Chris Lancelot: Revalidation and the imposter syndrome

I was intrigued to discover that Jeremy Paxman has confessed to suffering from imposter syndrome - feeling that he wasn't a proper journalist. This newly described condition describes those who constantly believe that they aren't skilled enough for their job and that one day they will be found out and their incompetence exposed.

Sufferers from imposter syndrome constantly discount their achievements, usually putting them down to luck or, for example, that 'the admissions committee/the examiners got it wrong'. Originally it was thought only to affect women (especially graduates) but new work shows both sexes are affected.

The causes are multiple, including personality type, upbringing and depression. Gifted people and those with very high standards are particularly prone to it.

I wonder: does the imposter syndrome have anything to do with doctors' current anxieties about revalidation? A fifth of GPs are considering retiring rather than going through the revalidation process. Is this because many of our high-achieving colleagues - as with Jeremy Paxman - harbour innate feelings of incompetence? Their fears are made worse by the revalidation process itself, which is currently so nebulous that no one can be sure who will pass - which of course allows those with imposter syndrome to feel certain that their perceived shortcomings are about to be laid bare.

The cure for imposter syndrome is to learn to recognise your true achievements rather than putting them down to luck; and to counter the automatic emotional thoughts of 'not being good enough'. But how can doctors recognise their true competence if they don't know the yardstick against which they will be measured? All the more reason for the authorities to develop revalidation protocols which are simple to administer and capable of self-administration. All doctors ought to be able to know whether they will pass or fail revalidation.

It is a sad fact that those most likely to suffer from imposter syndrome are hard-working people like doctors. If this describes you, then take heart: if Jeremy Paxman fears that he is an imposter, then there is hope for the rest of us.

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