Updated: Aug 7, 2022
I should be so lucky
By Dr Seline Ruby
“I wouldn’t want a doctor with anxiety treating me”. When my relative said this, it caught me off guard. Little did they know that I had frequently had my own battles with anxiety. I had put on a brave face to them during these times and felt unable to express the truth. It shocked me that this attitude was still held in the current times. I thought further about what they had said and attempted to put myself in their shoes. Unfortunately, although great improvements have been made, there is still significant stigma surrounding mental health; possibly even more so regarding health care professionals, who sometimes have a higher standard to uphold from the greater public's perspective.
This stigma resulted in me feeling unable to express how I felt to friends whilst at medical school, and later to colleagues. It resulted in me at times being plagued with self-doubt and wondering if I was cut out to be a doctor. I sometimes wondered how I got here and felt it had been a result of luck rather than anything intrinsic I had done or had to offer. These feelings are now recognised as imposter syndrome. This has received increasing publicity and recognition in recent years, with famous figures including Michelle Obama expressing these feelings. It can be described as feeling like a fraud, for example, being in an esteemed position, but attributing the success to external factors such as luck, rather than individual competencies. It can be associated with a fear of being ‘found out’ and a negative self-view, which is often incongruent with the world's view.
This is believed to be common in doctors and medical school students, with research showing that perpetual feelings of inadequacy are not uncommon and can contribute to burn out. Some studies suggest this may be more common in ethnic minority groups, as individuals from majority groups may receive more recognition for their work and intelligence, which may result in any feelings of self-doubt subsiding. It is also thought to be linked to some personality traits such as perfectionism and competitiveness, and we do often tend to be a competitive bunch!
During the Covid-19 pandemic, mental health issues have unsurprisingly increased. This is amongst the general population, due to isolation, fear, and uncertainty, and amongst healthcare professionals facing the same hardships, with the added stress of working in the increasingly overstretched NHS.
In my case, I feel I have had underlying anxiety for several years, and I was subsequently
more susceptible to the recent stresses and to imposter syndrome. I have only recently felt able to share these feelings with my colleagues and a soothing wave of relief washed over me as I learnt that several colleagues share many of these feelings. This was a huge weight off my shoulders, and a relief to realise we are often all in the same boat. It also equipped me with more strength to remind myself that perhaps I am in the position I am due to hard work and ability. Granted, we all know with the huge numbers that apply for medical school and subsequent training posts, a bit of good fortune never goes amiss also.
Through this post I hope to remind all of you, whether you’re considering applying to medicine, currently at medical school, a junior or senior doctor or allied healthcare professional, experiencing a degree of self-doubt is normal. We are often thrown into new, unpredictable situations, and spend vast amounts of time outside our comfort zones. We are fortunate to have such opportunities to grow, however, it is only natural to second guess yourself in such situations. But it is important to not allow this to spiral further, and to result in questioning your abilities.
During this unpredictable and messy time, I’d encourage anyone with similar feelings to strive to be open and share your thoughts and feelings, as well as being attuned to signs friends and colleagues may be struggling. Please feel free to contact me also.