Imposter Syndrome and Senior Clinicians: A Different Way to Relate

Do you ever feel like a fraud, doubt your abilities and fear you will be “found out,” despite clear evidence of success and competence? Welcome to the extremely common Imposter Syndrome, the inability to accept success based on your competencies and capabilities and instead attribute it to luck, error or personal connections (Clance and Imes, 1978).

Imposter Syndrome is powered by our Inner Critic, a negative internal voice that judges and criticises, making us feel demeaned, less confident and bringing down our mood.

One in 4 physicians in the US report feelings of Imposter Syndrome (Salari et al., 2025), while Leach et al. (2019) suggest it does not lessen with surgical seniority. But Imposter Syndrome is not an inevitability. It's worth spending some time getting to know your Inner Critic and why it exists.

Imposter Syndrome is common in high-performing professionals that does not lessen with seniority

Although everyone has an Inner Critic, several factors make senior clinicians, particularly doctors, vulnerable to Imposter Syndrome:

• The clinical decision "buck" usually stops with senior doctors. High-stakes, complex, ambiguous and ethically challenging cases, where there is no single right or wrong answer, often fuel feelings of self-doubt.

• Senior doctors are undeniably high achievers, operating in a culture of perfectionism. Even though we know that learning from failure is valuable, errors are professionally, emotionally and intellectually unacceptable. When they happen, they are held up as proof of not being good enough.

• Benchmarking, league tables and feedback, are routine and necessary parts of clinical practice. They are also constant reminders that others are better and that you can fall as well as rise.

• Roles that de facto escalate into leadership and/or academia can make one feel like a fraud who will be "caught out" at any time.

• Reluctance to show uncertainty or vulnerability under the expectation of expertise and the pressure to perform.

The Inner Critic is a part of the mind that is trying (clumsily) to keep us safe. This typically comes out as an internal voice picking out faults, mistakes or inadequacies and often speaks harshly, producing feelings of shame, self-doubt, low self-esteem, and sometimes depression. The problem is that the Inner Critic focuses on what is "wrong" rather than constructive guidance. It is working so hard to protect us from failure, rejection or harm that it is actually doing the opposite.

Psychologists Jay Earley and Bonnie Weiss. have identified several types of Inner Critics, each with its own style of criticism, each holding you back from realising your full potential. The narrative of your Inner Critic tells you which type is talking and how it thinks it is keeping you safe. The good news is that, with a bit of practice, you have the power to change that narrative.

Coaching can help you to "catch" your Inner Critic and reconsider what is really going on. If you would prefer to explore at your own pace, the online FIRE: Free, Ignite, Realise, Enjoy™ programme includes structured activities to listen to your Inner Critic, discover your Inner Champion and understand how they influence your motivation and wellbeing.

Spend some time with your Inner Critic, the internal broadcaster of limiting beliefs, then turn a full 180 degrees and say hello to your Inner Champion and discover your empowering beliefs.