Impostor phenomenon common among physicians, study finds

In a survey of 3,116 U.S. physicians, 36.4%, 17.4%, and 5.8% reported moderate, frequent, and intense impostor phenomenon, which was associated with increased burnout and suicidal ideation and less professional fulfillment.

Physicians often experience impostor phenomenon (IP), or the persistent belief that success is undeserved rather than due to personal effort, skill, and ability, according to a recent study.

Researchers surveyed U.S. physicians and a probability-based sample of the U.S. population between Nov. 20, 2020, and Feb. 16, 2021, to determine the prevalence of IP experiences and their relationship to personal and professional characteristics, professional fulfillment, burnout, and suicidal ideation. They measured IP using a four-item version of the Clance IP Scale and used standardized instruments to assess burnout and professional fulfillment. The results were published Sept. 15 by Mayo Clinic Proceedings.

A total of 3,237 physicians were invited to complete the survey, and 3,116 (96.3%) completed the IP questions. Of these, 1,259 (40.4%), 1,135 (36.4%), 541 (17.4%), and 181 (5.8%), respectively, had scores in the minimal, moderate, frequent, and intense IP range. IP scores were higher for women physicians than for male physicians (mean, 10.91 vs. 9.12; P<0.001). The odds ratios for burnout among those with moderate, frequent, and intense IP were 1.28 (95% CI, 1.04 to 1.58), 1.79 (95% CI, 1.38 to 2.32), and 2.13 (95% CI, 1.43 to 3.19), respectively, versus those with minimal IP. Odds ratios for high professional fulfillment and suicidal ideation, meanwhile, were 0.58 (95% CI, 0.48 to 0.70), 0.41 (95% CI, 0.31 to 0.53), and 0.40 (95% CI, 0.26 to 0.62) and 1.29 (95% CI, 0.86 to 1.97), 2.21 (95% CI, 1.41 to 3.49), and 2.62 (95% CI, 1.46 to 4.65), respectively. In a multivariable analysis, physicians endorsed greater intensity of IP than those in other fields in response to the item, “I am disappointed at times in my present accomplishments and think I should have accomplished more.”

The researchers noted the potential for response bias and that they used cross-sectional data, among other limitations. They concluded that IP experiences are common among U.S. physicians and are associated with increased burnout and suicidal ideation and less professional fulfillment. “Holistic efforts to address the professional norms, perfectionistic attitudes, and system factors that contribute to this phenomenon are necessary to reduce the prevalence of IP and the associated personal and occupational distress,” the authors wrote. “Efforts to instill a growth mindset during the training process, reduce the stigma associated with help-seeking, and create a culture of vulnerability with colleagues will likely be critical to these efforts.”