Impostor Phenomenon in Pediatric Residents: Prevalence and Association With Clinical Performance

Area of Science:

• Medical Education
• Psychology
• Resident Well-being

Background:

• Impostor Phenomenon (IP) is prevalent and linked to physician burnout.
• Data on IP in pediatric residents are limited, with unclear links to performance.
• Women are disproportionately affected by IP.

Purpose of the Study:

• To investigate the prevalence and correlates of Impostor Phenomenon in pediatric residents.
• To examine the relationship between IP and resident performance metrics (Milestones).
• To explore demographic differences, including gender identity, in IP experiences.

Main Methods:

• Four items from the Clance Impostor Phenomenon Scale were administered to pediatric residents.
• Responses were linked to Accreditation Council for Graduate Medical Education Milestones.
• Linear mixed models and polynomial mixed models analyzed associations between IP, demographics, burnout, resilience, stress, and Milestones.

Main Results:

• 736 residents participated (49.8% response rate).
• The mean IP score was 3.09±0.97, with 15.4% reporting intense IP.
• Higher IP was associated with lower resilience and higher stress/burnout. Residents with non-binary gender identities reported significantly higher IP.
• No significant association was found between IP and Milestones in adjusted models.

Conclusions:

• Impostor Phenomenon is common in pediatric residents.
• While not linked to female identity, IP is higher in residents identifying with non-binary genders.
• Educators should reassure residents that feelings of impostorism do not indicate a lack of competence.