app

When Will They Find Out I'm an Imposter?

— Intellectual self-doubt stems from factors beyond individual control

MedpageToday
A woman wearing a turtleneck sweater with the neck pulled up to cover her face

Even as I sit down to write about imposter syndrome, I'm experiencing it. I'm an infectious disease epidemiologist, not a writer or expert on imposter syndrome, so why would anyone care about what I have to say on the topic? Perhaps you will relate to my feelings of "" as a woman in science, starting a new job remotely, amidst a global pandemic.

As you may already know, imposter syndrome is the experience of feeling like a fraud, having self-doubt, and questioning your competence despite your expertise. It is often studied in the context of achievement in the workplace, but it can happen in any context. Feeling like an imposter goes beyond feeling like you lack specific skills -- it is the experience of questioning whether you belong at all or fearing that your lack of knowledge will be "found out." Another hallmark of imposter syndrome is an inability to accept personal accomplishments, instead attributing them to good luck, sympathy, or pity. And despite linking your success to chance, you often blame yourself for any mistakes. Minor errors reinforce this belief and the frustrating cycle of living in fear of discovery and striving for perfection sets in. For some, these feelings give way to debilitating anxiety and depression.

While this phenomenon is labeled a "syndrome," which can imply it is a medical condition, it is not a recognized disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The term imposter syndrome was first coined in the 1970s and thought to be mostly linked to high-achieving women, particularly members of . But feeling like you are not as competent as others perceive you to be can happen to anyone. A of 62 studies -- which included survey responses from 14,000 men and women from around the world -- found the global prevalence of imposter syndrome varies from 9% to 82%. If anyone, including both men and women, can face imposter syndrome then why does it seem like appear to experience it more?

Since starting my new job as a research epidemiologist, I have been grappling with feelings of imposter syndrome daily. I recognized these feelings as soon as I joined my first meetings with highly qualified (and more experienced) scientists and found myself questioning whether I should even speak up during a study design meeting, despite being specifically hired to do this. (One aspect of being an epidemiologist is developing appropriate studies to adequately answer research questions). And to be abundantly clear, I was warmly welcomed and no one in the meeting said anything negative or offensive to warrant these feelings. So, after spending weeks giving myself pep talks as reminders that these weren't true feelings of fraud and that I was hired because of my specific skill set, I decided to attend a webinar on imposter syndrome. I noticed that out of the 110 attendees, approximately 80% were women. While some experts women appear to experience imposter syndrome more because it is more socially acceptable for them to admit to these feelings or because of greater individual angst about our capabilities, I began to question whether another cultural factor could be at play: our shared experiences as women in the workplace.

It turns out that others have wondered about this same issue. Recent that we need to reconceptualize the imposter phenomenon. It is often framed as the insecurities of the individual, but outside forces are playing an important role too. Ruchika Tulshyan, MS, and Jodi-Ann Burey, MPH, wrote about the specific with imposter syndrome and questioned why its designation as pathology or syndrome exists in the first place given the role workplace systems have in exacerbating it:

"The concept, whose development in the '70s excluded the effects of systemic racism, classism, xenophobia, and other biases, took a fairly universal feeling of discomfort, second-guessing, and mild anxiety in the workplace and pathologized it, especially for women. The answer to overcoming imposter syndrome is not to fix individuals, but to create an environment that fosters several different leadership styles and where diversity of racial, ethnic, and gender identities is viewed as just as professional as the current model."

Could my insecurities be the result of the cultural circumstances of being a woman, and more specifically, a woman in science? Women are often labeled as bitchy and aggressive when self-advocating, while men are labeled decisive for the same behaviors; women are still compensated at of the average man's salary (these gaps are larger for women of color and trans individuals); and systematic bias and racism remain pervasive in many workplaces. often feel like they don't belong, are undervalued, and are granted less respect compared to their male counterparts. Women also encounter more unprofessional behavior than men. In 2018, the National Academies of Sciences, Engineering, and Medicine (NASEM) released a detailing that as many as 20% to 50% of female students experience sexual harassment from faculty or staff. Moreover, let's not forget that women tend to do more than men, which has long-term implications for our careers. Before we question whether our expertise is good enough, we need to consider these obvious systemic reasons why women may feel like imposters.

Most -- if not all -- of these reasons are out of our control. Yet, the prevailing recommended feelings of imposter syndrome remain focused on what the individual should do: talk about your feelings, recognize your expertise, remember what you do well, realize no one is perfect, and change your thinking. Even when doing this, I am still left with feelings of imposter syndrome. Focusing on myself can only get me so far. Instead, our workplace cultures must change.

I understand feelings of self-doubt come with the start of any new job. Adjusting to new colleagues, new systems, and new work takes time and I should be patient with myself. But imposter syndrome is more than discomfort associated with a job transition. What are we going to do to make systematic cultural changes to our workplaces to ensure women feel safe, welcomed, and empowered to remain in the workforce?

is an infectious disease epidemiologist and science communicator, currently working as a research epidemiologist at .