At this very moment, while writing this, I am beside a stream in Washington fishing for salmon during a “real” weekend. #humblebrag. It wasn’t always like this.
It will be 10 years this fall since I started med-school. But as as all of you know, getting to the beginning started many years before that… and that journey is not easy. This message is for you premeds, grinding away at your courses and MCAT prep; for the medical students feeling overwhelmed with the test schedules; the interns and residents who have yet another sleepless night followed by an unrelenting day: It gets better… But enjoy the journey.
I completed family medicine residency about 3 years ago and life is SO different on this side of the journey. I can’t wait for you all to see it. You know those shows that you watched (prior to medschool) where there was a ridiculously good-looking doctor that finds a rare disease and help change a life? Yup, thats me now! (…well, my mom says I’m good looking). The days are not easy, but they are challenging, exciting, and fulfilling. As a family medicine physician, I get the privilege and honor of working with patients from all walks of life and it’s AWESOME!
This is me about 13 years ago. Night stock boy at Superstore (it’s in Canada and has the best cheese buns). We all have beginnings and this was mine. God had different plans for me than staying there. But the journey from there has seen me become a laborer, computer on- call-help, lab tech, waiter, and volunteer counselor. Looking back, each job and experience shaped me to be the kind of person and doctor I am today. Back then, I never would have thought that I would one day be helping set up a pandemic clinic but here we are today!
Here’s where I’ll end this. These are my closest friends from med school just after we met in Arizona. Without them and some great program directors and mentors, I truly wouldn’t be here. Yes, the road to becoming a doctor is hard. But people like these make it bearable, exciting, and help lighten the stress. Enjoy the journey, you’re almost there!
After training, supervising and mentoring hundreds of medical students, medical residents and practicing physicians, Jennifer Hunt, MD, became aware of the very high prevalence of imposter syndrome among high achieving women. Now, in addition to serving as the Chair of Pathology at the University of Arkansas for Medical Sciences, she is also a keynote speaker (and TEDx speaker), dynamic workshop leader and experienced executive coach who works for current and aspiring women leaders. Dr. Hunt builds programs and individual engagements to help women overcome self-doubt, increase self-confidence and enhance their resiliency. She teaches her participants and clients skills and tools to amplify their personal power and grow faster and higher into leadership. Dr. Hunt believes that imposter syndrome is holding back talented women, and so she developed and leads a popular leadership development program for women to help address impostor syndrome in their professional lives. Her passion-mission is to increase the number of women in leadership roles across all industries through her speaking and coaching.
My Story
I remember sitting in that big auditorium on my first day of medical school. The Dean was welcoming us and said something about the amazing members of our class: a pianist who had played Carnegie Hall; an Olympic gold medal athlete; blah-blah-blah incredible, amazing people and then there was me. I shrunk down into the crack of that fold-up wooden chair, thinking, “I was the last person admitted to this medical school. I am not smart enough to be in this class, I don’t belong here.” (That wasn’t all my inner critic, I really did get off the waiting list the day before school started.)
Mine is not a rags-to-riches success story. By the time I graduated, I could suture, write a note (in paper charts!), draw blood, do CPR (after being remediated through ACLS), and do everything else a medical student should be able to do. My Dean’s letter was bland and my evaluations read like standardized form letters. By my account, I started out as an average newly admitted medical student, and I graduated as an average newly minted medical doctor. Or, was I?
A couple of weeks ago, a fellow medical school colleague and I were chatting and she said
“We always knew you would be a Chair. You were on that path from the beginning.” I was taken aback and a little shocked. Didn’t they all think, like I thought, that I was average? Mediocre? Passable? Or, was that just the story I was telling myself at that age in that stage?
Here is my definition of a story:
Pieces of information, details, and emotions that are selected, arranged, and embellished to infuse meaning into circumstances (Unlocking Your Authentic Self, 2020, page 201). Importantly, a story is not equivalent to the facts. The facts about my medical student experience were a lot different from the story I used to describe it in my memories. The facts were actually much kinder than my story. And, so were my friends…who apparently had a lot more confidence in my future than I did—a lot kinder to me than I was to myself! I’ll bet a lot of you reading this have a story, too. Is your story less kind than the facts? If so, you may be experiencing a little bit (or maybe a lot) of impostor syndrome.
Importantly, a story is not equivalent to the facts...The facts were actually much kinder than my story. And, so were my friends
In one study, almost half of the women and nearly a quarter of men in American medical schools experience impostor syndrome (1). Impostor syndrome shows up as under-appreciation of your own skills and talents—where others think you are pretty awesome, you just can’t see it in yourself. It shows up as a smoldering feeling of self-doubt and worry that someone is going to eventually discover that you just aren’t as good as everyone seems to think. It shows up when you enter a new classroom, start a new rotation, or get up to present and you think, like I occasionally did, “I don’t belong here. I am not good enough to pull this off.”
So why does imposter syndrome matter?
In the abstract, impostor syndrome shouldn’t matter all that much—your self-under-appreciation and mine is mostly hidden, tucked away, and not out in the open. But in real-life it matters a whole lot. Impostor syndrome is associated with physician burnout, low self-esteem, derailed career progression, and decreased satisfaction with life. Take a look at this graph with data from a program I run for women physicians that shows a direct correlation between impostor syndrome and burnout (Figure 1)(2).
Figure 1. This graph shows impostor syndrome rising as burnout rises. These unpublished data come from the women in my impostor syndrome program cohorts.
How do we fix it?
When doctors start to address self-doubt, self-under-appreciation, their relentless inner critic, and beat up self-confidence, they can start to rediscover joy, satisfaction, and meaning in their careers and lives. And if you are a medical student, just starting out on this journey, how would your life change if you never again thought, “I don’t belong here”? Remember, someone (more likely a whole bunch of someone’s) thought you did.
Impostor syndrome is complex and multifaceted. Overcoming it can be a life-long journey, filled with a few steps forward and a few steps backward. How about starting on that journey today? Ask yourself, what is the story I’ve been telling myself? Can you relinquish that story for just a minute and tell it as unembellished, unemotional, uninterpreted facts? Let me set an example for you.
My story: I was an average student entering medical school.
The facts: I graduated college magna cum laude.
My story: I was an average medical school graduate
The facts: I graduated with a combined MD/MEd degree with honors.
Starting today, think about how you can adopt an attitude of appropriate, intentional, and realistic self-appreciation for your skills and talents.
References:
Villwock, Jennifer A., et al. “Impostor syndrome and burnout among American medical students: a pilot study.” International journal of medical education 7 (2016): 364.
Hunt, Jennifer. Unlocking Your Authentic Self: Overcoming impostor syndrome, enhancing self-confidence, and banishing self-doubt, 2020 (Amazon Publishing)
If you are looking for tools about how you can prevent and overcome impostor syndrome make sure to check out Dr. Jennifer Hunt ‘s new book!
I’m not a fan of prolonged articles that frankly take forever to get to the point so here’s my conclusion upfront.
Balance. Balance is the essential quality absent in the lives of the majority of premed students. I’m not talking about your cerebellum’s basic function here, I’m talking about an attribute that when lacking has the ability to dramatically decrease the quality of your life.
Hear me out here, I know that the FUNDAMENTAL quality of any successful premed student is dedicated and consistent work-ethic. However, it increasingly seems we’re living our lives primarily to complete each stage of requirements. We go from SAT, to MCAT, to USMLE, to Boards and on and on. We’re living to fulfill pre-reqs, fill up volunteer hours, and scouring for new shadowing opportunities. We’re in this endless race, in competition with our peers, to do the most. We put our bodies under immense stress- taking 18 credits a semester, doing research, and being leaders of clubs. We work really hard, and the people who may work slightly less than the absolute maximum are seen as wanting it less.
The problem with this culture of devoting our entire beings is flawed in many aspects. It’s not uncommon for people to routinely sacrifice their family time, time with friends, and health in order to get ahead in this field. I know the gut reaction of this sort of post- If I don’t prioritize my education then I’m going to fall behind and be an uncompetitive applicant. I’m not saying to de- prioritize your quest to medicine, but to build better habits that allow you to lead a healthier, more joyful lifestyle that allows you to prosper.
These years are supposed to be the best of our lives! By pursuing our own passions and dedicating time to personal development and socialization we can prevent burning out (which is officially a medical condition as recognized by the World Health Organization) and actually spur us to become better academics and future physicians. Below are a few applicable tips of how to gain more balance and lead a healthier lifestyle as a premed and beyond.
Schedule time for yourself. No matter the circumstance, ensure that you have a small portion of time every week to do whatever you want to do. Make it a timed event. Put it on your calendar! Just don’t push it off to study or do other things, schedule it at a good time so you can reset and avoid burning out.
Try new things! Try the things you’ve always wanted to do and the things you’d never thought you’d like. I personally tried hot yoga for the first time and despite being the only 20-something male there, I had an incredible time. It was a really great experience and one I want to continue for a long time.
Cut out unnecessary time wasters that make spending time with family or friends feel like they’re wasting your time. Specifically, social media. We spend so much time on Instagram, Twitter, Facebook etc. throughout the day and right before bed. If we cut down social media use during study sessions and wasting free time aimlessly scrolling then we’ll find ourselves with ample time to do significant things in life. You know that hour of sleep you get during daylight savings? Imagine that every night! Just don’t watch YouTube videos that no one needs or scrolling through Instagram for ages (Unless it’s on my profile @premed.plus).
Continuation of the last one- make sure you get good sleep! Sleep at the same time. Wake up at the same time. Every. Day. Your body needs a routine in order to thrive and it won’t do that when you pull all-nighters and feed it tacos and Mountain Dew.
All in all, living a balanced lifestyle will benefit you in both the short and long term. As a med student and beyond you’ll thank yourself for being able to budget time and have different reliable stress relieving activities. If you’d like to list some of the things you do to balance your medical lifestyle leave them in the comments below!
About the Author:
We’re PreMedPlus, a business oriented towards helping the next generation of doctors. We offer academic advise, productivity tips, and warn of common premed pitfalls on our Instagram page. On our Facebook page we offer personalized services for those who want one-on-one attention from a team of MD students. We know that being a premed is expensive and exhausting so we strive to make ourselves as affordable, accessible, and efficient as possible! Whether you want to enroll in our personal statement service or simply listen to how we got into medical school we’re happy to have you for either!
“Mom, what’s that?” my four-year-old daughter asks curiously as she stares at the pink and purple colors of the page I had just been staring at and trying to memorize.
“Skin.” I reply simply, because she’s not going to have any idea what Sweet’s syndrome is, or that many of those cells are neutrophils or that there are a list of other causes of papillary dermal edema or that a characteristic histology is only one part of the diagnostic criteria of Sweet’s. Her question means that her patience for my absence is wearing thin, and I only have around 5-10 more minutes to study before she’ll want to just sit on my lap and “help” me study.
Medicine is a demanding field that requires years of study and practice. It is a constant cycle of studying, test taking, applications and deadlines. It is all consuming, and in some regards, it should be. If you don’t know your shit in other jobs, you may lose the sale, lose the customer, or even lose your job. In the medical field, you could lose a life. So in a field that is years of training, a seemingly endless competition for the med school spot, the TA spot, the test score, the residency spot, and at times literally puts someone’s life in your hands, there is no time for distractions right? Do you have to choose career or family?
I know that it is absolutely possible to have kids in medical school and residency and be successful. But let’s be real about it, and practical about it. This question and its answer are very different for each individual person. I think there are four things to consider. But first, I want to give you my back story, so you can appreciate my perspective and the potential biases and misunderstandings I may have.
My husband and I decided to try to get pregnant at the start of my fourth year of medical school. We decided in June that we would try for two months- July and August, because then I could use my elective and vacation months of April and May for maternity leave, before having to report to residency training in the following June. If we didn’t get pregnant, we would wait a year or two before trying again. We got pregnant the first month. I had my first daughter at the end of March. My second year of dermatology residency (PGY3), we decided to give our daughter a sibling and got pregnant with our second daughter, who was born April of my second year. Obviously, I did not do most of medical school with any kids and have pretty limited experience regarding that, but I can extrapolate from my experience in residency.
Ok, so back to the four things to consider regarding having kids and pursuing medicine as a career.
What are your goals? Do you want a super competitive residency spot? Do you plan to do a residency and fellowship, etc, etc that will extend you to PGY6 or more? How much work are you going to have to put in to meet these goals, and is it possible to balance the time commitment of kids, with the time commitment of study in med school, extracurriculars, research and residency?
Because I didn’t have kids in medical school, I was able to focus my studying to obtain great test scores and grades and publish case reports in order to be a good candidate for dermatology. In general, dermatology is not one of the most time demanding specialities during residency, although there is an above average amount of study and focus on academics, more on that later.
What kind of student are you? If you are super smart or have a super good memory and can be an excellent student without having to spend extra time studying, then you will easily have some time left over to spend with your kids after studying. If you know that you will have to dedicate a lot of time and tutoring to stay afloat, it may be difficult to find any extra time for your kids.
I am the type of student who has to study a lot and repeat the material over and over in order to remember it. However, after doing this, I do retain it pretty well and I am a good test taker. So I really need to spend a lot of time on the foundation of material, but can relax my time after I have “put in the work”. So again, having a kid in medical school would have really been a struggle for me as I wouldn’t have been able to commit all the time that I did to studying. Again, this is just me personally. However, because dermatology is such a demanding speciality academically, my first year was a crazy load of material to memorize and I needed a lot of time to be able to go over it again and again to get it down. This is where scheduling my time and my support network came into play.
How much support do you have? To me, this is the most important thing. In general, I believe in the statement that it takes a village to raise a child. Children, especially when very young, are extremely demanding of your time, sleep, emotions, etc. To do it all alone and manage to study for medical school and residency is nearly impossible. However, it is very doable with a strong support network. Whether that network is a spouse, family members friends or nannies, there needs to be people in place to give you the ability to be at work when you need to be, and to have extra time to study.
I owe so much to my husband, who at times functioned as a single parent while I was in training. This was especially true my intern year when I was often working 12 hour shifts and would go days without seeing my daughter. It was true my first year of residency when I would spend the entire weekend before a test studying at work. It was true when I had to travel out of town for 6 weeks to do a rotation my second year, seeing them only every other weekend. And it was true leading up to my board exams my final year of residency, when again I would shut myself away to study for hours at a time. A lot of spouses would resent this burden, and I have seen marriages struggle as a result. We had a nanny as well to help ease the burden and give him a break as well.
Finally, what are your priorities? During medical school, after a long hard day of studying, I would enjoy going for a run or watching Office reruns with my husband. Those little breaks were filled with bath time and story time once I had kids. If you are already a parent, you know the extreme level of selflessness that goes along with that. If you are going to get burned out by not getting that down time or alone time, you really need to think hard about your career choices. It all depends on your priorities.
Having kids has changed my whole life perspective in a beautiful way. It has allowed me to see what is really important in life. Getting a B + instead of an A doesn’t make me a worse doctor or person, but spending that little bit of extra time I could have used to study, in order to play pretend with my daughters is absolutely worth it. My time with them is exhausting, but in the same way, is so refreshing. I love seeing the world through their eyes. I am frequently in fits of laughter at their antics and my heart is so full when my eldest gives me a cuddle and tells me I’m the best mom ever. I wouldn’t want to do this life without them. There are sacrifices that I have to make, but to me, they are worth it.
“Hey Mom, that’s skin!” My daughter says proudly a month later when she catches me reviewing another H&E photo. Silently I’m grateful that she didn’t come up while I was reviewing genital lesions, and I answer her with extra enthusiasm in my voice “Yes it is! I’m proud of you for remembering.”
