The New Clinician and Imposter Syndrome

You have done it!  You not only survived PTA school, but you have also successfully passed the difficult NPTE-PTA and finally have your PTA license in hand.  You have accepted your dream job, you work alongside amazing co-workers and on top of that, with a population you enjoy.  Life should be grand! Yet secretly you are harboring a gnawing feeling that you do not have what it takes to be where you are.  You may be experiencing what is commonly known as imposter syndrome, also referred to as the imposter phenomenon. 

Imposter phenomenon is a unique kind of self-doubt that occurs more often than you might expect.    It contributes to feelings that you may be exposed as not being as competent or knowledgeable as you should be in your job. The concern though is that persistent self-doubt can lead to increased stress, anxiety, and burnout.  It certainly can limit job satisfaction. Health professionals, including PTAs, are at a higher risk of this phenomenon due to the challenging nature of the profession, where your skills are imperative to healing others.

American psychologists Clance and Imes first identified the syndrome in the 1970’s and defined it as the inability to internalize success and a tendency to attribute it more to luck, error, or a personal connection.  In the past several years the syndrome has gained increased media attention and information is now abundant.  What we now know is that imposter phenomenon occurs in all people from diverse ethnic and cultural backgrounds, in a variety of professions.  The 2024 movie about the Blue Angels Navy pilots refers to how even elite first-year pilots experience feeling of imposter syndrome despite their years of intense training.  So, you are not alone, and join the elite members of a group you may not wish to belong to!

So, what do you do when feelings of inadequacy and doubt creep in?  First remember that being new at anything, whether it be a new hobby or skill takes time to master and feel confident in. Liken the process to learning to ride a 2-wheel bicycle or learning to drive.  You may have had the skills down enough to be safe, but it took time to feel confident to go it alone, or to hit the highway…. but over time you got there.  You would not have a license in hand if you were not safe and competent, so be gentle with yourself as you navigate the roads of a first-year clinician.

As a PT that went from clinician to educator, I understand too well the feelings of imposter syndrome.  My educational background was solid, but I needed to learn some new skills such as lesson plans, recent technology, and how to manage a classroom. Though I knew my topics from a clinical perspective, it took me time to trust that I could take on the challenge of teaching a new generation of therapists.  So, whether you are entering the PT profession as a new PTA, or changing settings, or taking on new job responsibilities or titles, you may be feeling that twinges of being an imposter.  Here are some tips I would like to share to help ease the transition to the place of confidence you long to be:

1. Trust that you have what it takes to be where you are!  You have proven that you have what it takes to be safe and competent, you have met all the marks of a qualified practicing entry level therapist, you belong!

2. Find a good mentor, someone that has some years of experience in the job you are doing.  Be sure the person you choose will help you grow using methods that work with you and your personality.

3. Ask questions without fear!  No one expects a new graduate to know everything (after the NPTE is over!), so ask away!  It is always better to ask and clarify things at the risk of seeming silly than being unsafe with your patients.

4. Take time to investigate the answers to the clinical questions that come up each day.  Realizing concepts you do not know is a sign of intelligence! Good for you for wondering!

5. Sign up for continuing education in the areas that interest you. Keep adding tools to your toolbox and know that you have just begun with a start set, adequate but will be growing your entire career.

6. Take note of your successes!  You are doing good things every day, you are connecting with patients, coworkers and making lives better. Focusing on your accomplishments and all that you do know will be helpful.

7. Talk kindly to yourself and reframe your thinking, using a growth mindset.  When things do not go as planned, focus on how you will improve with your next opportunity rather than label your mistake as something horrible.

8. Look around you and watch how your team members operate.  You will pick up many tools of the trade, treatment ideas, and ways of managing patients and stressful work situations by observing how seasoned clinicians deal with the things that school did not prepare you for!

9. Accept the fact that new situations can be scary and certainly a new job working with patients can be intimidating.  Being nervous is normal, do not equate unease with being unworthy of sharing your skills and talents with your patients each day.

10. Know that professional help is always available. There is no shame in seeking help to sustain your well-being and mental health.  A good therapist can help you develop strategies to promote your self-worth and confidence in both your personal and professional life if necessary.

You have entered the wonderful world of physical therapy, a profession that will provide you with great satisfaction as you heal and connect with the patients you are privileged to treat.  It also is a profession that will require a lifetime of learning as you continue to add new tools and skills to your toolbox.  Be kind to yourself as you begin your journey, knowing that even the most seasoned therapists do not know it all, and that the best therapists never stop learning and growing.  You have earned a license to treat patients, you are now behind the wheel and a little nervous to be on the road.  That is completely normal and a safe reaction to a large responsibility. Take it slow, take note of all the signs and signals you know you must follow, and trust that you can get to where you are going.  You may encounter some detours, you may have to reroute your trip now and then, but someday in the future you will realize you are in the fast lane, cruising the highway doing fine and loving the road you are on!  Enjoy the journey you have signed up for, you are in for a wonderful Physical Therapy ride!