Unmasking the Impostor Phenomenon in First-Year Residents
Abstract
Learning Objective: To determine the prevalence of IP and related attitudes in first-year residents.
Background: Impostor phenomenon (IP) is an experience in which individuals attribute their success to external factors and maintain a fear of exposure as a fraud. Times of transition are particularly high-risk for IP. Encouraging reflection and conversation about professional identity and self-doubt may decrease IP in first-year residents.
Objectives: To determine the prevalence of IP and related attitudes in first-year residents.
Methods: This was a prospective mixed-methods study conducted in July 2021. 63 first-year residents (47 EM, 16 FM) from 3 institutions participated in a session on IP during orientation: a formal lecture and reflective activity in which learners painted masks representing their internal and external selves and shared reflections with peers. Prior to the session, learners completed the Clance Impostor Phenomenon Scale (CIPS) and free-text questions related to IP. Learners were invited to repeat the survey 2 weeks later. Descriptive statistics and inductive qualitative methods were used to analyze the results.
Results: 53 learners (84%) completed the survey prior to the IP session. Mean CIPS score of learners was 66.5, range 42 - 100 (>61 indicates high impostorism). Mean combined female and non-binary learner scores vs male learner scores were 69.9 vs 65.5, respectively. Major qualitative themes included: IP in medical school, cyclic feelings, and self-doubt. 2 weeks after the session, 18 learners reported a mean CIPS score of 65.5. Themes included describing the IP session as therapeutic and the value of shared experience.
Conclusions: High IP was prevalent among first-year residents. Preliminary results suggest that a session on IP including a hands-on activity such as mask-making may help to mitigate feelings of impostorism and allow learners to reflect and create a therapeutic and bonding experience early in training. We plan to assess all participants at 6 months to determine recall, IP, and related attitudes at that time.