I pulled up to the big hospital near downtown in the dark of the early morning. Six police cars surrounded the yellow-taped entrance to the ER. After parking, I filed through the main entrance. This involved a bag check, metal detector, scrutinizing front desk staff and a photograph of my driver’s license. Next, I navigated the maze of identical-looking hallways to Medical Staffing, and then to the OR.

This was my introduction to the busiest hospital in the state.

After studying the surgery roster the night before, I was already intimidated. 500 cases per day, wide-ranging in acuity, for a population of patients that are more complex than average. It gave me flashbacks to my years at the university hospital where I’d trained and then worked for my first decade of practice as an anesthesiologist. Don’t get me wrong, I had a great experience there overall. But it had been a while since working in such a bustling environment.

For the past few years, I’ve had it pretty good. In my transition to more freedom, location independence, and more nonclinical endeavors like speaking and coaching and raising a family, the clinical locum tenens assignments I’ve accepted have mostly been laid back. Lots of elective cases on healthier people. Lots of cosmetics. It’s been a fun and relatively easy way to keep up clinical skills while interacting with both patients and other clinicians.

Recently, I got an opportunity to work for a group where I can do regular PRN/as-needed work on my own desired schedule, in a closer location. But it involves spending some time at the major big city hospital. Brand new computer system, busier/longer days, bigger cases, and sicker patients. And so went a text conversation between me and my husband the night before my first day:

Me: “I looked at tomorrow’s surgery list, and it scared me. It’s crani’s and sick people stuff. What was I thinking saying yes to this?”

Him: “You will be ok… I think you will enjoy the challenge.”

In the lead up to this new job, I had developed a major case of impostor syndrome.

What is Impostor Syndrome?

In medicine, the physician wellness space used to be dominated by discussion of burnout. Now, there’s a lot of talk about impostor syndrome. There is even a reat podcast physicians all about the topic. It’s a phenomenon that occurs when people feel inadequate or doubtful of their skills, to the point where they develop a persistent fear of being exposed as a fraud. With ever-changing technology and the fast-paced environment, you can imagine how this would play out in medicine, but it’s quite common in non-medical fields as well.

Movie stars and famous performers have described feeling like impostors. I recently heard an episode of ReThinking with organizational psychologist Adam Grant, where he interviewed actress Reese Witherspoon. She admitted that she almost quit her role as June Carter Cash due to her impostor syndrome. This is the role that ended up winning her an Oscar!

The truth is, when you’re doing challenging things, making intentional changes and living life fully, you’re going to have self-doubt. These are very real and very normal feelings. Every coaching client I’ve helped successfully navigate a major change in their work roles for better balance ends up experiencing it.

“Movie stars and famous performers have described feeling like impostors.”

On this go-around, I used some self-coaching techniques that really helped me. Maybe they’ll help you the next time you feel like an impostor:

Talking to myself

Yes, I talk to myself, and yes, it is helpful. You can do it in your head; you don’t have to walk around talking full-volume like a crazy person. Basically, I kept reminding myself that my feelings are common and normal during work transitions. I recalled helping all my past clients, how I know they had a breakthrough when they started talking “Impostor”!

I like mantras. I like to quietly say to myself things like, “You’ve got this. You can do it. You’re beyond caring what other people think of you.” Say whatever resonates with you, in clear, concise language.

Practicing mindfulness

I’ve been knee-deep in the mindfulness practice, given that I’m almost finished with a wonderful 200-hour yoga teacher training course. I have to admit, practicing almost every day has really helped with other things – like these impostor feelings. Do you need accessible ideas for how to get more mindfulness?

Besides doing some yoga asanas, my go-to favorite mindfulness techniques are simple breathing exercises such as 4-7-8 or box breath patterns, and spending a minute or two focusing on one of my senses (like touch, vision, or hearing).

Reminding myself of my strengths

A friend on Instagram happened to post a call to action for others to share three words that describe her. I took her idea and did the same; it felt great to see common themes in the way people would describe me. Reviewing my core values, it made me feel even better to know that I’m living in alignment with what I say I want.

Another great thing to do is to keep a list of skills and accomplishments that you can refer to when the impostor thoughts start to creep in. It may seem like bragging, but it’s just for you.

Visualizing doing the thing

Visualization is a common technique used by athletes and proceduralists of all types. In this situation, I visualized myself navigating the maze of the hospital with ease, doing procedures that I haven’t done in a while. When it came to my first day, it actually happened! Well, maybe not perfect navigation of the hallways, but there were always friendly faces to guide me in the right direction. In terms of the procedures, I had to do two I haven’t done for probably a couple years, and they went very smoothly.

Remembering my WHY

If clinical work for me is optional at this point in my life, then why do I still do it? I kept reminding myself that I still enjoy the personal interactions and the challenge of the dynamic environment. I know that when I’m focusing on the other aspects of my life (the nonclinical work, the creative work, the physical work, and my important family time), I’ll enjoy them and feel grateful for them so much more.

Even if your work at hand is not optional, why do you do what you do? Use this as a guiding light when you navigate self-doubt.

My first day was a confusing cluster of cases, supervising nurse anesthetists – their presence to carry out the cases both helpful and slightly chaotic at the same time. By halfway through the day, I was figuring out where everything was and completing my patient assessments/paperwork without too much trouble.

I never could find the cath lab without asking, but everyone was very gracious. People kept checking on me and asking me how it was going. I felt included. I left tired but feeling like I could do it again.

True confidence comes from self-awareness and being in line with your purpose. Try the things I listed above, and see if you get a boost of confidence next time you’re facing a big transition!