After 20 years in practice, I still feel like an impostor—and that's not a bad thing

I've been a veterinarian for more than 20 years, and if there is one thing I have learned during that time, it's that confidence in this profession rarely arrives when you think it should.

Veterinary school gives you a degree, but it does not give you certainty. It gives you enough knowledge to begin being dangerous in a controlled environment, and then reality takes over. The first emergencies, the first nights alone, the first patient that refuses to behave like the textbook promised and decides to deteriorate in a way that was definitely not covered in the lecture slides—that is usually where the real education begins.

I still remember those emergency shifts, sitting at 2 AM with a hospitalized patient, reading papers in English while trying to decide whether I was making the right clinical decision or simply choosing the least bad option available. At that stage, the authors of those papers felt like mythical figures, people who existed somewhere very far away in universities, referral hospitals, and conferences I could not afford to attend. Their names carried the kind of authority that made you feel smaller just by reading them.

Years later, life becomes strange in the best possible way. You end up meeting some of those authors. You share coffee with people whose names used to intimidate you in PubMed searches. You realize they are normal people who also get tired, also doubt themselves, and probably also had nights reading someone else's paper at 2 AM. Eventually, one day, someone invites you to write for these publications, and you have the deeply uncomfortable feeling that there has been some kind of mistake.

That feeling, of course, has a name: impostor syndrome.

Veterinary medicine is fertile ground for it because it's a profession built on uncertainty disguised as confidence. We work in an environment where perfection is impossible, mistakes are expensive, outcomes are emotional, and comparison with others is constant. There is always someone who seems to diagnose faster, cut better, communicate more elegantly, publish more, and somehow manage to have a social life. It becomes very easy to believe that everyone else received a professional manual you somehow missed.

I know that feeling well. At one point, I decided to complete a master's degree in business administration and management. I found myself surrounded by engineers, lawyers, economists, and people from professions that sounded much more respectable at family dinners. I was the only veterinarian in the room, trying to explain why discussing earnings before interest, taxes, depreciation, and amortization (EBITDA) and customer acquisition costs somehow mattered to someone who spent the morning looking inside dog ears and talking about diarrhea.

That sensation of not belonging does not disappear just because you get older or because your CV becomes longer. Sometimes it simply becomes more sophisticated.

Then came writing. I started contributing to a veterinary magazine that no longer exists, and I did it for free, which is usually how most romantic professional mistakes begin. There was no business plan behind it, only the dangerous combination of enthusiasm and the belief that maybe saying something useful was enough reason to keep doing it. From there came a book. From the book came a talk. And for that first talk, my mother attended because there was a very real possibility that nobody else would.

There is no stronger combination of emotional support and brutal honesty than your mother sitting in the front row while you try to look like someone worth listening to.

This year, I returned as an invited speaker to the 2026 AVMA Convention, and if I am being completely honest, there is still a part of me that assumes someone will eventually realize they meant to send that email to another Ignacio. Achievement does not eliminate impostor syndrome. Sometimes achievement simply gives it better furniture and a nicer office.

Unfortunately, modern professional culture has complicated this syndrome more. We belong to the generation of "fake it until you make it," where confidence is often performed long before it is genuinely felt. Social media has turned competence into theater. Everyone looks certain. Everyone looks successful. Everyone seems to have a 5-year strategic plan, excellent lighting, and perfect emotional stability.

Meanwhile, most of us are still trying to remember whether we actually sent that blood sample.

The truth is that many of the people you admire built their confidence exactly the same way you are trying to build yours: badly, slowly, and while doubting themselves most of the time. If you ask someone who now lectures at international conferences how they started, they rarely tell you glamorous stories. They tell you about hiding in the bathroom during consultations to quickly check a book before walking back into the room pretending they had known the answer all along.

Today, thanks to the internet, the search is faster. The emotional experience remains equal.

This is where psychology becomes useful, because 2 concepts explain much of what happens to us professionally: the Dunning-Kruger effect and the relationship between stress and performance.

The Dunning-Kruger effect is uncomfortable because it reminds us that beginners often feel more confident precisely because they do not yet understand how much they do not know. Then knowledge arrives, and with it comes the deeply unsettling realization that medicine is mostly uncertainty wearing a lab coat.

That's often the moment when confidence drops sharply. The more you learn, the more aware you become of complexity, nuance, and the number of ways things can go wrong. Ironically, the people who worry most about being impostors are often the ones who are actually becoming competent, because competence creates awareness. The dangerous veterinarian is rarely the one asking too many questions. It's usually the one asking none.

Then there is stress, which we tend to treat as if it were always the enemy. It's not.

More than a century ago, psychologists Robert M. Yerkes, PhD, and John Dillingham Dodson, PhD, described what we now know as the Yerkes-Dodson law: the relationship between stress and performance. Their work showed something most clinicians understand instinctively—performance improves as pressure increases, but only up to a point. Too little stress creates complacency. Too much stress creates paralysis. Somewhere in the middle is where we perform best. No surgeon wants a completely relaxed anesthetist. No emergency clinician should feel emotionally identical managing a blocked cat and ordering lunch.

A basic level of stress is not pathology; it is professionalism. It forces preparation and reminds us that what we do matters and that outcomes have consequences beyond our own comfort.

The problem is not fear. Fear is useful. Fear makes you check the dosage twice. Fear makes you review the anesthetic protocol one more time before induction. Fear forces humility and prevents arrogance from becoming dangerous.

The real problem is panic.

Panic is different because panic does not make you better, it makes you smaller. Fear keeps you responsible; panic convinces you not to touch the case at all. Fear helps growth; panic builds paralysis.

Professional development happens in that narrow and uncomfortable space between fear and panic. Too little fear and you become reckless. Too much panic and you stop moving entirely. The art of becoming a better veterinarian is learning how to stay in that middle ground long enough for competence to catch up with responsibility.

That process requires something veterinary medicine does not always reward enough: the ability to admit limits.

There is enormous professional maturity in saying, "I do not know." There is strength in saying, "I need help." There is wisdom in referring a case, calling a colleague, checking a source, or asking a nurse who has seen more practical reality than your textbooks ever contained.

But ego makes that difficult. We confuse independence with competence and vulnerability with weakness. We think asking for help makes us look smaller, when in reality it is often the clearest sign of professionalism. The veterinarian who never asks for help is rarely the strongest person in the building.

My grandad always told me: "Nobody learns in someone else's head."

We all need our own mistakes. Advice helps, mentors help, books help, conferences help, but eventually every veterinarian must make decisions, get some of them wrong, survive the embarrassment, and keep going. Experience is often just accumulated recoverable mistakes.

The goal is not to avoid every failure. The goal is to fail in ways that teach rather than destroy—to understand where your limits are, to stretch them carefully, and to recognize when courage is necessary and when pride is simply stupidity wearing a lab coat.

Impostor syndrome is real, and pretending otherwise helps no one. But it should also not become a prison.

Most of the people you admire are improvising more than they publicly admit. Most experts are simply people who stayed in the room long enough. Most confidence is built after competence, not before it. And most careers are not built on moments of brilliance, but on years of showing up while quietly suspecting you are underqualified.

That feeling does not necessarily mean you are failing. Very often, it means you are growing.

So, if you still read papers at 2 AM, still doubt yourself before difficult conversations, still wonder whether someone will eventually discover that you are making this up as you go along, that's probably not a sign of weakness.

It's usually a sign that you care.

And caring, with enough humility and enough courage, is where good veterinarians usually begin.