Impact of Imposter Phenomenon on Medical Learners and Clinicians: A Scoping Review

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Objective: The imposter phenomenon (IP) is the belief that one does not deserve success. Medical students, residents, and physicians experience IP at significant rates, often due to the stress of mastering the extensive diagnostic information and treatment modalities as well as the competitive nature of medicine. We aimed to identify the main factors of IP in medical students, residents, and physicians in the available literature to increase awareness of IP in medical education.

Methods: In this scoping review, PubMed, PsycINFO, Cochrane Library, Embase, Scopus, Web of Science, Google Scholar, Northern Lights Conference Abstracts, and Dissertations & Theses databases were systematically searched for relevant studies published before June 2020. Articles that examined IP in medical students, residents, and attending physicians were retained. References were hand- searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. Extracted data were tabulated to summarize characteristics and main findings from each study. Content analysis of this table identified major themes in the available literature.

Results: Twenty-four journal articles published between 1978 and 2020 were included. Three main themes were identified, including specific demographic characteristics of IP (n = 14), the professional impact (n = 10), and the psychological impact (n = 17) of IP. For demographic characteristics, IP was higher in older individuals (n = 3), racial and/or ethnic minorities (n = 2), and women (n = 12). Married individuals experienced less IP (n = 2). For professional impact, IP increased during career transitions or professional challenges (n = 8). For psychological impact, IP was associated with reduced self-esteem (n = 7), a negative self-concept (n = 2), increased self-doubt (n = 3), and perfectionism (n = 3). Depression, anxiety (n = 3), and burnout (n = 6) were also heightened with IP.

Conclusion: Results revealed a multitude of factors influencing IP. Increased awareness of the presence, impact, and severity of IP assists medical educators to combat its negative effects. Further research is needed to improve treatments for IP in this population and to better understand the impact of IP on diversity, career trajectory, and career satisfaction in medicine.