Imposter syndrome again and again and again and again

 I thought that after 3 years of med school and 2 years of residency the imposter syndrome would fade, not strengthen. Not the least of which because I'm expected to go into practice as a fully functioning family doctor at this point were it not for this +1 year. 

Yet here we are. My imposter syndrome has fed on what I can only assume is a steroid laden buffet of self-doubt and come raging out in full force. Yet this isn't quite the same beast I'm used to from the days of clerkship. Standing before a senior resident on internal rounds and being told to rattle off the costs of pancreatitis (I GET SMASHED) and only making it as far as "I GE" is imposter syndrome combined with simple lack of knowledge due to lack of experience. 

(Incidentally, I tried to use Google voice search to get the list of causes of pancreatitis appropriately summed up as the mnemonic above, and instead got recommended a list of ways to stay sober and manage a hangover. I appreciate the thought and the potential contribution to public health, but at <24hrs before my licensing exam it was less appreciated). 

These days the impostor feeling is associated less with my own work and knowledge base. I don't feel bad about the work I've done in the last two years and the associated knowledge and practice I have accumulated from it. In an average family medicine patient I'm pretty confident in my diagnosis, treatment, and bedside (tableside?) manners. 

What I do doubt is other people's confidence in my confidence. I've been developing literal shakes while waiting for a new set of preceptors (and a different one every day) to review my work and give me the go-ahead. I haven't been told by any of them in the last 3+ mths that I'm grossly incompetent, and have received very agreeable, constructive feedback that I can take into practice, but impostor syndrome does operate as such. 

I know part of it is that over the last year I've come to thoroughly understand the way my last preceptor prefers to work, I know her style and her approach to many diseases and treatments. She came to know mine as well, and as we shared an office side by side we developed a very cohesive working style. By the end her reviews of my patients were very much: "good, good, good, good, agree, yep" - which it should be for an end of residency student. 

I now accommodate the working style and preferences of at minimum 5 different physicians per week, across all different environments and systems. It's a little bit like being on tether hooks; never being comfortable in a single place/never feeling like I've quite got it right. 

I hope at the end of June next year at least some of this will go away, but who knows. The only thing every physician I've worked with has ever agreed on is that the impostor syndrome never goes away. Maybe I should look into buying some confidence...Think the wizard of Oz is available still?