Why This Episode Almost Didn't Happen
Shanna Miranti, PA-C, opens by defining imposter syndrome as a psychological condition where a person doubts their competence and fears being exposed as a fraud despite their skills and training. She notes it's commonly reported in healthcare, with high rates documented among dermatology residents, but it is far less studied in PAs and NPs. The audience, she says, specifically asked the hosts to cover this one.
Buchi Neita, PA-C, admits she originally turned the topic down when SkinSync first pitched it. Her immediate 'no' surprised even her, and when she sat with why it triggered her, she realized it was because she still feels imposter syndrome regularly, sometimes daily. That vulnerability sets the tone for the whole conversation: even seasoned, confident clinicians live with this.
How Imposter Syndrome Shows Up in Clinical APPs
Neita walks through how imposter syndrome shows up. For some, it’s perfectionism, which is common among people used to being at the top of their class and can actually hinder growth. For others it's what she calls 'superheroism' — taking on every task and every assignment until you wear yourself down to the bones. She points to a strong link between imposter syndrome and burnout, plus a genuine fear of failure that stops clinicians from taking jobs or opportunities they're actually qualified for.
Both hosts emphasize that the condition is especially prevalent among healthcare workers, women, and people in minority or marginalized groups. Miranti connects it to the reality that many APPs are moms, multitaskers, and high achievers who still hear a voice asking whether they can handle the next patient, whether they truly understand the inflammatory cytokines, and whether they're keeping up with the latest and greatest.
Two Vulnerable Stories From the Chair
Neita shares that since joining the Elevate-Derm Alliance team about a year and a half ago, imposter syndrome hit her hard. Walking into a room of colleagues whose names she recognized from publications, national stages, and past SDPA presidencies, she felt like 'just a regular old derm PA' who didn't belong. Rather than shrink, she poured herself into her first lecture, got strong feedback from peers she respected, and turned that fear into fuel. She recounts a more recent ad board where she saw a past AD president's name tag and thought she was in the wrong room — but she stayed in her seat and participated.
Miranti's story is more personal. Early in her career, in her late 20s and years into fertility struggles, she was on multiple hormones and medications when a teenage acne patient told her, 'Why should I listen to her? Her acne is worse than mine.' Instead of running out in tears, Miranti chose to be vulnerable back, telling the patient that her passion for treating acne came from not wanting the patient to feel the way she felt. The teen did a double take, and the moment became a lesson in meeting patients in their vulnerability without pretending to have it all together.
Coping Strategies the Hosts Actually Use
The hosts land on several practical strategies. First, normalize it. Neita relays that one of her mentors, a national speaker, gets nervous before every talk — proof that the emotion never fully disappears even at the top tier. Second, find your community: reach out to people doing what you want to do, ask questions, and let mentors lift you up.
Third, give patients — and yourself — permission not to know everything. Miranti stresses that no one graduates from PA school or an NP program knowing it all, and that it's okay to tell a patient, 'I actually don't know this, but I want to look it up and learn it together.' Finally, both hosts return repeatedly to counting wins: every article published, every talk given, every ad board attended, journaled or written down as evidence against the self-doubt.
Neita adds a caveat with teeth: if you're not doing the work, you truly are an imposter. But if you're putting in the time, effort, and energy to learn, you can flip imposter syndrome into a positive force. Miranti closes with her husband's coaching line — 'get comfortable being uncomfortable' — and a reminder that you can be something for everyone, just not everything for everyone.