The Role of Impostor Syndrome on Medical Student Career Plans

Abstract

Background/Objective: Impostor syndrome (IS) is an internal experience, among high achieving individuals, of feelings of intellectual incompetence and inadequacy, accompanied by fear that others will discover them to be intellectual frauds. Originally defined in successful women, IS has been identified in numerous successful individuals, including medical students and residents. IS has also been correlated to race-related stress experienced among Black students. We measured IS among medical students and compared the prevalence of IS among underrepresented minorities in medicine (UiM) medical students compared to non-UiM medical students at two medical institutions. We also analyzed if different levels of IS negatively correlates with students applying into competitive specialties. Methods:A 5-10 minute anonymous survey was administered to all medical students at a private ivy league medical school (school A) and a historically Black college/university (HBCU) medical school (school B) through the software Qualtrics. The survey consisted of three parts, including collecting demographics, assessing student’s specialty interest, and the Clance Impostor Scale, a validated tool to measure IS, which places students into one of four levels of severity of IS. Statistical calculations were performed through Excel and R-Studio using paired t-test and chi-squared test. Results:A total of 284 students fully completed the survey, 187 students (66%) from the ivy league medical school, and 97 students (34%) from the HBCU. 37% of students identified as UiM, with a majority of UiM students from the HBCU (70 students versus 36). Among all students, 3.2% experience low IS (1), 38.4% moderate IS (2), 49.6% have IS feelings (3), and 8.8% experience intense IS (4). More students from the ivy league experienced higher levels of IS (1: 1.6%, 2: 32.1%, 3: 54.5%, 4: 11.8%), while more students from the HBCU experienced lower levels of IS (1: 6.2%, 2: 50.5%, 3: 40.2%, 4: 3.1%) (P<0.001). There was no statistically significant difference in the level of IS between UiM students and non-UiM students (UiM 1: 4%, 2: 45%, 3: 45%, 4: 6%; Non-UiM 1: 3%, 2: 34%, 3: 52%, 4: 11%) (P: 0.184). There was also no significant difference in the distribution of feeling of IS among students who have a desire to go into a “competitive” specialty versus those who do not. Conclusion: From this pilot study, a majority of students suffer from normal to intense feelings of IS. We found there to be a statistically significant higher number of students from the ivy league medical school to experience normal to intense feelings of IS compared to students who attended an HBCU. We found no statistically significant difference in the severity of IS among gender, students who identify as UiM or not, difference in age group or year in medical school, first-generation college graduates, students who applied or plan applied into competitive specialties versus not, and students who applied or plan to apply into a primary care or surgical specialty. More work should be conducted to understand why students who attend an ivy league medical school have higher levels of IS compared to students who attend an HBCU medical school, along with creating initiatives to help address these feelings of IS students experience.