Abstract

Background: Impostor syndrome is a complex phenomenon defined as self-doubt, low sense of belonging, and persistent worry of being discovered as a fraud, despite objective measures of success. Impostor syndrome is associated with increased burnout and worse mental health in several physician studies. This systematic review explores impostor syndrome among resident and fellow physicians. Objective: We performed a systematic review to identify articles that studied the prevalence of impostor syndrome among resident and fellow physicians. Methods: Using standard PRISMA protocol, relevant peer-reviewed articles were identified in 2023 that explored impostor syndrome among resident physicians. The primary inclusion criterion was assessment of impostor syndrome in graduate medical trainees. Conference abstracts and non-peer-reviewed literature were excluded. Article quality was assessed using the Newcastle-Ottawa criteria. The study protocol was registered in PROSPERO. Results: 296 studies were initially identified. 212 articles were screened for relevance after duplicates were removed. 34 articles were assessed for eligibility. 15 articles were identified, 13 of which were good quality. Impostor syndrome tends to be higher among women and is associated with increased anxiety, depression, and burnout. Impostor syndrome is also associated with negative impacts on professional identity development and readiness for autonomous practice. No difference was found among White and non-White trainees. Conclusions: Impostor syndrome among trainee physicians is highly prevalent and has multiple negative associations for mental health and professional development. While typically viewed as pathological, given its prevalence, impostor syndrome may also be viewed as a developmental stage for many trainees. A multi-pronged approach is needed that addresses institutional culture and learning climate to ameliorate impostor syndrome. Longitudinal, multi-center trials would help elucidate these issues further.

Keywords

  • Medical education
  • physician well-being
  • burnout

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