Reframing the Imposter: From Fear to Self-Trust
High-achievers tend to experience imposter syndrome precisely because they care deeply about their work.
We strive for excellence, hold ourselves to the highest standards, and never want to let our patients or colleagues down.
But that same drive can morph into perfectionism, and perfectionism always carries a shadow of inadequacy.
When imposter thoughts take over, we usually respond in one of two ways.
The first is avoidance: we stop doing the thing that triggers us.
The second is overcompensation: we do it anyway but suffer the entire time.
As an ENT surgeon, I’ve lived both.
When Fear Masks as Caution
Imagine hitting a juicy vessel during a tonsillectomy (it’s always the big muscular guys with thick necks). You eventually get control, but you find yourself in fight or flight the entire time.
Big emotions create big memories, and those experiences live in the body.
The next time that archetype of patient with a similar story appears on your schedule, you feel the echo of fear.
If imposter thoughts layer on top of that fear, the dread intensifies.
You might refer the case out, telling yourself you’re being cautious.
Or you take the patient to the OR but spend every minute tense and hypervigilant, convinced something will go wrong.
That anxiety ripples through the whole team. The scrub tech senses it. The nurse senses it. Anesthesia senses it.
You finish the case safely, but not from your best self. Instead, from an anxious version of you.
This is the real cost of imposter syndrome. It doesn’t just drain confidence; it steals creativity, efficiency, and peace of mind.
Our patients lose, too, because they don’t get the version of us that operates from calm trust.
Bravery, Not Fraudulence
Dr. Catherine Harmon Toomer says it best in her TEDx talk, “Imposter Syndrome by Any Other Name Is Bravery.”
Feeling like a fraud does not make you an imposter. Pretending to be something you’re not makes you a fraud.
But feeling self-doubt and taking action anyway? That’s bravery.
We are not pretending to be surgeons. We are surgeons. Fully trained, educated, and board-certified.
The term “imposter syndrome” is misleading because those who experience it are not frauds. In fact, they are the very opposite: capable professionals who struggle to internalize their own success.
Why the Mind Keeps You Stuck
The fascinating part is the cognitive dissonance between what we feel and what’s true.
Externally, we’re accomplished; internally, we feel undeserving.
It’s like seeing a police car in your rearview mirror—you know you’re not speeding, but your stomach still drops.
That’s imposter syndrome.
It’s an internal alarm system based on non-truths. Even when every piece of evidence says we’re capable, our nervous system still reacts as if we’re guilty of something.
The brain loves to confirm what it already believes.
If you secretly think you’re not enough, your mind will scan for proof, comparing you to those who seem more talented, successful, and “legitimate” than you.
It won’t look laterally. It only looks upward.
Rationally you know you’re competent, but emotionally you still feel like an outsider.
Bridging that gap between knowing who you are, intellectually, and knowing who you are, in your bone marrow, is the work.
Four Steps to Reframe the Imposter
Since more accolades will never silence the inner critic, we work at the level of thought.
Here’s a simple (but not easy) framework to retrain the mind:
Identify the thought.
It’s usually a version of “I’m not good enough,” “I don’t belong,” or “Someone can do it better than me.”
Write the exact sentence down. Seeing it on paper creates space between you and the thought.Flip it.
Try its opposite: “I am good enough.” “I do belong.” “I can do it better than somebody.”
This tests your brain’s favorite story for accuracy instead of treating it as fact.Find evidence.
Where have you been capable, prepared, or skilled? Be specific. “I was good enough when all my cases went well last week.” “I can do it better than the non-fellowship trained colleague in my practice simply because I have a year of extra training.” “I felt like I belonged when a patient told me how happy they were with their results.”Practice.
The old pathway is well-wired. Expect it to resurface. When it does, thank your brain for protecting you, then redirect to the new thought.
With repetition, your reticular activating system begins searching for confirmation of self-trust instead of self-doubt.
This is brain surgery without a scalpel.
Data Without Drama
Support your new mindset with data.
Review the past six to twelve months of cases.
Calculate your complication rate. Compare it to benchmarks.
From that lens, examine individual cases with clarity, not criticism. Every time you have a complication, look back to your data to show your brain that you are not an outlier or hack.
Seeing the numbers and the patterns teaches your nervous system that you are doing your job, and doing it well.
The Shift to Self-Trust
The fact that you’re reading this, reflecting, and actively working to serve at a higher level is proof of integrity.
Keep going.
The more you practice this work, the more you lead and operate from self-trust rather than self-doubt.
Your team feels it. Your patients benefit from it.
And you get to practice medicine from a steadier, kinder place within yourself.
Reflection Prompt:
What thought about yourself are you ready to retire? And what truer one will you practice instead?
If you’re ready to step out of imposter syndrome and into grounded confidence, join us inside Empowered Surgeons Group—a community of surgeons reclaiming courage, clarity, and purpose. [Join here.]
