Maybe you are actually something special.

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. Thanks so much for taking a moment to be vulnerable! This was an especially great read today.

    I was a standardized patient in undergrad to make a few extra dollars on the side, and I remember thinking, “This is going to be SO.MUCH.FUN.” But then I got assigned “psychosis and schizophrenia”.
    So, that was an adventure.

    Good luck to you, and congrats on being really close to the light at the end of this tunnel!

    Liked by 3 people

      1. It was awful! But everything in life is a learning experience, and I learned that it must be tough for docs of mental patients to come across as helpful without sounding patronizing. I really wouldn’t want that job! So much room for improvement for mental healthcare!

        Liked by 1 person

  2. My husband and I were just talking about this last night (we both survived med school). It’s the Dunning-Kruger effect. Google it. Of course, it came up because we were discussing that insane/incompetent/murderous neurosurgeon who just went to jail for killing and maiming people. I mean, was he a truly terrible surgeon who just thought he was amazing, or pure evil? But the other side of the D-K effect is a cognitive dissonance suffered by truly high performing people who assume things are also easy for other people, fail to acknowledge their own awesomeness, and often feel like total frauds. You are probably grossly underestimating your own skills, and it’s not really your fault. It’s a brain thing (to be, you know, super science-y) that plagues all of us.

    The fun/great/captivating thing about this essay of yours, James, is its metacognitive honesty. Even if you totally suck (which is quite doubtful), you won’t be the kind of sucky doctor who thinks he’s amazing (as those are irritating at best, dangerous at worst). Plus your writing pulls me right back into fourth year of med school and those awful exams. I had a test “actor” with breast cancer who needed comforting and, I suppose, tests or something. Her acting was so terrible, I giggled though the whole thing. Somehow I passed. And became a doctor. And got breast cancer. And now write and counsel oodles of women about it. Without giggling.

    Bravo, James. And good luck. xoxo

    Liked by 6 people

    1. Thank you so much for your comment. Well, I am sure to fall into the Dunning-Kruger effect wormhole very shortly. I really appreciate the encouragement, especially coming from someone as accomplished and successful as you. Without giggling. 🙂

      Liked by 1 person

    2. As an Occupational Therapist Britt, we also had exams like OSCEs, but called them OSPEs for some reason. Thanks for giving a name to this Dunning-Kruger effect, it rings a bell from my psychology or psychiatry lectures. James’s post just took me back to 3rd year, a tough year in which I felt like I would never survive as I went through a series of self doubt. It’s the worst feeling ever, and if you are not careful or if you don’t talk about it, depression can be a mile away.

      But hey , I made it!

      Liked by 1 person

  3. Reblogged this on Insight Counselling • Ipswich and commented:
    It’s amazing how many of us suffer from Imposter Syndrome – meaning that every time we achieve something we assume that the authorities missed something, or gave us a free pass. It seems almost impossible that maybe we are genuinely capable human beings. Somewhere along the line we learned or decided that we were stupid, unworthy, ‘less than’ everybody else. But this blog post has a moment of pure epiphany – a sudden realisation that a long and deeply held belief about oneself can be completely wrong. And it changes everything.

    Liked by 5 people

  4. Well the results should be out now? Congratulations?

    I feel most of the time the same: I am a nervous wreck at times during my internship as I have to demonstrate that I can do things but I am always afraid that I am going to be exposed as an imposter. I don’t know how that is going to end


  5. This is awesome! So encouraging for all of us, and a reminder that it is often only our insecurities that whisper these lies to us and make us think we are unworthy. So glad you found the pride to hold your head high that day. What a gift!


  6. This is a great blog!!! I feel like you speak my low self esteem and lack of self confidence issues louder than I’ve ever voiced, and commend your efforts on saying all this out loud. You have a world of support around you and beside you – you’ve got this!!!


    1. Thank you, Monique! I definitely feel that support and appreciate it very much. I’m glad you were able to get something out of my blog. Be confident and let the world see how amazing you are!

      Liked by 1 person

  7. Thank you for taking the time to write this! You won’t believe how many anxiety filled, spazzing out students you are helping. I recently had an episode somewhat like yours and felt like I had no choice but to admit that I was a failure and I would never pass college because I just wasn’t smart enough. (Accounting major problems…) But soon enough I realized that this is what I wanted from the beginning and nothing was going to stop me from getting it. Especially not the fear of failure.

    Have a lovely one.


  8. Hi, my name is Kimberly Balles. I am a Social Worker with a Masters in Social Work. My internship experiences were not good ones for me and my last Field Supervisor was impatient with me and actually told me I would not make a good Social Worker nor could she recommend me for employment. Thus has made it very hard to want to look for a job.

    Your article was point on for me. I have been told by many people in my life that I would make a good Social Worker. I know I have the natural abilities, like listening and showing compassion, and providing sound feedback. It’s the diagnosing that I lack and the ability to apply different t to a client.

    What I can do, however, is learn or relearn the knowledge that is lacking and practice putting that knowledge into practice by grabbing from scenarios that I can read online.
    What I don’t have to do is believe that I am a fraud. I don’t have to continue to harbor my anger towards her and myself. I do have control over this. Will I at times doubt? I think that is part of being human. I can remind myself that I do have the skills and I am learning and can relearn.
    Thank you so much for writing this and posting it on your blog, especially sonething that is vulnerable. I am rooting for you.
    Oh and I am good writer!!


    1. Thank you for your comment, Kimberly. It sounds like you definitely have what it takes to be a fantastic social worker. Keep working on those areas that are difficult for you and there will be no stopping you! Good luck!


  9. I think the best of us go through things like this! I am new on here and wanted to call and delete my account because I have doubts if I am good enough to even be heard


    1. I had those very same doubts when I started my blog. (still have similar doubts, actually) But I’ve come to the realization that being heard is simply a consequence and shouldn’t be the goal. The goal should be to express whatever you need to express. If you can do that, you should consider yourself a success. Anything beyond that is a wonderful bonus. Good luck!


  10. Thank you so much for the inspiration you just gave me! As a second-year medic I often find myself struggling and crying mid-lessons too, thinking how worthless and stupid I am and wondering why the hell am I studying something so out of my league, but you, kind sir, just made me look at the whole situation differently. Thank you and good luck, doc! 🙂


    1. Thank you for your comment, Aerinne. It makes me so happy to hear that my words helped to change your perspective. Just keep pushing forward and try to find those moments of clarity when you can. Good luck with everything!

      Liked by 1 person

  11. Believe it or not, this is something many people struggle with (myself included). After working so hard and constantly looking ahead and thinking about what you can do better, it can be easy to forget what you have done right. Never forget to take a second and take pride in what you have accomplished. Congratulations on being brave enough to go after your goals. 🙂


  12. This was an amazing article, when I graduated as a nurse, I felt sure that someone was going to come on the ward and cart me away as a fraud. So relayed to your anxieties. Good luck, I am sure you have done well. Love and light DL


  13. James, beautiful man, your post totally touched my heart. Be proud of what you have accomplished so far. Don’t sell yourself short! I admire your honesty and I’m sure many students/doctors to be felt that way at one time. Experience will help your confidence. I have a funny story to tell you. Recently I thought I had the flu, 3 days of the shakes, of 103 degree temp, when I finally told a family member to take me to the hospital. Something was wrong for sure. When the doctor walked in, she was a young, beautiful woman about half my age. She figured out that I actually had a kidney infection that was starting to go septic! (I was in the hospital for 4 days! I was a hot mess!) I never doubted her, and the funny part is after she was done examining me, I turned to my sister and said, “when did the doctors get younger than us?” Our world needs good doctors and I’m sure you’ll be one. You got this dude! Best of luck!

    Liked by 1 person

    1. Thanks so much, Robin! I think you’re right about experience helping my confidence and I hope you’re right about me being a good doctor. 🙂 And, boy, I’m glad to hear she got that kidney infection diagnosis!

      Liked by 1 person

  14. May I say as a RN who has worked with many doctors & been a patient of many doctors over the years, I believe without doubt, that IF you keep your humanity, genuine honesty, and never stop embracing your feelings and not be afraid to face others (patients) feelings (so many scared, lost ones who feel no one listens or cares), you will be an outstanding physician. You can be the smartest & most quick witted one in the class, but if you don’t have a heart & compassion, you’re going to suck as a doctor (trust me on this-I know TOO many like this). Beautifully written, and a wonderful read. I was inspired & excited your you! Thank you for sharing.

    Liked by 2 people

  15. OMG what timing of this post! I think yesterday only I “discovered” Imposter Syndrome and felt like I might have it too and was trying to figure it all out. It is all so overwhelming. Loved your post and candidness and thanks for exposing your vulnerability. Looks like we all go through the same shit, it is just a matter of time. While I am still figuring how to get rid of this imposter syn, I am glad at least I am able to diagnose it 🙂

    Liked by 1 person

    1. Thanks! Yeah, I’m realizing that we definitely do all go through the same shit. Just try to appreciate those moments of clarity when you’re able to objectively see what you’ve actually accomplished. 🙂

      Liked by 1 person

  16. I really know this feeling as I can relate my situation some what during examination days. I hope you’ll pass with a great score. You have described the pressure and stress so well. I was almost back to those days. I really love your writing style.

    Liked by 1 person

  17. Sometimes I have that feeling too, that feeling of being an imposter. I also think that I never good enough and despite quietly enjoy being acclaimed by other friends and acquaintances, I just secretly blame myself for unjust satisfaction that I honestly don’t deserve. This really got me down at that moment

    Liked by 1 person

      1. Thanks, right now if I happen to think about it again, I would carefully examine the initial reason why this negative thought keeps existing and find out whether it is because I didn’t work hard enough or it is because I was just too stress. But thanks for your sharing as now I know I am not alone.

        Liked by 1 person

  18. Such a brilliantly honest piece, and really well shared. Only one problem – I’m kind of dying to know more about what thoughts/insecurities could have been strong enough to make you doubt the reality of your ability!

    It happens to so many high achievers. They become their own biggest critic, and while everyone else is blown away, it seems like they can almost never sit back and be happy with their progress, as if there will never be a point where it would finally all be enough. Ironically, it’s often that incredibly high standard and constant anxiety that drives them to achieve so highly in the first place.

    I’d love to learn more about those insecurities that high achievers often harbour, and hopefully be able to help friends who are like that to come to a healthier mindset about it all.

    Liked by 1 person

    1. Thank you for your comment! It may be hard to describe without writing an entire novel about it but, essentially, it’s my constant attempt to achieve perfection. Of course, perfection doesn’t exist so there are always mistakes and room for improvement. That’s where I get stuck. I get caught up in thinking only about those mistakes and ways to improve that I can completely neglect and ignore the successes I’ve had up to that point.


  19. Oh my god, you don’t know how much I relate to this. I think to myself my grades are better than what they should be, that people trust me more than they should, that I must always improve so that people don’t find out how much I actually don’t know, or how many crazy things I do that are too irresponsible to trust me, etc. I think the key in your story was to have pride in yourself. Instead of focusing on where we’re lacking, we need to stay mindful of everything we’ve achieved so far and be proud of that. Thank you for this so I can keep reminding myself that I am truly as special as everyone likes to think I am.

    Liked by 1 person

    1. Thanks for your comment! Definitely make that attempt to stay mindful of everything you’ve achieved. It’s too easy to get lost in our inadequacies and be too hard on ourselves. Good luck with everything!

      Liked by 1 person

  20. I just accepted a position as an ER nurse, starting in July. While I am so excited and fought so hard to get my nursing degree, I also want to throw up all the time… because I don’t know anything. Thanks for this post. It’s nice to know the doctors feel that way too.

    Liked by 1 person

  21. This was a really interesting read, I felt your insecurity with you as I read about you standing up in front of everyone. Self-doubt is one of the weirdest things. You may be so good at something, however in your own mind you are still a beginner. OR. You may be a beginner and think you are terrible, so you give up or never start… I mean how long does it take for most people to start a blog? James, your post really made me think, I could write a 500 word comment about this topic! Congratulations on passing!

    Liked by 1 person

  22. As a pharmacy student, I can totally relate to this feeling of not being good enough. Feeling as though you’re no where near qualified to be in charge of another human’s life. But I would say it does get better with the right kind of nurturing preceptors during clinical rotations where you do realize that you can in fact be a health professional.

    Liked by 1 person

    1. Thank you for your encouragement. I’m gaining some experience and a tiny bit of confidence and I’m thinking you might be right. 🙂 Good luck finishing up pharmacy school. Thanks for reading and commenting.

      Liked by 1 person

  23. U really hit a nerve 🙂 I’m really insecure about any of my abilities no matter what other people say and it scares me So so much thinking about getting into medical school failing to do that ,failing whilst I’m there messing up people instead of curing them and that’s a scary scary burden to have when you just Wna be living so I really admire you for finding your worth, God knows it’s a difficult but beautiful thing 🌟

    Liked by 1 person

  24. I want to slap you on your face for trying and not appreciating your triumphs even when you fail. I’m not a a religious person but I believe you were chosen to be there; mediocre or not , your presence was a plan…just try and try and try…someone out there has a plan.

    Liked by 1 person

    1. I think everyone has moments of self-doubt. If we’re going to speak destiny etc. then let us talk about those who doubted themselves.

      Peter, John the Baptist, Moses, Joshua, and on and on the list, goes.

      So I believe what Self-Doubt does is strengthen us when we push passed the discomfort and do it anyway which is what you’re doing here, so I have only good things to say back to what you’ve written.


  25. I have an exam in 2 months and I am scared . I so much like to be in my comfort zone and I also hate it here and it just gives me anxiety . I want to disappear because I hate what I am working for .

    Liked by 1 person

  26. Lol I can totally relate! But then I know you’ll do just fine…. Better than fine actually. I wrote my last exams crying all through! I could barely read the questions. My answer scripts git all soggy. osce almost had me commit suicide, but I made it. That’s how I know you will too. Stay strong and smart! I’m glad I found your blog.

    Liked by 1 person

  27. James, wow. I am speechless. The other bloggers have stolen all of the words that I wanted to say. Well, here it is again. This blog has volume to it. I love it! I love your honesty. And James keep on moving! Never stop! And congrats! 😊🙈😍☺️

    Liked by 2 people

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