From Jamie Katuna: I failed a test in medical school. I got my score back and there it was: 57%. I wasn’t even close. I felt shocked, because I have never failed a test before. I felt embarrassed, because I was comparing myself to my peers. And I felt dumb. But the worst part about this experience wasn’t the fact that I got a low score — the worst part is the identify shift that accompanies a failing grade. I felt like I, as a person, was a failure. I was reminded of this quote by Dr. Suzanne Koven in the New England Journal of Medicine: “I have been haunted at every step of my career by the fear that I am a fraud.” Her experience is not a unique one. Throughout medicine — from first-year medical students to tenured physicians — there exists an overwhelming feeling of inadequacy. Each individual feels that he or she is the only one who is struggling; the only one who doesn’t belong. People turn inwards. They suffer in silence and embarrassment. They quit. They abuse substances. They disconnect from others because they think others won’t understand what they’re going through. Chances are, others would understand. Chances are, they have been feeling like a fraud too. So why don’t we talk about it? The culture that exists in medicine makes us feel like we should be perfect. And since none of us are perfect, we pretend. We hide our doubts and our fears, our failures, and our mistakes. We convince ourselves that WE are the only ones pretending while everyone else has genuinely figured it out. We conclude that we are frauds. If you are in medicine, I have a challenge for you. Talk to someone about your fears and doubts today. Tell them about an obvious mistake you made. Embrace your imperfections with love and curiosity. Watch the way your confidence grows.