In a field filled with history, data, and very smart people, it can be difficult to do anything with confidence. And yet, this is one of the most desirable traits a doctor can have, that and a light hand when it comes to handing out narcotics. However, I have never been a fan of over-confidence. I feel that if you are going to say something with confidence, it has to be right because to be wrong dissipates trust, which is essential to any patient-doctor relationship.

One way to help prevent false over-confidence is to pass my bill on universal shock collars (the writing of which is not yet finished … nor started for that matter). A more obvious method to preventing false-overconfidence is to be knowledgeable. While this is self-apparent, it can be difficult in a field with inexhaustible data and constantly changing protocols. Which begs the question: What if you’re simply not “smart” enough to retain all the knowledge? Or maybe you did not grow up in a family with medical knowledge, so medicine is still somewhat foreign to you?

This is one of the common themes that those going through medical training encounter. The feelings of inadequacy, inferiority, and the sensation that you are an imposter who is supposed to be helping those you care about (your patients) while you have no right to do such a thing. This is what I consider the “imposter syndrome.”

During the intern year of residency, one of the greatest sources of joy comes from simply finishing the year. On the other hand, one of the greatest sources of frustration comes not from having to learn a new job each month or having to ask questions about the simplest logistics every time you turn around or having people ridicule you for not knowing how to do a brand-new job or having countless hours of work; rather, the frustration comes from the sense of responsibility that comes with this title of “doctor.” How can I always be telling others what’s best for them, especially since I believe only the individual can really know what is best for him?

So how can I, a new doctor with lots of doctor jokes but very little personal or family experience in medicine, not only tell my patients to do something with their lives and bodies but also say it with confidence? The answer for me has been to use empathy, but this has been an ongoing area of difficulty. Why?

“It’s not rocket science.” This is one of those sayings we hear many times throughout our lives when someone wants to say that a complicated job is not impossible. Since graduating college, this has always made me smile, seeing as I studied rocket science as an undergraduate. I knew I’d be able to get through other tough hurdles if I could get through those courses. I point this out not to say that I am very smart but to suggest that everyone feels dumb at some point. Socrates said that, “The only true wisdom is in knowing you know nothing,” which (I must point out) was also famously quoted by Keanu Reeves and Alex Winter in Bill and Ted’s Excellent Adventure. Embracing our ignorance is a way to avoid over-confidence, and it helps us do the right thing for our patients. Still, how do we embrace it when our patients are expecting unwavering confidence?

While I would love to naturally have the confidence to walk into my patient’s room with my collar popped and a really good mullet, I have settled on putting myself in his shoes and treating him as I would my sister, mother, or father. In doing so, I can be much more certain about my decisions without feeling that I am an imposter.

Although I still often feel inadequate in my medical knowledge, this feeling serves as a driving force for my research and extra reading. That being the case, my imposter syndrome pushes me to do better for my patients. Even though the stress associated with constantly striving to learn can flare up old anxiety and depression, a strong support system has kept me working toward my goal of my patients’ health. I’ve even managed to work on my own health. I have been able to get married during residency and start the foundation of my new family life.

Medical training is notorious for being difficult, and I believe the epidemic of the imposter syndrome plays into this difficulty. While I don’t want to tell any of you what to do with your lives, I suggest that if you are dealing with imposter syndrome as I do, try to use empathy to lead you to the path of confidence. It will ultimately lead to our patients’ well-being.

Joel Wecker is a family medicine resident.  This article originally appeared in Family Medicine Vital Signs.

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