doctors asking for advice and I was overwhelmed with kindness. People I had studied with, worked with or never met reached out. There were constructive suggestions amongst the kindness, including the recommendation to start working with a psychologist to unpick everything. I needed to stop feeling like I didn't belong in my career and to stop feeling like an imposter.

I now see a psychologist every few months, who helps me process the stresses of working in medicine and the pressures I place on myself. I am proud to say it is helping, but is definitely a work in progress. I feel stronger and healthier most days, but still have days or weeks when it is on top of me. This week hasn't been great but I am hoping next week will be better.

If you are struggling with self doubt, I encourage you to not go it alone. Share with family, friends or trusted colleagues. Consider those around you who might have been in a similar situation and ask what worked for them. Work with a psychologist if you need to - sometimes you need a second objective opinion to reframe the way you think about yourself and experiences.

Be brave. You've got this.

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