Maybe you are actually something special.

Posted on by James Munro

I cried in the middle of a class. Again. That’s happened more than I would’ve expected in my life. This time, it was a Friday morning, before a really important exam.

In medical school, we have these yearly exams to make sure that we kind of know what we’re doing when it comes to patient care. They’re called the OSCEs, pronounced Oss Skeez, (Objective Structured Clinical Examination). We go from room to room with “standardized patients” (actors) who pretend they have some disease and we have to diagnose them by asking the important doctorly questions or performing the right physical exams or we have to deliver a difficult diagnosis, depending on which room we’re in. This happens while 1 or 2 real doctors stare at us with judging eyes and clipboards where they make notes of all the things we messed up and all the reasons why we shouldn’t graduate and don’t deserve to be doctors.

It’s terrifying and really really important. I’m in my last year of school and this exam represents the last significant hurdle I have to clear before I graduate. If I get past this one, all I have to do to graduate is not fail any of my classes or clinic rotations and that’s pretty easy, all things considered.

In the weeks leading up to my OSCE, my schedule was relentless. I was growing more nervous by the day and I had no time to deal with it. I sincerely convinced myself that I wasn’t smart enough to pass the exam, that I’m not worthy of graduating or becoming a doctor. It was a hard week. I became unbelievably fragile. Every small mistake I made was irrefutable proof of my inadequacy. I was so hard on myself.

The exam itself really is stressful but I think I was more caught up by the fact that I’ve been doing this for so long and I’m finally at the point where I can actually succeed. Becoming a doctor is no longer this theoretical thing that might happen down the road if I keep on plugging away. It’s suddenly coming down to a few tangible loose ends – then it’s over and I’ll have done it.

But of course, I don’t feel worthy. I’m not ready. I don’t know enough. I make too many mistakes. I have no idea what I’m doing. They can’t possibly let me be a doctor. I can’t graduate! As my Friday exam approached, I was extremely insecure and filled to the brim with self-doubt.

The night before my exam, I had a first-year student with me for my evening clinic shift. She followed me around and observed my patient interactions. After a patient visit, she told me how great it was to see the way I took the patient history and how impressed she was by the way I guided the discussion so I could obtain all of the pertinent information and come up with a reasonable diagnosis and treatment plan. She thought my physical exam skills were smooth and efficient. She said she learned a lot from observing me.

I quietly thanked her and told her I enjoyed working with her. I was struck by a memory of the first time I observed an upperclassman, the same way she had just observed me. I was just as impressed by the student I watched. But now I was that upperclassman and I immediately started having a really intense identity crisis. I felt confused. I didn’t know who I’d become. I didn’t know what I was.

As I was riding my bike home I had a definitive, defiant thought; No. She’s wrong. She was only impressed because she’d never been in the clinic before. She shouldn’t be impressed. My physical exam skills are not smooth or efficient. She just doesn’t know any better. I convinced myself that I’m a fraud and I was about to be exposed during my OSCE. That thought stung. It hurt. I started crying.

Somehow I made it home alive and fell asleep. (Don’t cry and bike, please. Very dangerous). When I woke up, I didn’t feel any better. I went to my morning oncology class even though I knew I wouldn’t be able to pay any attention.

Class started and the professor asked everyone to stand up. I stood.

He said, “Ok, now please sit down if you don’t exercise at least 5 days a week for more than 20 minutes a day.” I remained standing. I’m an athlete and I mostly train for hours a day. Even on my rest days, I run or ride my bike more than 20 minutes.

Then he said, “Ok, now please sit down if you have more than 3 alcoholic drinks a week.” I remained standing. Beer makes me feel like garbage and I rarely have more than 1 drink a week.

Then he said, “Ok, please sit if you eat less than 5-9 servings of fruits and vegetables a day.” I remained standing. Well, that’s pretty much all I eat and it takes more than 9 servings to get me through the day.

I was in the front row and facing the professor so it wasn’t until this point that I realized almost all of my classmates were seated. It filled me with anxiety. Please, let me sit down on the next one.

Then he said, “Ok, please sit if you eat less than 38 grams of fiber per day.” I remained standing. A few years ago, I set a personal goal of eating 45 grams of fiber per day and I put a massive amount of effort into figuring out how to make that happen. It took time and practice but these days, on a rare low-fiber day, I’ll still eat 40 grams.

I quickly glanced behind me and didn’t see anyone standing. I think there may have been a few of us left but I didn’t look hard enough to notice. Something interesting happened to me right then. I felt like a fraud. Like I should be sitting. Like I don’t actually do all of these things. I assumed everyone was looking at me standing and seeing through my blatant lies.

Of course, this is ridiculous because not only do I consciously do all of these things, I’ve actually practiced and put effort into creating these habits. But I somehow still felt like an imposter.

The professor gave a few more scenarios, sit down if you smoke, if you have an above-optimal body mass index, etc, and I remained standing. By the time the exercise ended (which felt like 3 hours) and I sat down, I was closer than I’ve ever been to having a panic attack. My heart was pounding. I was sweating. I was embarrassed. I was ashamed. But it didn’t make any sense.

The professor began lecturing on cancer risk factors and genetic predisposition and I didn’t pay any attention whatsoever. I was busy trying to understand what was happening to me. He turned the lights down and put on a TedTalk by some incredible doctor doing incredible things (I assume. I don’t actually know, I wasn’t listening).

I was trying to reasonably comprehend why I was feeling like a fraud when I got violently slapped by the answer. I felt like a fraud because I have some unrelated and unfounded insecurities. I was wrong to feel like a fraud. I exercise and eat vegetables and count my fiber intake. This is all completely true. I’m totally not a fraud.

It took another minute before I was struck by the implication of my realization; Maybe I’m also wrong about my skills as an aspiring doctor. Maybe I am worthy. Maybe I can graduate. Maybe all of the things I’ve dedicated my life to are actually coming to fruition. Maybe I am actually something special.

I started crying. Again. But this one was different. These tears came from a feeling I didn’t know how to process. An overwhelming emotion I absolutely was not ready for. Pride.

Luckily, the TedTalk wasn’t a short one. I mostly pulled it together by the time the lights came back on. The class eventually ended. I learned nothing about oncology that day.

Before I left to go to my exam, a classmate asked if I felt ready for it. I said, “No, I’m terrified.” She looked surprised, “Really?” She smiled. “I would totally vote you least likely to fail.” I laughed and thanked her.

I took my OSCE later that day. I really don’t know if I did well enough to pass. We’ll get our results in a week or so but I’m not very concerned with that. I gave it everything I had. I tried as hard as I could. If I fail, it doesn’t mean that I’m a fraud or an imposter or that I don’t deserve to graduate. It just means I have to try again. And while I still have my doubts, at least I know I’m really good at trying.

329 thoughts on “Maybe you are actually something special.”

  1. I know exactly how you feel. I’ve been there thinking that I’m just not good enough and anyone complimenting me is lying. That’s so cool that you take such good care of yourself! I need to be more physically active 😝 Best of luck with the exams! I’m sure you’ll do fine!

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  2. Ah! This was totally me almost 4 years ago and by the time I realized I had nothing to freak out about, my nerves really let me down for the first of my 3 final OSCEs that week. It surely didn’t mean that I was a fraud, imposter or not meant to graduate and the same goes for you! You’ve worked hard and done well over the years!

    Writing this comment has also brought me to the realization that I’ve been following your blog for probably almost that long. So much has happened and you’ve grown so much in the past 4 years. It’ll seem daunting but I bet it definitely only gets better! 🙂

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      1. Hi, my name is Patty Fletcher, and while I’m not a doctor, med student, etc I am absolutely thrilled to have read this post. It so motivates me. I’m a writer, motivational speaker, and nonprofit consultant. I am totally blind, and work hard every day to improve my life. I also suffer from Bipolar Disorder, Fibro and Short Term Memory loss. I have one book out and for a while I felt so much like what you wrote here, and then one day I had a similar experience, and WOW! I have really begun to find myself. Thanks so much for writing and I’m so proud to have read this.

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  3. Like all that I’ve read by you, this made me feel so much less alone.
    The reason I dropped out of school and the reason I may never go back is because that anxiety attack you said you almost had? Well, I get them all of the time. Imagine feeling like you’re going to die from fear at least a couple of times a month? It was enough to slow me down and take me off the steep climb to Doctorhood.
    What points to your strength, dear friend, is how you persevere despite these fears and obstacles. It is easy for people who have no self doubt or anxiety to do these things, and it is therefore less remarkable when they achieve them. That being said, I don’t think there is anyone pursuing an ND that doesn’t feel like they are going to die at times.

    Keep it up, you are so close, and truly, you have already made it.

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  4. Hey, I found you through the Community Pool. I love this piece! You have absolutely nothing to worry about in terms of relatability. There’s lots of detail and this is a state of mind most people go through at some point, I think.
    This also terrifies me because I’m gearing up for medical school, hopefully.
    Good luck with everything. 🙂

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  6. This is fantastically written!! I loved it… It was funny and emotional… I’m not a medical student, but I can totally relate to the feelings you described.. I am very self critical too. Very well penned.
    It’s not “May be you are something special”. It’s “You are something special”.

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  7. Very well written. I love how straightforward you are in writing and how you managed to engage me to continue reading to the next paragraph, and to the next, and to the next. And don’t you dare feel like a fraud now, I’m sincere with my compliments. 😊 As with the upcoming results, just relax for now buddy. Let us know what happened (if you feel like sharing it) but no pressure!

    Oh, did I mention I was in awe of your healthy lifestyle habits? I personally think that’s a good characteristic of someone on the path of becoming a doctor! I wish I have that enough discipline to monitor my lifestyle habits. Maybe you should write about it, you know, how you manage to keep up with it… It’s sort of inspiring, really.

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  9. This is amazing! Although I’m not in school having to take classes and tests I still understand the feeling of inadequacy and not being authentic. Your writing style is so easy to read and stay engaged in as well!

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  11. Great post, oftentimes the last few steps feel harder than the first ones. You made it to the final year on your own merits and have everything you need to finish.

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    2. We all do and yet it’s the fact that we forget. We allow others and circumstances to influence us. We all have what it takes to be awesome and I believe that with all my heart.

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  13. Hey James, I can relate to this. I went to graduate school for marine science. My research didn’t really turn out the way I expected, so I blamed myself. However, I kept looking in literature and other data sources and started to build a story that fit my data and what I had researched. Even right before my public thesis defense I was prepared to laughed out of the department. He didn’t happen and I got my degree. I still have those doubts, however. It never really goes away for me. That is one of the reasons I enjoy science so much, there are ways to check my work. When I feel like an impostor, the data says I’m right where I’m supposed to be. Good luck in the home stretch.

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  14. Seriously you sound like one of those annoying people who have their suit together. I tell myself at least once a week that i shouldnt be allowed near patients or any medical equipment of any sort. Anything that requires actually putting all this medical theory in real life is absolutely terrifying. I’m much more comfortable learning theory (and even with that I feel like I don’t know enough to be a decent doctor) so I completely understand the osce fear. From the sounds of it, especially your dedication to health and your conscientiousness, you will be a great doctor. This post has given me more comfort and motivation.

    https://onlyindreamssite.wordpress.com

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  15. Well written, it’s a testimony. We are all worried we will be found wanting. The more educated, the more worried. You are just fine. Maybe try yoga, meditation, deep breathing. I always hated it when people came into my classroom with clipboards. It sucks. So I breathe.

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  18. So true… Can totally relate to it.!! We always seem to put ourselves down from our own insecurities instead of upholding ourselves.. The day we fight our own insecurities nothing can beat us…
    Well… Very Nice blog..😊😊😊😊 And All the Best for your Exams..☺😊

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  19. You will be just fine, James. I think everyone have felt the way you did at some point and even still do.
    Just do what you gotta do to the best of your abilities.
    I honestly can’t wait to know how great your results will be…

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  20. You have to work hardest for the things you love
    It’s like being in the fight of your life.
    The most important thing is that you didn’t give up.
    You made the decision that if by chance you didn’t pass the test to give it all you got the next time around. In my book you’ve already pass the test.

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  24. Before reading this , I had never heard about impostor syndrome, I even searched in wikipedia and found out that known personalities in arts, writing ,science have it as well.Thank you so much for sharing, it is such a valuable information and I am very impressed of your sincerity. Congratulations on your achievements!
    It explains a lot of insecurities we experience every day😊.

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  27. There are a lot of obese/unhealthy doctors out there who nevertheless try to lecture their patients about keeping well or simply load them with drugs. They should have remained sitting down and never allowed to stand up again.

    If your doctoring is as good as your writing then you have nothing to fear.

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  28. Well done for a well put-together piece. I think would hit-home to many medical students, and as a senior nurse in a teaching hospital I can only assume you are managing to put very eloquently what many of the medical students are thinking/doing/saying. Good luck in your career.

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  30. Sounds like a common issue to me. You are not alone. I’m glad you had an aha moment and know you’re headed in the right direction. I have a feeling you did well on your test. Thanks for sharing. It let’s us know we’re not alone.

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  31. These exams sound terrifying. I’m in a doctoral program for neuroscience, and we take classes here and there alongside our research. The big exam comes 2 years in–you present what you propose to do for your entire PhD, and then you are questioned on every single detail that could happen by a committee of professors. After a few hours of intense questioning they ask you to leave, and they talk about you and decide if you are capable of doing a PhD, or if you fail. I passed mine last August, and I think I’ve only grown more nervous about my capabilities. Maybe as I get closer to the end I’ll have that ah-ha moment.

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  33. I read your blog for the first time today, it was recommended to me by Discover. I’m doing my PhD and am in the final stages. Just today I had a meeting with my advisor and I had to show him what I had written as the purpose of my dissertation. He said that what I had written was part of it, but that my study was much bigger and much more important than what I’d stated as its purpose. I realized I hadn’t dared to write that, because I didn’t believe it myself. But here I am, a PhD candidate writing her dissertation. Thank you so much for reminding me to believe in myself, that I know about what I do, and that if I fail, I must keep trying. Your entry meant a lot.

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    1. What a great comment. Thank you so much. That’s so great to hear about the feedback from your advisor. Keep going! It sounds like you’re on the verge of achieving some pretty fantastic things, even if you don’t believe it the entire time.

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  34. Well done and congratulations! I first heard about the Imposter Syndrome working in the ER (nursing) many years ago. I remember taking one of our courses, TNCC, and having to go through just one pretend scenario, nothing like you I’m sure, and that was enough! God bless you in your amazing career!

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  35. I chanced upon your post on Discover – it is a heart-felt piece, beautifully written, giving voice to the cry of many people I know. Thank you for your courage in facing your fears and sharing them in us community!

    Sending you hugs and positive energy!

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  37. I can relate to much of what you have written here. I am a budding counselor. I am in internship, in a master’s level program, and I am now a registered psychotherapist in the glories state of Colorado. However, I have yet to be comfortable calling myself one. I too still have so much to learn and am often plagued by self-doubt, even though I truly believe I have the ability to help people and have something to offer each person who walks through my door. I think with practice, time, consultation, supervision and experience in the field, our inner critics will calm down some. 🙂 Breathing and meditation certainly doesn’t hurt!

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    1. Thanks so much for your comment. I think (hope) you’re right; we just need more experience! Good luck with your career, the world is certainly in need of compassionate psychotherapists.

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  38. Insecurity or profound humility? Based on your blog post I’d argue the latter 🙂 Regardless, I can relate. I thought your post was wonderful and insightful. Best of luck to you- I bet you’ll be a great doctor!

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  39. I totally get this. I’m the same way. Pride is a sure way to unhappiness. Give yourself credit, you’ve consciously message decisions to better yourself and end up where you are. It’s so funny how easily others can see our potential, but as hard as we work for it, we don’t see it. I’m glad you came to the realization that you are worth it. I’m sure you passed your exam:)

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  40. Wow this was so real as I have felt crazy and the same exact thing happens to me often. Thanks for posting this and reminding me that I am not alone that I am okay….better than okay!

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  43. I have found the more I learn the less I feel I actually know. For me my self doubt can actually improve performance as I double check and research everything before treating my patients. I am in shock that I have degrees and sometimes feel I don’t deserve them. Then I remind myself I worked hard for these and my patients come first. The more I learn the more they will benefit.

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  45. Every medical student feels the same way. People think that we are pretty smart but beneath lies insecurities,personal failures,tears,worries – you name it.But I believe we are all going to make it because what’s important is the strength that lies within us besides all the other things that I have mentioned. I wish you the best for your results and for your future.Always remember we belong to the breed that’s tougher than many.

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  47. Sounds to me like you are super thoughtful, want to provide the absolute best of care for your future patients and have self doubts like most of us but don’t loose that!!! It just means you will always give it your all and I’m sure in the future your patients are gonna love that about you! I have to tell you that I was maybe the most impressed with my doctor when I had an odd issue and he just looked at me and told me he really was clueless, but he was going to research my issue and talk to some of his friends and let’s try this and see what happens in the interim – I was shocked and impressed both – oh, and yes he figured it out and fixed me 🙂 . Glad I found your blog and am following!

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    1. Thank you so much for your comment! I totally agree, there’s nothing worse than someone unwilling to accept that they don’t know everything. It sounds like you have yourself a really great doctor. I hope I can be as effective as him someday.

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  48. Great post James. A couple of years ago I acted in OCSE’s at a University in New Zealand – I was always so impressed by the trainee’s and did everything I could to put them at ease – though sometimes difficult when you are supposed to be a really difficult patient! Those ones were always testing. I hope that you get the results you’d like and thanks for this post 🙂

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