Multi-Institutional Assessment of Imposterism Among Internal Medicine Residents

Background

Imposterism—also known as imposter syndrome or imposter phenomenon—has become an increasingly well-known concept within academic medicine, yet there is relatively limited data in the GME population to assess prevalence and/or risk factors.

Objective

To assess the prevalence of imposterism among internal medicine residents across multiple academic medical centers, and to examine its relationship with various demographic groups, as well as psychosocial and experiential factors.

Design

We conducted a national study of internal medicine residents from six major academic institutions. Residents across all sites were invited to participate in this voluntary survey.

Participants

A total of 373 residents (overall response rate 48.4%) completed the survey. Participants were 54.5% female and 49.9% white, with a mean age of 29.52 years (SD 3.47).

Interventions

The survey consisted of two measures of imposterism—the Clance Imposter Phenomenon Scale (CIPS) and the Young Imposter Scale (YIS)—in addition to experiential and demographic questions.

Main Measures

The primary outcome was the prevalence of imposterism among internal medicine residents, using the total score from CIPS. Secondary outcomes included comparison of the prevalence of imposterism of various demographic cohorts, as well as associations with potential risk and protective factors. In addition, we examined the association between CIPS and YIS.

Key Results

Overall prevalence of imposterism across all sites was 62.7%, with no significant differences in prevalence between institutions. Imposterism was associated with female gender and depression and/or anxiety. Additionally, the CIPS and YIS were strongly correlated.

Conclusions

Our study demonstrated a high prevalence of imposterism among internal medicine residents, consistent across all institutions surveyed. Imposterism was associated with female gender, anxiety, depression, and possibly IMG status. Future research is crucial to develop and identify effective interventions to target imposterism for all trainees.