Transition To Residency · Year 4 · from Transition To Residency
Case 1: Imposter Syndrome in a New Intern
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Source: Wikipedia - Impostor syndrome - CC BY-SA 4.0
Case Presentation
A 27-year-old female internal medicine intern, two weeks into residency, presents to a faculty mentor's office expressing significant distress. She reports persistent feelings of inadequacy despite graduating near the top of her medical school class. She describes constant worry that her supervisors will "find out" that she doesn't know enough, avoids asking questions during rounds for fear of appearing incompetent, and spends excessive hours reviewing basic concepts that peers seem to know effortlessly. She has difficulty sleeping, often replaying perceived mistakes from the day. Physical examination reveals mild tachycardia and she appears anxious but engaged. PHQ-9 screening is negative for clinical depression. She is counseled that imposter syndrome affects the vast majority of new physicians and represents a normal response to the profound transition from medical student to responsible clinician. Management includes normalization of her experience, encouragement to ask questions openly, connection with peer support from other interns, and scheduled follow-up in two weeks to reassess adjustment.
Key Learning Points
- Imposter syndrome is nearly universal among new residents and manifests as persistent feelings of inadequacy despite objective competence
- The transition from medical student (observer, follower, permission-seeker) to physician (responsible clinician, order writer, decision-maker) represents one of the most profound shifts in professional identity
- Recognizing imposter syndrome as normal and seeking support from peers and mentors are essential first steps in healthy adaptation to the intern role