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

Impostor phenomenon is prevalent, linked to physician burnout, and disproportionately affects women. Data on pediatric residents are limited, and its relationship to performance is unclear.

Four items from the Clance Impostor Phenomenon Scale were added to the 2024 Pediatric Resident Burnout-Resilience Study Consortium's survey. Responses were linked to Accreditation Council for Graduate Medical Education Milestones. Linear mixed models examined associations of demographics, burnout, resilience, and stress with impostorism. A cubic polynomial mixed model assessed unadjusted and adjusted relationships between impostorism and Milestones.

Seven hundred and thirty-six residents responded (response rate = 49.8%) from 25 programs. Mean impostor phenomenon score was 3.09 ± 0.97 (1=low; 5=high): 17% "minimal", 36% "moderate," 31.4% "frequent," and 15.4% "intense" impostorism. Adjusted analyses showed no significant associations of impostorism with most demographics. Residents with gender identities other than binary reported significantly higher impostorism. Impostor phenomenon was associated with lower resiliency and higher stress/burnout. While unadjusted models showed marginally lower Milestones with higher impostorism, adjusted models found no significant associations.

Impostor phenomenon is common in pediatric residents. No relationship with female identity was found, but residents identifying other than binary gender reported significantly higher impostorism. Educators should reassure residents experiencing impostorism that these feelings are not reflective of competence.