Should Medical Educators Help Learners Reframe Imposterism?

Abstract

Issue: Impostor syndrome, impostor phenomenon, or imposterism, is a very common, likely ubiquitous, psychological construct in the general population and certainly among health care providers. It has been the subject of many, mostly descriptive, articles and blogs in the medical literature as well as in the lay press and on social media. Evidence: Imposterism has been associated with, but not demonstrated to be causative of, psychological conditions including stress, shame, guilt, and burnout, and behaviors such as “hiding out,” which impede career development. The authors argue that to avoid these more serious potential manifestations of imposterism, the approach to imposterism should be reframed, and medical students, residents, and physicians should be helped to view episodic feelings of imposterism as appropriate situational responses. Implications: As feelings of imposterism are virtually universal for those on the journey from medical/graduate student through practicing physician/scientist, handling them appropriately could hopefully channel them into positive responses that mitigate potential psychological and behavioral consequences and improve emotional health.

Keywords:

• Imposter syndrome
• impostor phenomenon
• imposterism
• humility
• perfectionism

Notes

* Authors’ note: we are using BAFI in a broad way, to include both psychological conditions and behaviors. Some of the former, e.g., burnout, anxiety, depression are clearly quite serious. Our goal in using BAFI in this broad way is to accept that, while causation between imposterism and these manifestations has not been formally established, the probability of some degree of causation is high. Our hope is that by assisting people in handling the feelings of imposterism which they are almost guaranteed to encounter along the journey, we might be able to mitigate the risk of BAFI, especially the most serious.