"Imposter syndrome" in pediatric residency - does anyone relate?

[kellie]

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Does anyone relate to feeling inadequate, despite positive feedback to the contrary? I'm more than halfway through my pediatric training (not in US), passed my exams on my first attempt last year, and have always had good feedback from my consultants/attendings about my clinical decision making, communication skills and knowledge. Despite this, I just feel like I'm not good enough, not smart enough, and I can't imagine ever being a competent, independent pediatrician. I have never had any adverse incidents with my patients and in fact if anything I'm probably over-cautious and too dependent on running things past my consultant (but again that's just my feeling - no one has ever told me that).

If anyone else ever felt this way, has it improved with more years of experience? I thought it would improve the more senior I became, and especially post-exams when my knowledge was at a peak after 18 months of study - but it hasn't improved. I'm always on edge at work, especially when I'm working alone e.g. on a night shift. I feel like quitting because the thought of being an on call general paediatrician overnight just makes me sick to my stomach. I don't know if this means that pediatrics just isn't for me, or if I'm just feeling this way because I'm too junior, and things will improve.

I'm aware that this could all just be anxiety, but would still appreciate hearing from anyone else who has had a similar experience...

 

[Stitch]

I don't think what you are feeling is that uncommon. As an intern, you really don't know how much you don't know. As your knowledge increases, you realize how much you still have to learn, and you've seen enough bad cases to know how sick a kid can get. I tend to view this as a good realization, since it tends to motivate people to study hard and learn as much as possible. As you get into your final year of training your confidence will grow, and hopefully your attendings will give you the space to make your own decisions. Most even get a little cocky.

And then once you're an attending, you'll be terrified again. I admit to still holding my breath every time I do an RSI, knowing that I'm in charge of the ICU at night. You'll worry about the fist kid you send home, even though you know he just has a cold. That's normal. Just remember, that you're never really alone. You can always call your former attendings, or bounce an idea off of one of your partners if you need to. We have all done that, especially when we are new attendings. It's partly why picking a good practice with collegial environment is so important.

 

[Cuthbert]

I'm 5 years out and a general pediatrician. I get nervous when attending a crash csection. I review NRP prior every time. I worry about my patients in the nursery, NICU or on the general floor. I bounce patient care concerns off of my partners and they do the same with me. It did not take me long to realize that my partners all feel the same way I do. They may not talk about it, or they may try not show it, but the concern is there. We care about being good physicians and want to live up to a high standard. I think that is a good concern to have. Overconfidence is a weakness.

 

[Easily_Sunburned]

PGY2 - I'm so glad other folks are feeling this way. The thought of graduating in a little over a year is terrifying for exactly these reasons. Thanks, @Stitch , thanks @Cuthbert . I think the closer I come to being a senior resident, and to graduating, the more aware I am of the incredible amount of information I don't know - not good for one's confidence.

How does one balance the confidence needed to do a good job and counsel patients, encourage them to buy into a management plan etc, though, with the need to not be 'overconfident?' Because I agree, Overconfidence is a major weakness.