Background
Transitioning within medical school to new responsibilities and challenges represents a significant change in responsibility in the life of a physician. Many individuals in healthcare experience the imposter phenomenon, including medical students, fearing exposure as a fraud. Identifying when imposterism may peak during training, historical social determinants, and personal history that can lead to the overall imposter syndrome are critical, as during medical school, student wellness and professional identity typically decrease. This study aims to characterize the imposter phenomenon in medical students at a single institution as they transition from one academic year to the next.
Methods
This study is a cross-sectional observational design. We constructed a 30-item survey using the Clance Imposterism Scale survey and selected demographic characteristics. Indicators of interest include environment of upbringing, education, socioeconomic status, and race/ethnicity. We analyzed the data using Pearson’s Chi-Square and Fisher Exact tests and a two-tailed Type I error of less than 5% to assess statistical significance.
Results
Out of 387 students, we received 89 responses for a response rate of 23%. 4th-year medical students reported more feelings of imposterism at the frequent or intense level compared to the first three years. Females had frequent/intense levels of imposterism more than males or non-conforming individuals. More than three-fourths of individuals raised in rural areas experienced frequent to intense imposterism compared to those raised in a suburban or urban environment. Completing an undergraduate degree with dedicated mentoring from physicians did not ameliorate feelings of not belonging.
Conclusion
We characterized medical students by cohort to identify points of intervention. Our findings highlight the importance of addressing the imposter phenomenon, especially in environments like medical school, where the expectations to excel may be intense. Recognizing that certain groups, such as females, underrepresented minorities, and first-generation college students, may be more susceptible to these feelings is an important step toward providing support and resources tailored to their needs.