Medical Imposter Syndrome

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Hey everyone,

Sorry if this is a stupid question or issue that I am having.

I'm a first-year medical student at the end of the first year, and I have done okay in my classes. I feel like I'm terrible at coming up with a differential, and I get that I'm only a first-year and this is probably true for all first-years. However, I am struggling with doing the patient encounters. Specifically, I feel like I'm playing dress-up and am having trouble knowing when to take charge and be assertive, or be the leader of the group in multidisciplinary patient encounters without coming across like I am a jerk. I want to correct this and hope someone on here can give me some tips. I learned from some amazing physicians, and I always idolized their abilities to lead a team. I will add that I am a natural leader.

I just want to be able to excel at leading by coming up with a differential, and I do not want to look like some of the "gunners" in my class that already feel they should be given the respect of an attending as a first-year.

Thank you all in advance.

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This is normal.

The answer at your level is to just do your best. You don’t know much, so you kind of are playing dress up, and that’s ok because that’s the only way to learn. If you can at least make a stab at a differential as a first year, even if it’s terrible, that’s fine. By 3rd or 4th year is when you need to have at least some idea of an assessment/plan, but not yet
 
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I encourage you to listen to the podcats CPSolvers, specially the morning report to have a better understanding of not only ddx but strong and thoughtful communication.
 
I have, and they assure me that it gets easier, of which I’m sure it does. I just feel like some classmates are solid at doing a ddx, and I’m behind, lol.

You can't be an expert at everything at once. This is a learning curve. Have a little faith in yourself.
 
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I just feel like some classmates are solid at doing a ddx, and I’m behind, lol.

Everyone has their strengths - and their weaknesses. In a high level professional degree program like medicine, you’re with the cream of the crop of students, and they don’t have as many weaknesses and/or they’re better at hiding them :)

While you may struggle with differentials (which, c’mon now, you’re a first year!), you obviously have other strengths like leadership, teamwork, athleticism, self-discipline, initiative, etc etc. Those are things many of your classmates may wish they had! So remember to take this opportunity to learn: put yourself out there even if you don’t know the answer. Float an answer that you know isn’t 100% right but may be getting you close. Make an effort to interact and improve; that will be noticed positively by your peers and your teachers.
 
You are a first-year and know relatively nothing at this point. You SHOULDN'T be good at coming up with a DDX at this point...keep working on it. As you learn more, your confidence will grow.
 
While it gets better when you have more experience, we ourselves encounter out-of-context problems even after long experience. This is why it is called a practice, as we always have room to improve our skills.

That said, you recognize acutely your own weakness, which is the first step. I would take the advice from above, but also take the Pathology view and work backwards. Once you know the diagnosis, retrospectively examine what should you know and when, especially when you got it wrong. That will help with learning to look and be perceptive to the right symptoms and signs. But even now, Pathology at times has the duty of telling us our own professional oversights and failures.
 
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