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Confidence is as important as becoming competent

Debrah Wirtzfeld, MD and Elizabeth Pedersen, MD
Physician
April 20, 2021
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As medical trainees, we learn how to be competent in our craft. If we are competent, it is assumed we will be successful and confident in our abilities. However, empowered performance requires a focus on not only competence, but also confidence. We stumble in our endeavors even though we may be highly competent.

The study of medicine does not support the attainment of higher levels of confidence; in fact, it actually erodes our feelings of confidence. Many, if not all, of us have been on the giving as well as the receiving end of comments, actions, and attitudes, which work away at our confidence. Medical culture seems to demand that we push trainees and junior staff to the brink or over the edge to ensure competence; however, this is where confidence becomes completely eroded. Although we practice as surgeons, we know that surgery is not the only area where trainees are expected to learn through struggle rather than support. The culture of medicine is changing, but it still has much further to go.

What most people fail to recognize is that true success is measured through the attainment of competence and confidence. In the traditional sense of the definition, confidence means to trust. We must move towards a place where we accept our important responsibility of empowering our trainees not only to learn the skills of our profession, but also to trust in the fact that they can perform well. This is the only way to allow them to achieve success and empower their performance.

Studies have shown that it is especially important that we promote this element of success in our women trainees. Confidence is not an issue that affects only some women; it affects all women. Even world leaders such as Angela Merkel and professional women athletes have issues with imposter syndrome. This likely reflects how our current society socializes women, with aspects of our upbringing often unconscious and ill-defined. An example would be the tendency of women to internalize responsibility for negative events, such as complications. This impacts how we see ourselves as professionals and can be associated with higher rates of burnout and women actually leaving the profession.

Many of us have been peppered with events that lead us to question our success. An example is when patients ask women surgeons if they will actually be the one doing the operation, or asking women doctors when they will see the real doctor, or assuming that the male resident is actually the one in charge. At the most basic level, it relates to what is in a name. Male physicians are often referred to by their title, while women physicians in the same context may be left with only their first name. These repeated events over time have been shown to leave women with ever-decreasing levels of confidence. This process may not even be perceptible.

With the advent of COVID-19 in early 2020, this recognition led us to review the literature around confidence. As we began to recognize that most women struggle with imposter syndrome, we felt it was imperative to pivot and focus on enhancing confidence in physicians and other professional women. Our passion is to assist women professionals, including physicians and surgeons, to empower their performance by working on their confidence and competence. We recognize these women already have confidence; otherwise, they would never have gotten to where they are today. However, they can benefit from learning more about the skills and strategies behind confidence. We want to take them from good to great and great to exceptional.

We look forward to joining together in person once COVID subsides.

Attainment of the skills and tools of confidence needs to be afforded the same importance as becoming competent. We should be on a constant journey to enhance both.

Debrah Wirtzfeld is a surgeon. Elizabeth Pedersen is an orthopedic surgeon.

Image credit: Shutterstock.com

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