Dear Editor,
I was extremely moved by this article. Twenty years out of medical school, I still resonate with the pressure described and the imposter syndrome. Hopefully I’ve also learnt a few things from the intervening years, including crippling depression which has nearly taken my life, much as a result of work stress.
Firstly, pretty much all of us have imposter syndrome, from students to GPs to consultants. With the possible exception of a few with very high self esteem (who are usually not the best doctors) we all have the heart of a terrified student waiting to be found out.
Secondly, being a good enough doctor is good enough. I tell all my students that I believe I’m a below average doctor. Why? Because I have no idea where I place and it’s just as likely I’m below the mean as above it. And in actual fact, providing the bell curve starts at the threshold for have the skills to practice, even if we are well below the mean, we are still good enough. Of course, in reality it doesn’t work like that: everyone of us is likely above average at some things and well below at others. That’s why we work in a team.
Thirdly, and related to that point, someone who knows something we don’t has just had different experiences. I remember as a junior impressing my firm on a post take ward round by calculating the Cockcroft Gault equation by memory. How? Because Im a genius? Far from it! I had just done a palliative care job and have been prescribing bisphosphonates all day one day a week for months.
Fourthly, life is about so much more than work. When I was severely ill as a GP partner and unable to work, at home under the crisis team, what helped me keep going wasn’t my identity as a doctor. If anything, apart from the loving support of family, it was the connection to my community that came from being a scout leader. When people say “how do you find time to be a scout leader as a full time GP” I say “I don’t do it for the kids, I do it for me”.
I am sure the authors are well on the way to understanding what is important and I hope the students and doctors reading are too. Of course, there will be some who feel the need to step on the treadmill of striving for excellence through endless clinics, surgeries, presentations and papers. But, if so, do so cautiously. You don’t have to be the best. You don’t even have to be above average. GK Chesterton is quoted as saying “if a jobs worth doing it’s worth doing badly” and that applies to our careers. Well, maybe not practicing medicine badly, but “good enough”.
Re: Everything, every day, all at once—why we need to ask less of medical students