Still have occasional imposter syndrome as third year...

[sliceofbread136]

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Through out all of residency I have had waxing and waning feelings of imposter syndrome...

I’m an excellent test taker and crush written tests, never made any huge mistakes or caused patient harm. But sometimes I just feel like I’m not ready to hit the big wide world. Usually this occurs when I havent slept enough, but sometimes after discussing a patient with an attending I realize my initial thought process was off base and my original plan would have been sub optimal. I especially find I over think simple things and underthink non-simple things, have a tough zeroing on the complaint that really matters in patients with multiple complaints and pan positive review of systems. Sometimes on the other hand I feel great and ready to take on what the world throws at me but this is often fleeting.

Just not sure if I’m ready to be a fellow or attending where as all my senior residents in the past just seemed to know all the answers and be super confident all the time. Hoping I’m not alone here

 

[oldbearprofessor]

I've always believed that the first year as an attending is the second hardest year of the whole medicine thing from premed onward. Regardless of whether you did a fellowship, as an attending you have a unique responsibility set that you didn't have before. The trick is learning when to ask for help and when not to and that's not easy as if you ask for advice from a senior person and you don't take that advice, it can be problematic. The great thing is that you will do well as an attending, just be aware that the first year as an attending brings a bigger salary, but it's own set of concerns. I have a lot of confidence in you Slice and yes, imposter syndrome among new attendings is common if not nearly universal!

 

[SurfingDoctor]

Most of this just takes time and experience. There’s nothing unique about your situation. I also agree that the first attending year is challenging and honestly, in the retrospectoscope... I made a handful of mistakes and missteps during my first year plus out of training. It happens, you learn from that experience and you move on. It’s a far bigger problem if you can’t learn from mistakes or the things what you missed...

 

[Stitch]

This is a good thing. You still have more time to hone your skills and a little fear is a good motivator. You are not alone in feeling this way at all, and it's something we all go through. As others above pointed out, your first day/year as an attending will be scary, and you'll second guess yourself a lot. But the fact is that your residency program, wherever it is, has very likely trained you well and you will be ready when the time comes. Don't feel bad about bouncing your thoughts off a more senior doc; we've all done that too. Hang in there, don't be afraid to talk about this.

 

[holaback]

Through out all of residency I have had waxing and waning feelings of imposter syndrome...

I’m an excellent test taker and crush written tests, never made any huge mistakes or caused patient harm. But sometimes I just feel like I’m not ready to hit the big wide world. Usually this occurs when I havent slept enough, but sometimes after discussing a patient with an attending I realize my initial thought process was off base and my original plan would have been sub optimal. I especially find I over think simple things and underthink non-simple things, have a tough zeroing on the complaint that really matters in patients with multiple complaints and pan positive review of systems. Sometimes on the other hand I feel great and ready to take on what the world throws at me but this is often fleeting.

Just not sure if I’m ready to be a fellow or attending where as all my senior residents in the past just seemed to know all the answers and be super confident all the time. Hoping I’m not alone here

You're not alone. Actually this is quite normal. A healthy fear of the big responsibility that we have as physicians.
I believe experience comes with time. You will be fine, and like everyone else, will just need to have a mentor or two in your first few years as an attending. This is something they never tell you during training - that even after you're done, it's okay to ask gray-haired people for help. Everyone talks about "are you ready to be on your own?" But if you think about it, what is the difference between last year of residency and 1st year of attending? Now compare that to first year attending vs 20-year attending? My point being, the learning continues at the same rate, and a lot of what you will know will be gotten after training.