The resident experience: coping with impostor syndrome as a surgeon

The unspoken weight behind the white coat

You scrub in before sunrise, race through rounds and still go home wondering if you’ve done enough. That quiet voice whispering “you don’t belong here” can be louder than the OR monitors. 

As one first-year surgical resident shared,

“Sometimes, when I'm working with a second year or third year resident and they are in control of everything and they're really good at what they do, … [I think] ‘oh will I ever be like this?’ I always put a lot of pressure on myself thinking like ‘why am I not like this now?’” — (PGY1, Male, Informant #26; Chodoff et al., 2023)

If this inner monologue sounds familiar, you’re not alone. Nearly every resident has felt this way at some point. Studies have shown that a significant number of medical students and residents experience symptoms of impostor syndrome (Chodoff et al., 2023).

Where do these feelings come from?

Impostor syndrome was first introduced in 1978 as “Impostor Phenomenon” by psychologists Dr. Pauline Clance and Dr. Suzanne Imes, who noticed that even highly accomplished women often dismissed their success as luck, timing, or charm rather than skill. They lived in a constant fear of being “found out” (Clance, P. R., & Imes, S. A. , 1978).

Decades later, that same fear shows up in operating rooms around the world. But it didn’t start when you decided to go to medical school, its roots go much deeper.

1. Upbringing: The conditional high achiever

Early family dynamics can shape the way we perceive achievement, failure, and self-worth (Clance, P. R., & Imes, S. A. , 1978). Children who grow up in highly achievement-oriented households may learn that love and approval are conditional and dependent on success. This can create a deep-seated belief that worth must always be earned, feeding the constant need for perfection.

2. Personality: The Perfectionist’s Paradox

A recent survey of surgeons found that the cohort was “a self-efficacious group of perfectionists” and that higher perfectionism correlated with greater impostor syndrome scores (Medline et al., 2022). However, these same traits can also be fertile ground for impostor feelings.

The more driven and highly performing you are, the more likely you are to internalize self-doubt. Psychologists call this the perfectionist’s paradox: the same ambition that drives excellence also makes failure feel catastrophic. And for surgeons, that mindset can become emotionally draining.

3. Environment: Where pressure meets personality

To make matters worse, the surgical environment is uniquely challenging. The OR becomes both stage and mirror, reflecting every perceived flaw. Unlike written exams or lab exercises, there’s little room for private error; mistakes can feel like public proof of inadequacy.

Add to that the hierarchical culture of medicine, where authority and competence are closely tied to respect, and it becomes clear why even highly skilled residents can feel like they are “faking it.” The environment both magnifies existing personality traits and reinforces the messages internalized from upbringing, creating a perfect storm for impostor feelings.

Why impostor syndrome hits surgeons harder

Imposter syndrome shadows many high achievers, but in surgery, it can feel especially heavy. It isn’t just about mindset; it’s about the system itself.

1. Performance is constantly visible

Every suture, every decision, every minute in the OR is observed, documented, evaluated, and often compared.

2. Feedback is immediate and sometimes public

Unlike exams or written evaluations, feedback in surgery happens in front of peers and attendings. Even small mistakes can feel like public failures.

3. Control is limited

Residents rely on institutional simulators and structured labs to practice laparoscopic skills. But between restricted hours and limited simulator time, many are unable to practice. This leaves them feeling unfulfilled and unprepared.

In short, impostor syndrome in surgery isn’t just psychological; it’s environmental and systemic. When opportunity, feedback, and belonging are all externally controlled, self-doubt becomes the natural byproduct of the system itself.

Breaking the cycle and regaining control

There is no quick fix to impostor syndrome, just like surgery, it takes practice and patience to unlearn, and you’ll have to test what works best for you. These are some methods that have been proven to be effective:

1. Build your own community

When your days stretch 14 hours and your nights blur into studying, “building community” can sound like a luxury. But it doesn’t mean attending loads of events or joining social clubs. It’s about finding small, sustainable ways to connect. Start with realistic interactions that already fit into your schedule:

• Enjoy your coffee break with a co-resident after rounds. Even a two-minute check-in can build trust and open the door for honest conversations. It will get you much further than forced networking.
• You probably already scroll through Reddit or Quora and although it may not seem like it, when you start interacting, you’ve entered a community.
• Try speaking to a senior resident or surgeon about the struggles they faced during their first few years. Most will be happy to share their tips and advice they wish they had.

These small moments of connection and vulnerability will help you feel less alone in this constantly evolving field. 

2. Celebrate your wins

Celebrating wins can feel uncomfortable, especially in such a competitive landscape. So, instead of considering them as large scale victories, treat them as milestones that help you get to your end goal; becoming the best surgeon you can be.

Try reframing celebration as a checkpoint, not a finish line:

• Write down small victories. For example, what is one thing you handled better today than last week: a smoother knot, a faster diagnosis or a calmer interaction with an anxious patient.
• Share wins with your peers. You’re not showing off, you are sharing a milestone to reinforce trust and the feeling of community.
• Reflect on your wins. Analyze what you did differently this time that made it go well. This helps you be less critical of not seeing it as a win in the first place. 

It’s easy to be hard on yourself, but celebrating your success and wins, no matter how small, will help you gain more trust in your own abilities.

3. Take control of skill-building

Limited lab time, simulator access, or attending availability can leave you feeling stuck. Finding ways to practice independently restores a sense of control and reinforces confidence.

Use deliberate, hands-on practice whenever possible. Even short, focused sessions strengthen both technical skill and self-trust.

When so much of your training feels outside your control, having tools like Laptitude can help you reclaim a piece of it. Portable and flexible, it lets you practice on your own schedule and track your progress over time.

If this way of learning sounds interesting to you, join the Laptitude waitlist.

Final thoughts

Impostor syndrome does not define your actual abilities. It’s important to give yourself compassion and recognize that growth takes time. You are constantly learning and adapting to meet the challenges of a demanding environment.

Every surgeon, at every stage, has questioned their place in the OR. What matters most is learning to recognize those thoughts and keep moving forward anyway.

As Dr. Iba reminds residents, “It’s normal to doubt yourself. Even over small things. But don’t ignore it. Work through it. You’re trained for this. You belong here.” (American Medical Association, 2022).