Anyone else feel dumb as a new attending?

[WanderingBlast]

First week on the job as a new attending at an academic center and I’m in a constant state of low-level anxiety because I feel incredibly stupid. I remember feeling like this before intern year and fellowship, but it’s scary to feel this way as a new attending. You feel like you should be more confident by now. I did a lot of research my 3rd year (at an academic center) and just came off of a month between fellowship and starting as an attending entirely so I feel like it’s been awhile since I was in the thick of clinical things. And that doesn’t help. I am studying for boards so I know that will help though. I guess it’s just the constant worry about lacking clinical expertise, having never independently steered the ship before. We didn’t have a fellows clinic so my entire fellowship was spent seeing patients rotating through other attendings’ clinics, which isn’t quite the same.

I guess I’m just wondering if other new attendings feel/felt like this at the outset.

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[gutonc]

First week on the job as a new attending at an academic center and I’m in a constant state of low-level anxiety because I feel incredibly stupid. I remember feeling like this before intern year and fellowship, but it’s scary to feel this way as a new attending. You feel like you should be more confident by now. I did a lot of research my 3rd year (at an academic center) and just came off of a month between fellowship and starting as an attending entirely so I feel like it’s been awhile since I was in the thick of clinical things. And that doesn’t help. I am studying for boards so I know that will help though. I guess it’s just the constant worry about lacking clinical expertise, having never independently steered the ship before. We didn’t have a fellows clinic so my entire fellowship was spent seeing patients rotating through other attendings’ clinics, which isn’t quite the same.

I guess I’m just wondering if other new attendings feel/felt like this at the outset.

Yes. Everyone feels like this. If you don't, you're dangerous.

 

[whoknows2012]

First week on the job as a new attending at an academic center and I’m in a constant state of low-level anxiety because I feel incredibly stupid. I remember feeling like this before intern year and fellowship, but it’s scary to feel this way as a new attending. You feel like you should be more confident by now. I did a lot of research my 3rd year (at an academic center) and just came off of a month between fellowship and starting as an attending entirely so I feel like it’s been awhile since I was in the thick of clinical things. And that doesn’t help. I am studying for boards so I know that will help though. I guess it’s just the constant worry about lacking clinical expertise, having never independently steered the ship before. We didn’t have a fellows clinic so my entire fellowship was spent seeing patients rotating through other attendings’ clinics, which isn’t quite the same.

I guess I’m just wondering if other new attendings feel/felt like this at the outset.

It’s very normal and to be expected at this early point. I was a complete idiot for the first 6 months. You’ll be fine

 

[RainerMaria]

Yes, normal, as stated above it does fade. That said do in the beginning find a colleague who you can run a list of cases to get a sense of how they do things. Even if they are perfunctory/mundane and simple, and you think you know the answer, just a reality check is good practice in the beginning while starting out. Institutions do things differently, where you trained may have done things differently than where you're working now. They want you to succeed and be someone they can rely on for good clinical judgment. A teacher once told me that the most important thing in medicine the following dictum (and listening to it has kept me out of trouble): "When in doubt, ask."

 

[gritsngravy]

Just adding that you're not alone. Also started this week. Also never, ever, felt this dumb with such imposter syndrome. And I had a very clinically heavy third year knowing I was going into clinical practice. Also appreciate the encouragement and tips from everyone.

 

[whoknows2012]

Agree with @RainerMaria .

The way I got out of feeling like I knew nothing was to see and review how my colleagues dealt with more straightforward cases and in more depth go over complicated patients and really get a sense how to think about the decision making process (in my case leukemia patients with complications, relapsed/refractory dz, rare diagnoses and management associated with that for example) and this continues to some degree today 3+ years later for complicated cases. Reading helps but the actual experience of managing more and more patients as time goes on is unmatched as a way to
Feel more confident

 

[gutonc]

For my first couple of years I was fortunate to have 2 more senior docs in my group that I could bounce cases off of at pretty much any time. Since I was also still with the hospital system where I trained, I was able to easily reach out to my fellowship mentors for more complex things. I would say that I did this for well over half of my patients during that period.

95% of the time, my assessment, thought process and plan was "right". For the other 5%, I got some great learning opportunities.

 

[WanderingBlast]

Greatly appreciate everyone sharing their experiences and advice.