Exploring reasons for MD-PhD trainees’ experiences of impostor phenomenon

Abstract

Background Acceptance into U.S. MD-PhD dual-degree programs is highly competitive, and the lengthy training program requires transitioning between multiple phases (pre-clinical-, PhD-research-, and clinical-training phases), which can be stressful. Challenges faced during MD-PhD training could exacerbate self-doubt and anxiety. Impostor phenomenon is the experience of feeling like a fraud, with some high-achieving, competent individuals attributing their successes to luck or other factors rather than their own ability and hard work. To our knowledge, impostor phenomenon among MD-PhD trainees has not been described. This study examined impostor phenomenon experiences during MD-PhD training and reasons trainees attributed to these feelings. Methods Individuals in science and medicine fields participated in an online survey that included the 20-item Clance Impostor Phenomenon Scale (CIPS); higher scores (range 20–100) indicate more frequent impostor phenomenon. Some respondents who reported experiencing impostor phenomenon also voluntarily completed a semi-structured interview, sharing experiences during training that contributed to feelings of impostor phenomenon. Interview transcripts were coded and analysed using the constant comparative method and analytic induction to identify themes. Results Of 959 survey respondents (students and professionals in science and medicine), 13 MD-PhD students and residents completed the survey, nine of whom (five male, four female; four white, five other race-ethnicity) also completed an interview. These participants experienced moderate-to-intense scores on the CIPS (range: 46–96). Four themes emerged from the interview narratives that described participants’ experiences of IP: professional identity formation, fear of evaluation, minority status, and, program-transition experiences. All reported struggling to develop a physician-scientist identity and lacking a sense of belonging in medicine or research. Conclusions Impostor experiences that MD-PhD participants attributed to bias and micro-aggressions in social interactions with peers, faculty, and patients challenged their professional identity formation as physician-scientists. It is important to further examine how MD-PhD-program structures, cultures, and social interactions can lead to feelings of alienation and experiences of impostor phenomenon, particularly for students from diverse and underrepresented populations in medicine.

Healthcare professionals’ perception of their working environment and how to handle mental strain

“…Receiving or giving feedback is sometimes felt as personal critique and this makes HCP feel sad/miserably, examples in the interview show this. This is in agreement with the educational literature concerning feedback to trainees 19–21 . It implies that training in how to provide feedback and structure the conversations with colleagues could be improved.…”

Faculty Experiences of the Impostor Phenomenon in STEM Fields

“…, 2015 ; Chakraverty et al. , 2018 , 2022 ). Mentorship support could be especially valuable for women in improving their retention and advancement, providing scholarly support (e.g., in grant writing), reducing isolation through informational and psychosocial support ( Chesler et al.…”

“…Recent research has focused on the environmental contributors such as workplace harassment ( Chakraverty and Rishi, 2022 ); racial discrimination ( Bernard et al. , 2018 ; Chakraverty, 2020a , 2022a , b , c ); hypercompetitive learning environments ( Canning et al. , 2020 ); and the underrepresentation of women, first-generation learners, and scholars of color in academia ( Pulliam and Gonzalez, 2018 ; Stone et al.…”

“…, 2019 ), racial and/or ethnic minorities ( Stone et al. , 2018 ; Chakraverty, 2020a , 2022a , b ), first-generation learners ( Pulliam and Gonzalez, 2018 ; Canning et al. , 2020 ), undergraduate students ( Aycock et al.…”

“…Impostor phenomenon could be closely tied to identity development ( Clance and Imes, 1978 ; Bernard et al. , 2018 ; Chakraverty, 2019 ; Chakraverty et al. , 2022 ) and how faculty conduct themselves in their careers ( Hutchins and Rainbolt, 2017 ).…”