Why Imposter Syndrome Never Really Goes Away

Imposter syndrome stays with us, and that's not always a bad thing.

Most people assume that once you achieve something you’ve worked toward for years—a degree, a promotion, a leadership role—you'll finally feel confident and your doubt will disappear.

For many high-achieving professionals, the opposite happens: The higher they climb, the more vulnerable they sometimes feel.

I remember my first day seeing patients alone as a third-year medical student on my inpatient psychiatry rotation. I stood outside my patient’s room rehearsing what I was going to say, heart pounding, palms sweaty, convinced everyone could see right through me.

I didn’t know what I was allowed to do, or which questions would expose me as a fraud.

My attending noticed how nervous I was and offered advice that stayed with me for years:“Fake it until you make it.”

“Okay,” I thought. “I can do that. I can pretend like I know what I’m doing.”

A few years later, during my first month of residency, I found myself alone in the hospital after a scheduling error. My pager was going off constantly. I got home around 9pm, completely exhausted from work and having felt lost all day. At some point I found myself staring at the computer screen and suddenly burst into tears. My husband found me around 11pm, and gently ushered me to bed. I had to be back at the hospital again in just a few hours. “It’s okay,” I told myself. “I just need to try harder. Everyone else can do it, so why can’t I?”

After residency, I landed my dream job as core faculty in a family medicine residency program. I was ecstatic. After years of training and sacrifice, I had finally made it.

At least, that’s what I thought.

With the new titles came new responsibilities. As Inpatient Director during COVID, I felt like I was supposed to have answers for everything. I tried to live up to what I believed a model leader should be: always available, highly competent, tireless, constantly up to date on the latest research.“If I just work hard enough," I thought, “maybe people will see that I actually deserve to be here.”

Then I was promoted to Associate Program Director. Later I was elected Department Chair and voted into Medical Staff leadership.

I walked into meetings feeling like a fraud, terrified that someone would realize I had no idea what I was doing. I researched beforehand and rehearsed what I might say to avoid sounding incompetent. I told myself that good leaders worked harder than everyone else, that if I could just stay ahead of the game, maybe no one would notice that underneath, I still felt like I was faking it.

For years, I believed confidence would follow the titles and achievements. In some ways it did. But each new responsibility brought the same familiar doubt:

“You don’t belong.”

“You’re not good enough.”

“Eventually they’ll find out you don’t know what you’re doing.”

What I had been carrying had a name: imposter syndrome. Psychologists Pauline Clance and Suzanne Imes first described “imposter phenomenon” in 1978. They observed that many high-achieving individuals, particularly women, believed they were intellectual frauds despite clear evidence of competence and success. Even repeated accomplishments often failed to change that internal belief. Instead, success was attributed to luck, timing, or effort rather than ability. 

Research since then suggests these feelings are surprisingly common. Some studies estimate that imposter syndrome may affect up to 82% of people across professions and demographics. High performing fields like medicine, academia, and leadership create the perfect conditions for imposter syndrome to thrive. Training environments are built around constant evaluation, comparison, hierarchy, and high-stakes decisions. 

Early in our education, we learn that confidence reflects competence and uncertainty should be hidden. So we learn to project confidence even when we feel unsure, quietly carrying a deeper question of “What if I actually don’t know what I’m doing?”

For years, I assumed the feelings would disappear once I became more experienced. Eventually, I recognized the cycle and realized something important: Imposter syndrome rarely disappears. In fact, it often shows up precisely when we are challenging ourselves, taking on new responsibilities, and growing.

Understanding that changed how I interpreted that feeling.

One of the most powerful shifts for me was learning to separate feelings from facts. The voice of imposter syndrome is often rooted in fear. Our brains attempt to protect us from failure, embarrassment, or making mistakes, often stemming from an even deeper fear of not being enough. It tells us stories that our success happened because of luck, timing, or someone else’s oversight. But when you step back and look at the evidence, the story changes: Your journey did not happen by accident. It reflects years of effort, learning, resilience, and growth. Recognizing that truth can help quiet the voice of imposter syndrome.

In medicine, that perspective becomes especially important because the more you learn, the more aware you become of what you do not know. Physicians in training are evaluated on recognizing their limits and knowing when to ask for help. True confidence in medicine does not come from knowing everything but from learning how to navigate uncertainty: looking things up, asking questions, seeking input from colleagues, and remaining curious. When I see this in a physician, it signals a deep commitment to lifelong learning and one of the strongest indicators of an excellent doctor.

Perhaps the most freeing realization is this: Confidence rarely comes before action. We often imagine that successful people feel ready before taking the next step. In reality, most of us never feel completely ready. We take a step, then evaluate. Then we take another. With each step, confidence slowly begins to build. And just before each next step, the familiar voice of imposter syndrome often appears, the one that whispers your deepest fears and tries to protect you. Instead of fighting it, we can acknowledge it and quietly say, “Thank you for trying to keep me safe.”

Then we move forward anyway.

Imposter syndrome does not simply disappear as we progress in our careers or take on new challenges. But when we learn to recognize it for what it is, a reflection of uncertainty and growth, it begins to loosen its hold on us.

The doubt we hoped would disappear may never fully go away, but it's simply the feeling of growing into the next version of ourselves.

A version of this has been published on: https://www.psychologytoday.com/us/blog/the-other-side-of-the-white-coat/202603/why-imposter-syndrome-never-really-goes-away

References 

Clance, Pauline R., and Suzanne A. Imes. “The Imposter Phenomenon in High Achieving Women: Dynamics and Therapeutic Intervention.” Psychotherapy (Chicago, Ill.), vol. 15, no. 3, (1978), pp. 241–47, https://doi.org/10.1037/h0086006.

Bravata DM, Watts SA, Keefer AL, Madhusudhan DK, Taylor KT, Clark DM, Nelson RS, Cokley KO, Hagg HK. Prevalence, Predictors, and Treatment of Impostor Syndrome: a Systematic Review. J Gen Intern Med. 2020 Apr;35(4):1252-1275. doi: 10.1007/s11606-019-05364-1. Epub 2019 Dec 17. PMID: 31848865; PMCID: PMC7174434.

Huecker MR, Shreffler J, McKeny PT, et al. Imposter Phenomenon. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. ncbi.nlm.nih.gov/books/NBK585058/