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POSTED: June 17th, 2025
POSTED IN: EM Pulse - The Official Newsletter of MOCEP, EM Pulse Q2 2025,

Written by Tarrin Casey, MD

Hi, my name is Tarrin, and I struggle with imposter syndrome.

Though I confess this in pure vulnerability, I do so knowing I do not stand alone in this experience. In fact, I stand among many women in medicine who carry the same internal burden. A study conducted by the UNC School of Medicine found that female physicians were more likely to experience imposter syndrome than males, regardless of specialty or leadership role.

Imposter syndrome is a psychological pattern where individuals doubt their accomplishments and have a persistent fear of being exposed as a fraud, despite clear evidence of their competence. It often manifests as chronic self-doubt, attributing success to luck rather than ability, and a sense of not belonging in professional spaces.

This is not just a personal struggle but is a systemic one, rooted in long-standing cultural expectations, implicit bias, and the underrepresentation of women in medical leadership. Acknowledging this is the first step toward reclaiming our space and rewriting the narrative.

How Imposter Syndrome Shows Up

Imposter syndrome often creeps in quietly, especially in high-stakes environments like emergency medicine, where the pressure to act swiftly and flawlessly can be overwhelming. It presents not just as an occasional doubt but as a persistent, internalized belief that you’re somehow less capable than others perceive you to be.

Imagine being on shift and getting the page: a patient in cardiac arrest is en route. Without hesitation, you make your way to the resuscitation bay. Your mind switches into overdrive. You begin setting up airway equipment, ensuring suction is ready, grabbing the ultrasound machine to assist with supplemental diagnostics, confirming medications are drawn up, coordinating with nursing staff and ensuring everyone has a role. You feel focused, prepared, and in control. But then EMS arrives and, without pause, delivers the handoff report to someone else. Perhaps to a male colleague, another provider with a more dominant presence, or simply a more familiar face in the room.

In that instant, despite your readiness, a familiar wave of doubt seeps in. Did I not seem confident enough? Do they not see me as the team leader? Should I have spoken louder, stood differently, made myself more visible? That moment, small as it may seem, lingers long after the case ends. It reinforces the internal narrative that you must constantly prove your worth to be seen and trusted as a capable provider.

These moments build up over time and can take a toll, causing even the most accomplished providers to question if they should lead a resuscitation, apply for a fellowship, publish a paper, or advocate for a leadership role. The fear isn’t rooted in lack of preparation or ability, but in the nagging sense that success is conditional, that one misstep will confirm the fraud you fear you are. This internal struggle doesn’t just affect confidence; it delays growth, silences voices, and creates unnecessary barriers in a field that is strengthened by diverse representation and innovative thinking. Yet, it’s a struggle so many women in medicine carry silently, even while performing at the highest level.

Overcoming Imposter Syndrome

Combating imposter syndrome requires intentional effort and a supportive community. The first step is acknowledging that these feelings exist and recognizing that you are not alone. Simply knowing that others share this experience can be an incredible source of strength. Mentorship and coaching are also key. Having someone who believes in you, who pushes you beyond your perceived limits, and who challenges the voice in your head that says you’re not enough can be transformative.

Positive self-talk and affirmations can anchor us when self-doubt tries to sway us. Phrases like “Believe it until you achieve it” or “You’re not faking it, you’re becoming it” serve not to minimize the struggle, but to empower us to keep pushing forward. Keep a record of your achievements, big and small, and revisit them often. You did not stumble into success. You earned your place through grit, determination, and talent.

The UNC study also found that holding leadership positions served as a protective factor against imposter syndrome. That finding is not surprising. Leadership forces us to step into our power and see ourselves as others do. So, when you reach that next milestone, take a moment to honor the journey, acknowledge the obstacles you’ve faced and recognize the growth you’ve achieved along the way. And then, use your position to lift others. Mentor someone who’s navigating the same doubts you once had. Be the voice that helps quiet their inner critic and push them beyond their inner barriers.

We Belong Here.

Women belong in medicine. We belong in leadership. And we must own that truth, not just for ourselves, but for those who come after us. Now is the time to step forward, take our place, and redefine what leadership in medicine should truly embody.

Sources:

Iwai, Yoshiko MS; Yu, Alice Yunzi L MD; Thomas, Samantha M MS; Fayanju, Oluseyi A MD; Sudan, Ranjan MD, FACS; Bynum, Debra L MD, MMEL; Fayanju, Oluwadamilola M MD, MA, MPHS, FACS. Leadership and Impostor Syndrome in Surgery. Journal of the American College of Surgeons 237(4):p 585-595, October 2023. | DOI: 10.1097/XCS.0000000000000788