Learning from the past: medical school experiences predict meaning in work and imposter phenomenon among residents

Efforts to bolster resident well-being may benefit from exploration of how medical education experiences shape residents' mindsets as they transition to residency. The current study aimed to determine whether perceived psychological safety and exposure to negative aspects of the hidden curriculum during medical school predicted meaning in work and imposter phenomenon among medical residents entering into their new programs. A subset of participants (n = 297) in a multi-institutional survey of incoming residents (N = 1,674; response rate = 79.9%) were randomly assigned to complete the module assessing their perceptions of both positive and negative medical school experiences (i.e. psychological safety and hidden curriculum exposure) as well as their current feelings about themselves and their work (i.e. meaning in work and imposter phenomenon). Data collection took place during the summer of 2022. Linear regression models indicate that perceptions of psychological safety during the last 2 years of medical school were positively associated with meaning in work and negatively associated with imposter phenomenon among incoming residents. Linear regression models further indicate that perceptions of exposure to negative aspects of the hidden curriculum predicted imposter phenomenon, whereas no link was observed between exposure to the hidden curriculum and meaning in work. These data highlight how perceptions of medical school may influence the mindset of medical residents as they transition to residency. Next steps include exploring potential causal linkages among these variables and expanding the scope and operationalization of psychological states and experiences considered across time points during the medical training journey.