When I walk into the exam room to introduce myself and greet my patient, I'm often met with an expression of surprise. For context, I’m a 20-something-year-old, Punjabi female optometrist at an established private practice in a predominantly affluent and conservative Californian suburb.
It’s safe to say some people don’t expect me to walk into that exam room. If being a 2021 graduate and starting my career in the midst of a pandemic wasn’t scary enough, encountering skepticism from my patients was like throwing fuel on top of the dumpster fire known as “Imposter Syndrome.”
Here is what I learned about extinguishing the imposter syndrome dumpster fire.
Imposter syndrome and how to conquer it
So, I did it—4 years of undergraduate studies, 4 years of optometry school, 3 national board examinations, 1 state law and regulations exam, and the painstakingly long 3-month waiting process to become a licensed optometrist in the State of California. Now what? Why does it feel like I still don’t know anything? Am I doing any of this right? Wait, did this guy say 1 or 2…?
After several comments about my age and appearance, I decided to make a conscious effort to combat the nagging feeling that I was not competent enough. As I was met with both internal and external skepticism about my own abilities and learned ways to combat it, one thing quickly became clear to me; it's really more about confidence than anything else.
Imposter syndrome is a condition where high-achieving individuals ascribe their accomplishments to luck and contingency.1 In other words, it is a pattern of behavior in which competence exceeds confidence.2 The insidious nature of imposter syndrome means that it breeds a false sense of inadequacy that can be hard to overcome.
Understanding ruminative thinking
The brain harps on negative thinking cycles, called ruminative thinking, as a protective mechanism to keep us safe from venturing out into new and unknown territories.3,4 This is due to the brain’s negative bias; our brain reacts more strongly and is highly attuned to stimuli it deems negative.4
Imposter syndrome thrives in rumination mode: this feels like getting stuck in an endless loop dwelling on all the things you don’t know.3. This heightened nervous system activation can cloud our awareness and self perception; you are still evolving into a highly capable professional even if you struggle with self doubt.
Imposter syndrome is known to disproportionately affect women, minorities, and, strangely enough, high achievers.2,5.
In the book Think Again, psychologist Adam Grant describes a study that shows medical students with imposter syndrome were equally capable and actually had an advantage over their peers: “Those who self-identified as imposters didn’t do any worse in their diagnoses, and they did significantly better when it came to bedside manner—they were rated as more empathetic, respectful and professional.”2
If you struggle with imposter syndrome, odds are you’re doing something right! Trust your instincts and block out the noise. Imposter syndrome has been reported to impact career progression, leadership, and mental health.6 Therefore, it’s important to manage negative thoughts as a paralyzing fear of failure may lead to stunted growth and career stagnancy.
It might take some time to fall into a comfortable rhythm, but your self-assurance will accelerate and gain traction as you create your own flow. I’ll take you through some of my strategies that helped me soothe my inner critic and redirect my energy into patient care.
Add tangible value to a routine eye exam
Tailoring patient education to meet the individual demands of daily routines makes a lasting impression. I educate patients on how they can implement lifestyle changes to improve their ocular and visual health, using free or inexpensive methods. For example, due to the consequential rise in computer vision syndrome during the pandemic, I discuss workplace ergonomics and posture to optimize productivity as well as ways to combat both digital eye strain and digital dry eye.
Spending the extra time in the exam room on lifestyle-specific education gives way to establishing valuable patient connections. Patients feel appreciation for thorough explanations of their exam results.
Describing some of the equipment and techniques used in clinic along with their findings empowers patients to be informed and proactive about their health. Some of my patients even made the conscious decision to ditch their beloved lash extensions after I captured photo evidence of anterior blepharitis manifesting on their lids. After getting to know my patients, I’m able to collaborate on a lash and lid hygiene routine that works for their makeup and skincare habits, contact lens usage and other factors affecting eye health and the eye’s microbiome.
Sharing data from routine measures such as IOP, refractive error, fundus photos and OCT scans to name a few, is an easy way to build rapport with your patients and inspire them to be curious about prioritizing their eyesight and wellness.
I feel immense gratitude for the words of encouragement I receive from my patients. Despite the initial surprise, it seems that most people appreciate the increasing diversity in healthcare providers—times are changing!
Approach challenges with enthusiasm and curiosity
The goal is to meet every challenge from a place of positive enthusiasm and curiosity, and to shift focus onto learning and progress rather than perfection.
“As a daily reminder that mastery isn’t acquired overnight, I adopted the mantra, 'each day is another opportunity to learn.'”
Imposter syndrome is a manageable condition. Its important to give yourself grace during this transition period: initial fears of incompetency are natural for anyone at the start of their career. To help put things into perspective, think about how far you’ve already come. Recognize your achievements as they speak to your capabilities and perseverance. Learning how to manage your internal dialogue will serve as a catalyst for future confidence and success.
“Arrogance leaves us blind to our weaknesses. Humility is a reflective lens; it helps us see clearly. Confident humility is a corrective lens; it enables us to overcome those weaknesses.” - Adam Grant
- Bothello, Joel, and Thomas J. Roulet. "The imposter syndrome, or the mis-representation of self in academic life." Journal of Management Studies 56.4 (2019): 854-861.
- Grant, Adam. Think again: The power of knowing what you don't know. Penguin, 2021.
- Crowe, Toni, and Stephanie Slocum. "How to stop imposter syndrome from sabotaging your career." Women in Mechanical Engineering. Springer, Cham, 2022. 91-107.
- Marano, Hara Estroff. "Our brain’s negative bias." Psychology Today 20 (2003): 1-3.
- Nihalani, Shobha. REBOOT, REFLECT, REVIVE: Self Esteem in a Selfie World. SAGE Publishing India, 2021.
- Freeman, Joseph, and Carmelle Peisah. "Imposter syndrome in doctors beyond training: a narrative review." Australasian Psychiatry 30.1 (2022): 49-54.