Imposter Phenomenon or Perfectionism? Imposter Syndrome and Perfectionism in Plastic Surgery Training and Practice

Imposter phenomenon (IP) is reportedly high among academic plastic surgeons. The Clance IP questionnaire, assessing self-perceived inadequacy, has been critiqued for corresponding closer to perfectionism rather than imposterism. This study aimed to correct the incidence and severity of IP compared with perfectionist traits in academic plastic surgery.

The validated Clance IP questionnaire (range 0-100; higher scores indicate greater severity of IP) was distributed via the American Council of Educators in Plastic Surgery database. Clance IP questions were categorized as assessing either imposterism or perfectionism. Generalized linear regression was used to assess predictors of scores.

From 105 respondents, 46.66% were female (n = 49). The majority of respondents were attendings (69.52%, n = 73), followed by residents (22.85%, n = 24). Of questions representing true imposter traits, plastic surgery faculty and residents scored a mean of 57.33 ± 21.02, representing moderate IP and less than previously uncorrected scores. Mean true imposter scores varied by sex (60.83 ± 21.27 for women; 46.93 ± 19.17 for men) and academic position (50.09 ± 21.92 for attendings; 63.47 ± 18.03 for residents). Perfectionist scores were higher overall. They varied significantly by sex (67.50 ± 18.52 for women; 60.24 ± 16.74 for men) and position (60.40 ± 18.14 for attendings; 72.39 ± 13.74 for residents). Female residents had the highest true imposter scores (64.50 ± 18.81).

Understanding whether plastic surgery trainees and faculty truly tend toward IP is crucial to defining its overall burden and aiding in resource allocation to improve mental health across the specialty.