Welcome to the final newsletter in my series on imposter syndrome. I hope that this series has shone a light on some of the lesser-known aspects of this prominent problem, as well as providing ideas on how to deal with both the external and internal aspects of imposterism that may affect PA students.

I’d like to finish the series by making three important distinctions that we should make in considering the syndrome.

When we wish to help someone who has imposter syndrome (or give ourselves a little guidance when the feeling sneaks up on us), we should remember the following: 

Imposter syndrome is common, but not dismissible. 

We can acknowledge that imposter syndrome is a common feeling. Many people will experience it at some point, and many of us recover from it ourselves without any outside help, or at least manage to function well despite any occasional doubts that we truly belong. 

However, this does not mean imposter syndrome should be discounted as “no big deal.” Persistent feelings of not belonging, or of being a fraud, can lead to depression, anxiety, and lowered performance. 

Imposter syndrome is a cognitive distortion, but it can be externally exacerbated by the environment.

This is especially true for underrepresented people. Any of us can get imposter syndrome if we unfairly compare ourselves to others, forgetting how hard we worked and how much we deserve to be where we are. 

However, marginalized populations are particularly vulnerable to imposter syndrome because often their environments, unintentionally or otherwise, make them feel their “otherness.”  

Being one of the few representatives, or the only representative of a population, is itself enough to bring on imposter syndrome. A school that wishes to increase diversity and inclusion is heading in the right direction, but it is not always easy to see the hundred little ways in which we can still catch up. Bias and privilege can sneak into admissions, counseling, teaching, advising, advertising, publications and media. 

When someone feels like an imposter, it is helpful to identify when this feeling is strongest, and if it seems to be in response to a certain aspect of their environment. Does imposter syndrome strike during certain classes? When dealing with certain faculty? When trying to access resources?  When involved in group discussions or activities? 

The catch, unfortunately, is that getting people to talk about imposter syndrome is difficult. I feel there is value in having faculty and advisors willing to share their own experiences with imposter syndrome, if only to establish that sufferers are not alone in their feelings. This leads us to our next point. 

Talking about imposter syndrome can help alleviate it, but it depends on who you talk to. 

It may seem that talking to other students about imposter syndrome is one way to help – after all, many others may be going through the same problem. 

However, this can also backfire. When students speak to each other, they compare experiences, which can actually increase feelings of “otherness,” which then increases imposter feelings, especially when dealing with underrepresented populations. Talking about imposter syndrome with someone outside the sphere is a better idea, and the confidante should never be someone who has any evaluative power (grades or otherwise) over the student. If faculty relay their own experiences with imposter syndrome to students (which I do encourage), it is only to let students know that they are not alone in their feelings; students need not reciprocate in kind unless they feel comfortable doing so.

Conclusion

I have spent my career dealing with PA education, looking for ways to improve, energize, predict and debias the system from the admissions process to the finale of taking the PANCE. Much of my work has focused on the PA program’s responsibility in making student experiences better, including taking an active role in ensuring that they have the skills they need, and offering every opportunity for success. The result is not only happier students, but lower rates of attrition and higher PANCE scores. These are vital factors in the ongoing accreditation and profitability of a PA program.

When imposter syndrome enters our students’ experience, it can run the gamut of possible fallout – from a few weeks of feeling “out of place,” to genuine depression and lowered performance, to a symptom of the much larger problem of bias inherent in a system. By understanding the causes and addressing this issue openly, we can make progress. And as I stated in the last newsletter, progress is the goal.

I hope you’ll continue to join me for our weekly newsletters. See you next time.