Latest / The Hidden Load: For the educators and leaders in medicine who hold everyone up. / Data Over Drama: Overcoming Imposter Syndrome with Dr. Santina Wheat
Transcript
- Santina Wheat: Welcome back to The Hidden Load. I am your host, Dr. Santina or Tina Wheat. And I am so glad that you are joining me today for this important conversation. Because we are talking about a moment that almost every educator and leader in medicine has experienced. Yet almost none of us talk about openly while it is happening. Now I want you to take a moment and visualize this scenario. You receive an email and it says, congratulations. It is an invitation to step into a new role. Maybe this is the chair of a high-level committee. Maybe it's to take over as the clerkship director. Maybe it's to lead a clinical division or to step up to an executive task force. Welcome to the hidden load for the educators and leaders in medicine who hold everyone up. Thank you for listening to The Hidden Load. If today's conversation spoke to you, I would love for you to share it with a colleague who might need to hear it too. It's one of the simplest ways we can start shifting the culture of medicine together. We will tackle the hard topics and help you conquer your chaos and get to calm all by starting to acknowledge and remove that hidden load. And remember, your time spent reflecting here matters. You can earn free CME or CE credits for listening to today's episode through the Pinnacle app. You'll find that link in the show notes. On paper, this role is exactly what you have worked for. your qualifications, they're clear. ⁓ And peers respect you. This podcast is a space for us to name the things that are common, but not normal. Each week, we'll look at the invisible weight you're carrying and explore practical coaching-based tools to help you find more calm, better boundaries, and a sense of purpose that doesn't require you to run on empty. I'm so glad that you've carved time out for yourself today. Let's get into the episode. But the moment that you read that email, there might be a physical reaction that takes over after the initial excitement. It could be that your chest tightens. It could be that your mind starts racing. If you are looking for one-on-one coaching support or want to dive deeper into the resources we discussed today, let's connect. It could be that your palm start sweating. And then a quiet, insidious voice whispers in the back of your head. It says they made a mistake. They don't actually know what goes on behind the scenes. If I accept this role, this is the moment that I finally get exposed and they will realize that I am a fraud. You can find information on how to reach me in the show notes. don't forget to hit subscribe so that never miss an episode ⁓ and leave me a rating so that others can find too. Welcome to the Hidden Load of Imposter Syndrome. Just about every educator and leader that I know has shared a moment when they have experienced this. This is not just an individual quirk. This is not just a lack of competence. In healthcare leadership, self doubt can be a chronic cognitive drain. and take care of yourself because you deserve to be held up too. And I'll see you next time. It is a literal tax on your leadership bandwidth. And so today I want to pull back the curtain on what it truly means to navigate a seat at the table. We're going to dismantle the myth that you have to feel a hundred percent ready before you sit down. And we're going to explore how you can tell a difference between a paralyzing insecurity and the necessary healthy discomfort of professional growth. And then importantly, we're going to talk about how we, as leaders, are able to support our colleagues and trainees when they are stuck in this exact same spiral. So I wanted to talk about this because I had a recent conversation with someone who expressed that it was difficult to speak up in a meeting. And when I asked the question why, they said because they hadn't been doing this long enough, or because everyone else that was in the meeting had more experience than them. And the reality was that wasn't true. They were absolutely experienced enough. They needed to speak up. But it reminded me of a distinct transition in my own career where I felt similarly. It was time when I was offered a leadership role. I had worked really hard to get it. I had been working hard on the clinical aspect. I was teaching, I was publishing, I was checking every box. And when the title was handled to me, I was hoping that that external validation would finally allow my internal critic to be silent. was kidding myself. Instead, that critic just got louder. Because I felt like an imposter, especially standing in rooms filled with people who had trained me and who had been leading since before I was even in residency. And so when I reached that point, I did what many high achieving healthcare professionals do. I tried to overcompensate through a flawless performance. But of course, no performance can be flawless. I assumed that to protect my seat, I could not show a single crack in my armor. If there was a question that was asked in a meeting and I didn't know how to answer the question off of the top of my head, I would spiral for days thinking about what I should have said or how I could have prepared differently, how I needed to do everything differently. Because of this, I would spend hours prepping for routine briefings, thinking about what questions would be asked, how I would respond, how I could be prepared. I would treat a fifteen minute committee update like it was the defense of everything I had worked for. And I wouldn't delegate because I was terrified that if I handed something off and the person that I handed it off to made an error under my watch, it would be treated as definitive proof that I shouldn't be running the show. So this meant in reality, I was white knuckling my leadership. And I was driving myself to pure exhaustion under the guise of trying to reach excellence. But when I look back at that version of myself, I realize something profound. I wasn't actually leading. I was actually hiding. I was hiding behind overwork. I was using overwork as a shield to keep people from looking too closely at the things that I thought were my inadequacies. My imposter syndrome had turned a massive professional opportunity into an invisible prison of my own making. It meant that I didn't feel excited to show up every day. I was so busy trying to prove that I did belong at the table that I didn't always use my voice in an effective way to change the room. I want you to let that sit with you for a second. Have you ever turned an opportunity into an exhausting performance just to keep from being found out? So let's break down the anatomy of the hidden load. Because we use the term imposter syndrome, in my opinion, far too loosely in medicine. We tend to view any form of self-doubt as a psychological pathology that we need to fix with a mindset readjustment or wellness module. And I don't think that's always the case. I watch this impact my learners in thinking that if they don't feel totally comfortable with something, that they can't go and do it. And so I want to offer you a critical reframe. And this is the core thesis of how I think we should manage this load. Insecurity tells you to hide, but a healthy growth discomfort simply asks you to rise. When you step into a new leadership position, you should feel a level of discomfort. It is to be expected. If you don't, then you aren't stretching yourself. And you won't be able to grow. You won't be able to have new possibilities. Healthcare environments are staggeringly complex. They are rapidly changing. And they are absolutely high stakes. If you are a program director or a clinical lead, you are navigating budgets, institutional politics, and human dynamics that you were never taught in medical school. And you're doing this all while still trying to look out for your patients and their health. So healthy growth discomfort says, I haven't mastered the skill yet, and that makes me nervous and feel exposed. But I do have the foundational capacity to learn it. It focuses on the process of development and it focuses on your possibilities. On the other hand, Paralyzing Insecurity says, because I don't know this right now, I am fundamentally incompetent and do not belong in this room. That paralyzing insecurity focuses on the flaw in your identity. It makes you feel like you can't move forward. The hidden load happens when we that natural healthy growth discomfort as an identity crisis. When we mistake the normal learning curve of leadership for personal fraudulence. This matters ⁓ when we label everything as imposter syndrome, we build a habit of retreating from the table. We stop raising our hands for the very roles where our perspectives are absolutely and desperately needed, particularly for those voices who are underrepresented in medicine, particularly for those voices who already face systemic headwinds that amplify these internal critiques. So we need to rewrite the rules of the table. So how do we actively manage this load on a random Tuesday when that self-doubt creeps in? Well, I think we need concrete tactical interventions that can pull us out of the performance trap. The first strategy is to differentiate the data from the drama. Imposter syndrome thrives on drama, the emotional narratives that we build around the events. When an administrative project does not go perfectly, the drama says, Well, everyone realizes that I'm a terrible leader. I want you to force a clinical pivot to the data. What are the actual objective facts? The project missed a deadline because two staff members were out sick. a fact. That's a system problem, not a personal failure. I want you to treat your self-criticism like a questionable lab result. Look at the raw data before you make a diagnosis. The second strategy is to relinquish the expert illusion. The greatest generator of imposter syndrome in medicine is a belief that a leader must be an all knowing oracle. We carry our expert identity as clinicians. We carry our clinical identity where not knowing an answer on rounds felt dangerous. And we bring this into spaces where nobody knows a definitive answer. True leadership at the table is not about having all the answers. It is about having the structural curiosity to facilitate the right questions. The moment that you say, I do not know the solution to this operational hurdle yet. Let's look at the options together. You are able to drop that load of perfectionism and you're able to invite your team into true collaboration. Then you need to move on to strategy number three, moving from performance to purpose. When you sit at the table, stop asking yourself, how am I doing? That is a performance question. Instead, move to purpose and ask, what am I here to serve? When you shift your focus off of your own ego and onto your purpose. Whether that is protecting your residents' education or improving patient safety or advocating for your faculty, the imposter syndrome can vanish. You cannot feel like a fraud when your focus is on helping others. But fixing our own internal dialogue, that is only part of the battle. It's an important one, and it's important for us to show those who we lead and those who we're educating how we do it. But in addition to that, as educators and leaders, the true measure of our success is how we support others when they are drowning in this exact same hidden load. We have all had these experiences where a brilliant junior faculty member walks into their office, closes the door, and confesses that they want to step down from a committee. Or a superstar resident who finishes a fantastic presentation and immediately tells you all of the reasons why it was terrible. Or why someone that we nominate for a project tells you how they don't think that they're qualified and how you should just do it yourself. When you see someone stuck in an imposter spiral, how do you actually lift that load off their shoulders? Well, you can start by avoiding the validation trap. Our natural instinct as mentors is to offer toxic positivity. We say, ⁓ don't worry, you're amazing, you're doing a great job. Those words are great and you should be giving praise, but there's a problem here. Validation does not cure imposter syndrome. In fact, when someone feels like a fraud, telling them how great they are often doesn't help. It often backspires. They might just think, wow, I've managed to trick that person too. Instead of validating their feelings, ground them in objective reality. Say this instead. I hear that you feel unprepared. But let's look at the facts. You designed this curriculum, or the student evaluations are in the top 10%, or your peers are actively using your modules, or they're calling you to ask questions. Your feelings are feeling overwhelmed. But the data says that you are effective. You have to point out the concretes. The next part of the strategy is to share the behind-the-scenes footage. Imposter syndrome is born out of comparing our messy behind-the-scenes footage with everyone else's polished highlight reel. If you want to rescue a trainee or a junior faculty member or someone else that you're leading from this load, you need to show them your own unedited footage. You need to tell them about the grant that you didn't get. about the meeting where you felt completely out of your depth, or the days when you still feel the tightening in your chest. You need to normalize the discomfort. I recently had a faculty member who was frustrated about not getting a grant. And I shared all of the no's that I had received, not only over time, but in the just past year. You can also shift from praising genius to praising process. When you praise a junior colleague by saying you're a natural born leader, you're inadvertently amplifying their imposter syndrome. Why? Well, because the moment that they struggle, they will think, ⁓ I guess I'm not a natural-born leader after all. Instead, I want you to praise their effort and their strategy. I want you to say the way you managed that difficult conflict in the clinic today showed real tactical growth. You didn't give up when you got tense. You paused and you asked the right questions. Teach them that leadership is a must teach them that leadership is a muscle built through resistance. It's not a trait that they were supposed to be born with. We are not. Good at everything from the get-go. We have to learn it. Why is this vital? Well, because your team is absorbing your relationship with vulnerability. If you are a leader who operates out of paralyzed insecurity, you will inevitably create an environment of fear based perfectionism. Exactly what I was doing to myself before that was not healthy. Your residents will hide their mistakes. Your faculty will stop innovating because they see that you treat any lack of absolute certainty as a moral threat to your authority. You are passing your hidden load down the ladder. But when you own your growth discomfort, and when you actively coach others through theirs, you create an institution that's built on genuine psychological safety. So this week I have another Monday morning challenge. I want you to keep an eye out for a colleague or a trainee who is over preparing, pulling back, or dismissing their own achievements. I want you to catch them in that imposter spiral. Don't just tell them that they're great. Sit down with them and share a story of a time that you felt like a frost. and help them separate the data from the drama. Take a deep breath, uncross your arms, and use your voice. You weren't given a seat at the table by mistake, and neither were they. ⁓ Thank you for listening to this episode of The Hidden If it helped you put down a piece of your own internal weight today, I hope you will share it with a colleague, a trainee, ⁓ or another leader who is currently navigating their own new at the table. Let's lighten the load together, and I look forward to seeing you next time.