Is Imposter Syndrome Prevalent Among Cardiothoracic Trainees and Early Career Surgeons?

Imposter syndrome (IS), the phenomenon of feeling inadequate despite having the qualifications, accolades, and attributes to succeed, is prevalent among physicians in multiple fields. We sought to characterize the prevalence of imposter syndrome and determine its impact among cardiothoracic trainees and early-career surgeons.

A multisection survey instrument was distributed to cardiothoracic surgery trainees in the US and early career (EC) cardiothoracic surgeons within their first 7 years after training. The survey included a validated imposter phenomenon scale, instruments to measure social support, to detect burnout, and to assess symptoms of anxiety and depression. Multivariable logistic regression analysis was performed to identify characteristics associated with significant imposter syndrome. Relationships between imposter syndrome and associated conditions were explored using Pearson correlation coefficients.

A total of 1048 subjects were contacted; complete responses were received from 143 (13.6%), of which 64 (44.7%) were from trainees and 79 (55.3%) from EC surgeons. Significant imposter syndrome was present in 88 subjects (61.6%) and was more common among trainees than EC surgeons (71.9 vs. 53.2%, p = 0.01). On multivariable analysis, female gender (odds ratio (OR) 6.9, 95% CI, 2.8-19.1; p < 0.01) was predictive of clinically significant IS, while a thoracic training track (OR 0.26, 95% CI, 0.08-0.72; p = 0.03) was protective. There was a positive correlation between IS and anxiety, between IS and foregone career opportunities, and a negative correlation with social support.

Imposter syndrome, associated in particular with anxiety symptoms, was common amongst respondent cardiothoracic trainees and early career surgeons. Potential links with gender, training track, social support, and missed career opportunities were identified. Further study of IS, awareness and strategies to mitigate should be considered in cardiothoracic training.