Sole Purpose 66
Intern on the Outside, Spiral on the Inside: Residency and the Imposter Within

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I was recently at a conference where a kind attending made a passing comment. They joked that they hoped everything I have been doing in podiatry hasn’t been giving me a big head—and reminded me that I’m still an intern with a LOT to learn. I laughed and replied (mostly joking) that nobody is more convinced of how much I don’t know than I am. Truly, if there were awards for self-doubt, I’d probably question whether I deserved one.

It’s no secret that I struggle with imposter syndrome. In fact, at the very start of Sole Purpose, I wrote an article about my experience with imposter syndrome and the beginning of medical school, Sole Purpose 11 - Imposter Syndrome and Starting Medical School.

Today, I want to talk about imposter syndrome in residency—which, let me tell you, is a whole different beast. If med school was imposter syndrome on training wheels, residency is like trying to ride a unicycle uphill, while juggling scalpels, and wondering if you're the only one who didn't get the manual and needs a nap.

“What Is Imposter Syndrome?

I went more into this in my previous article but, for review, Imposter Syndrome is a psychological phenomenon where high-achieving individuals constantly doubt their abilities and live in fear of being exposed as frauds—despite clear evidence of their success.^1,2 In other words, you’re convinced that your accomplishments are flukes, luck, or the result of some elaborate clerical error. You’re just waiting for someone to say, “Ah, yes, we meant to give that acceptance letter to someone else.”

Some Examples

“The First Month of Residency

My entire first month of residency was basically one long wrestling match with imposter syndrome. I didn’t feel any different than I did as a fourth-year podiatry student on externships—but now I had actual responsibilities. And it felt like I was constantly failing to rise to the occasion. I got lost in the hospital more times than I care to admit, struggled to adapt to the new EMR system, and had recurring nightmares that I had “meat hands” and was destined to be a terrible surgeon who let everyone—including myself—down.

As a student, I felt like someone people could depend on. I had a reputation for being hardworking, enthusiastic, and having a bright future. But as a brand-new resident? I suddenly felt like a hot mess who couldn’t do anything right. The good news? IT GOT BETTER WITH TIME. I wrote a longer piece all about surviving that first month of residency—and how things do eventually start to click, Sole Purpose 32 - The First Month of Residency.

Lecturing

Just when I thought my imposter syndrome was finally starting to chill out a bit, residency threw me a curveball—in the best way. I was invited to give my very first “big girl” lecture at a state podiatric conference in a neighboring state. Ninety minutes. On opioid prescribing—pitfalls and pearls. A very important, very serious topic that’s required learning by the state medical board. To this day, I’m still not entirely sure how I ended up on that speaker list, but I was thrilled—and said yes immediately.

I dove in headfirst. I swear I read every opioid-related article ever published. I reached out to mentors who had lectured on the topic, watched other people’s presentations, and even read up on how to build a good PowerPoint^®. I over prepped to the max.

It was also my first time attending a conference where I didn’t know a single soul. And I was terrified. I sat down for the day’s lectures before mine and I watched some truly incredible speakers present—polished, confident, engaging—and slowly felt fear trickle into my bloodstream like a slow IV drip. I’m just an intern. I know nothing. Everyone here is so much smarter and more experienced than I am. I’ve barely started my career. Who am I to think I can teach them anything???

Cue internal spiral: My talk is going to be a disaster. They’ll think I’m arrogant for even trying. I’ll be laughed off stage. This is it—the moment I’m exposed as a fraud and my career is over. (Dramatic? Sure. But imposter syndrome loves a good overreaction.)

So I grounded myself in some facts—this is my most impactful way to combat imposter syndrome:

Fact #1: They invited me. Knowing full well I’m an unexperienced intern. They saw my CV and still said, “Yes, her.”

Fact #2: I am early in my career—but I worked incredibly hard on this presentation. I read the literature. I prepared. I’m not trying to teach them how to perform surgery—I’m contributing well-researched information on a shared, important topic.

Fact #3: People I respect and admire believe in me. I’d never tell them they were wrong if they believed in someone else—so why would they be wrong about me?

I also keep one of my third-year rotation evals saved on my desktop for emergencies—specifically, those “maybe I should quit” moments. It’s my go-to form of digital emotional support, and I highly recommend the practice. I even have the residency letter of recommendation that same attending wrote for me, which reminds me that not only do people believe in me—they’ve said some genuinely kind things, in writing, no less. Sure, imposter syndrome might not care that I read 42 articles to prep for that lecture… but my med school mentor knows I did AND I trust their opinion.

So—I gave the lecture. And it was scary. But I found my rhythm and taught a room full of a LOT of people about the pearls and pitfalls of opioids. I even kicked off the talk with a joke. I introduced myself, said I’m a PGY-1 at Ascension St. Vincent Indianapolis, and added: “If you’re wondering why an intern is lecturing on such an important topic—just know, I’m wondering the same thing.” The room laughed. I exhaled. And from there, things went surprisingly smoothly.

I wasn’t perfect. I talked faster than I practiced, said a few too many “ums,” and totally sped through the history of opioid overdosing in America because—frankly—everyone looked so freaking bored. But I did it. I showed up, I taught, and I learned in the process.

Off Service Rotations

I’ve found that my imposter syndrome hits hardest when I’m off service. Don’t get me wrong—I’ve genuinely enjoyed my off-service rotations. They’ve stretched me, challenged me, and reminded me that yes, this is where real learning happens. And yes, I do want to be a well-rounded physician. But that doesn’t mean it’s not uncomfortable.

Off-service means I’m practicing medicine I don’t usually practice. I’m in unfamiliar territory, surrounded by teams who don’t always know much about podiatry, our training, or where we fit into the healthcare landscape. It’s a vulnerable place to be—especially when I feel like I’m representing my entire specialty just by showing up.

To add to the internal pressure, whenever I talk about how much I love podiatry (and I do—I’m kind of a podiatry hype woman), it generally also comes up that I went to Western University of Health Sciences, where I completed all my preclinical years integrated with the DO students. But once I drop that little flex, I really want to back it up by being amazing. Because nothing says “this specialty rocks” like being competent in a fast-paced clinical setting.

Also—small detail—I’m an overachiever. I want to be the best at everything I do. Not just good. The best. At everything. Always. A chill and manageable personality trait, obviously.

These last three weeks, I’ve been on my emergency room rotation. And whew—what a ride. My first day? Full-on panic. I was so stressed I gave myself chest pain. I was also signing up for way too many patients and running myself into the ground to prove…what? That I know how to order an enema for a constipated patient?

Eventually, I found my groove. Turns out, I love doing laceration repairs, and I’m surprisingly good at retrieving foreign objects from every orifice imaginable. Chicken bones from throats. Toys from noses. Beads from ears. And, of course, mysterious sharps from feet. By week three, I was cruising. I knew the staff, had quick order sets for most of the frequent flyers, and—most importantly—no longer had chest pain. Things were good.

Then I worked with a new attending. He asked me to read an EKG—out loud. In front of him. No Google. No comforting auto-read box in the corner. Just me, some squiggly lines, and a prayer. I gave it my best shot… and completely missed the mark. Missed an inferior infarct, which turned out to be—wait for it—a STEMI.

I. MISSED. A. LITERAL. HEART. ATTACK. In the emergency department.

I was mortified. The team saw me fumble, flounder, and practically melt into a puddle of shame. I instantly became the walking meme of an ortho surgeon who only knows “bone bad” and refers to the heart as “that Ancef pump.”

The attending, thankfully, pointed out that the change was very subtle and that it required clinical correlation anyway (which I hadn’t gotten to yet). But internally? I felt like I had singlehandedly let all of podiatry down. This was it. The jig was up. The imposter had been exposed.

But then… five minutes later, a beautiful head laceration came in and I happily closed it. I didn’t sit there spiraling in shame. (Okay, maybe for like a minute.) But I texted my best friend from pod school, who immediately responded, “God I hate EKGs so much.” We laughed, she told me not to sweat it, and I did go home and study EKGs like my career depended on it (because, well, accountability).

But I also reminded myself: one moment doesn’t define me. One mistake doesn’t cancel out all the good, the growth, or the hard-earned progress. Even in that deeply humbling moment, I kept showing up. And honestly? I’m still a little nervous even putting this story on the Internet. But I am in residency because nobody graduates from school and is ready to be a perfect doctor. We are in residency for a reason and that’s to learn.

You Are Not Alone

Here’s the thing about imposter syndrome that I keep learning repeatedly: it lies. It isolates you. It whispers, “You’re the only one who feels this way,” when in reality, it’s probably the most unoriginal feeling in medicine.

I mean, think about it—I would have to be the most elite of elite con artists to have faked my way through undergrad, gotten accepted to WesternU for podiatric medical school, passed every single exam there, passed all three parts of boards, navigated residency interviews, survived Match Day, and made it through every day of intern year… all just to keep faking it? Please. Even I’m not that talented.

As I’ve shared before, I’m part of the APMA Emerging Leaders Program (if you haven’t read my article on APMA, Sole Purpose 64 - Why I Choose to Be Involved With APMA, go check it out, especially if you're considering applying). Our most recent session was focused entirely on imposter syndrome and let me tell you—it was incredible.

The discussion board absolutely exploded. I’m talking story after story from students, residents, and attendings alike—people at every stage of their careers—openly sharing how they felt exactly like I did. We talked about working twice as hard to prove podiatry’s place in the hospital, feeling like we’re faking it, and worrying that we’re letting everyone down—our profession, our patients, our families, ourselves.

We shared stories of mistakes. Missed diagnoses. OR complications. Post-op issues. Awkward moments. Emotional breakdowns. The whole vulnerable, messy truth. These things happen to everyone.

No one gets through this journey without a few bumps, bruises, and a couple of metaphorical face-plants. (Or in my case, a literal face-plant after passing out from low blood sugar—see my externship article if you need proof – Sole Purpose 3 - Some of My Most Embarrassing Moments of Externships.) The fact that we care enough to even worry about being good enough. that’s actually a sign that we are. We care. We’re learning. We’re trying. That’s exactly what makes us good clinicians.

I used to think confidence would come from perfection. That if I just studied enough, prepared enough, hustled hard enough, I’d eventually hit that magical point where I felt like how I imagine a “real doctor” feels—calm, confident, collected.

But here’s the truth: my imposter syndrome ebbs and flows. Some days, I’m absolutely killing it—I feel like I AM the doctor (plot twist: I always am), walking with purpose and knowing exactly what to do. Other days, I’m face-down on my couch wondering if I’m even qualified to work at McDonald’s. (Do they need podiatry interns?)

Final Thoughts

If you’re reading this and thinking, “Wow, I feel seen,”—good. That’s the whole point. Because you are not alone.

Imposter syndrome doesn’t mean you’re not qualified. It doesn’t mean you’re not smart enough, good enough, or cut out for medicine. It just means you care. You care about being excellent. You care about your patients. You care about representing your profession well. And sometimes, that care turns into self-doubt—but it doesn’t have to define you.

Residency is hard. Learning in public is hard. Being a beginner in a high-stakes environment is really hard. But every time you show up, ask questions, try again, and keep going—you’re doing exactly what you’re supposed to do.

So next time your inner imposter tries to creep in, take a breath. Remind yourself:

We’re all works in progress. But we’re also all doing our best—and that’s more than enough. Keep showing up. Keep learning. Keep being you. I am happy to be in medicine with you!