Exploring Impostor Phenomenon During Pre-Clerkship Period in Military Medical School

impostor phenomenon (IP) is defined as an experience where individuals attribute their success to chance or luck and not to their mastery of skills, which is commonly experienced within competitive environments such as medical school. Building on a prior study on IP during onboarding, the purpose of this study is to examine IP experiences throughout the pre-clerkship curriculum and provide insights into the possible evolution of IP during the initial 16 months of a military medical school.

The study participants were second-year medical students at a military medical school who had previously participated in an initial IP study at the beginning of their first year of medical school. Researchers conducted semi-structured interviews in December 2023 to explore how students' experience with the IP changed after their pre-clerkship education, and qualitative thematic analysis was conducted. Scores from the Clance Impostor Phenomenon Scale (CIPS) during onboarding and at the end of the pre-clerkship period were compared.

Researchers interviewed 21 of the original 29 matriculated military medical students who completed the initial study. Fifteen students (71.4%) reported frequent or intense IP experiences on the CIPS indicating that IP remained present in the study sample. Average CIPS scores from onboarding and end of pre-clerkship were 68.3 and 68.1, respectively, suggesting that the intensity of IP remained stable. Thematic analysis of interview transcripts identified 6 themes that influenced students' experience with IP: academic progress, military medical expectations, self-comparison, relationship dynamics and building relationships, extracurricular engagement and roles, and navigating uncertainty. Theme saturation was reached at n = 15.

Although the intensity of IP remained relatively stable from onboarding to the end of pre-clerkship, the underlying themes driving IP evolved as students transitioned into active participation in undergraduate medical training. Similar to the initial IP study, situated learning theory continued to offer a valuable framework for understanding these shifts, particularly through relationships with peers and upperclassmen. Future research incorporating mixed methods could further clarify how qualitative shifts in IP correspond to variations in CIPS scores. As participants advance into clerkship rotations, we anticipate continued evolution in IP experiences, warranting further longitudinal exploration.