What To Do When You Feel Like An Imposter In Residency Training
(AMA, Brendan Murphy) — You’ve earned your white coat. You’ve studied, trained and matched with a program. But some resident physicians—even as they have graduated and earned the title of “doctor”—may still feel as though they don’t belong.
Imposter phenomenon, often called imposter syndrome, is “the internal experience of feeling like a fraud and doubting the validity of one’s own achievements,” according to a study published in BMC Medical Education. Rates of imposter phenomenon among resident physicians range between 33% and 44%, says the study.
If you experience this phenomenon during internship or later on during residency, here is how you can cope with it.
It can creep up on you
One area in which impostor phenomenon can manifest, the study found, is during role changes. That could be during the transition from medical school to residency or fellowship.
A third-year psychiatry resident in Oklahoma, Brady Iba, DO, didn’t experience impostor phenomenon until his second year of residency during a shift on which he was moonlighting.
Dr. Iba was covering a 55-bed hospital on his own that night. A patient came in expressing suicidal thoughts—something he’d managed countless times during residency. The clinical decision to admit was straightforward. But this time, the responsibility felt heavier.
“It was just me,” said Dr. Iba, an AMA member. “There was no attending to back me up, no co-resident to run it by. It was a decision I’d made a hundred times—but now it was my decision. Solely mine. And I started doubting it.”
Realizing that he was feeling different about the experience, Dr. Iba spoke with the nurse working on triage that night.
“We walked through it,” he said. “This was the first time I made a decision that was wholly my own and not defended by other attendings or residents.”
That brief exchange helped him understand the root of his self-doubt: it wasn’t about clinical competence—it was about transitioning into independence.
The AMA Thriving in Residency series has guidance and resources on navigating the fast-paced demands of training, maintaining health and well-being, and handling medical school student loan debt along with other essential tips about succeeding in graduate medical training.
Living with uncertainty
There’s a difference between not belonging and not knowing something. As a resident still in training you won’t have all the answers, yet acknowledging that can be difficult.
“We need to be able to say, ‘I’m not sure,’” said Dr. Iba. “Admitting uncertainty isn’t weakness. It’s being responsible.
“No decision is small. Every choice you make matters to your patients. You’ve earned the right to make those choices,” he added.
Dive deeper:
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- Nervous about your intern year? 3 resident physicians offer insight
- 5 tips to help resident physicians shift from intern to PGY-2
Talk it out
In Dr. Iba’s program, psychiatry residents meet weekly in a formal “process group” led by an outside therapist. It’s a space where they reflect on the emotional weight of their work, including those nagging feelings of not being enough.
“We had an intern say, ‘I don’t feel like I deserve to make these decisions. I don’t belong in this role,’” Dr. Iba said. “And everyone in the room could say, ‘Yeah, I’ve felt that too.’”
“We’re trained to suppress our emotions. But in psych, and honestly in any field, reflecting on your feelings helps you grow. You realize this isn’t just happening to you—it’s part of becoming a doctor.”
It takes time
Over time, the moonlighting shifts got easier, and for Dr. Iba the title “physician” started to feel less like an act and more like a reality.
“I settled in. I reminded myself: ‘I’ve done this before. I know what I’m doing. I’m good at my job.’ That’s why we’re here.”
When impostor phenomenon does take hold, Dr. Iba said it’s important to acknowledge that feeling.
“It’s normal to doubt yourself,” Dr. Iba said. “Even over small things. But don’t ignore it. Work through it. You’re trained for this. You belong here.”