To the Editor:
Recent reviews 1,2 have summarized evidence on impostor syndrome among physicians, highlighting its negative consequences and revealing the limited data addressing its presence among minority physicians. Because of the minority tax and systems of privilege, 3 we believe impostor syndrome disproportionately affects minority physicians.
To date, systematic investigations of impostor syndrome have been minimal not only among minority physicians but also among physicians in general. One group 4 analyzed it among physicians at a single medical school, but did not compare the impact on professional outcomes among minority faculty with that impact among nonminority faculty. Meanwhile, various studies 5 have described inequitable professional outcomes between minority and nonminority faculty in academic medicine, but did not quantify impostor syndrome as a contributing factor. We suspect that this syndrome is, indeed, a contributing factor, which may help explain why the numbers of Black, Latinx, American Indian/Alaska Native, and Native Hawaiian/Other Pacific Islander faculty remain low in academic medicine. 6
Several reasons appear to explain why impostor syndrome has not been quantified as a contributing factor. First, studies have predominantly relied on the Clance Impostor Phenomenon Scale, seldom used in studies of physicians’ professional outcomes. Second, many studies have used small convenience samples, precluding stratification of results by race or ethnicity. Third, impostor syndrome is not routinely assessed by medical schools or societies.
To overcome these limitations, we recommend that future investigations refine their measurements to use short, validated questionnaires integrated with routine institutional data collection. We further recommend a sufficient sample size to permit subanalysis of data about minority groups. Last, we hope that more widespread research will help identify strategies that are protective against impostor syndrome’s ill effects for all faculty.
1. Bravata DM, Watts SA, Keefer AL, et al. Prevalence, predictors, and treatment of impostor syndrome: A systematic review. J Gen Intern Med. 2020;35:1252–1275.
2. Gottlieb M, Chung A, Battaglioli N, Sebok-Syer SS, Kalantari A. Impostor syndrome among physicians and physicians in training: A scoping review. Med Educ. 2020;54:116–124.
3. Rodriguez JE, Campbell KM, Pololi LH. Addressing disparities in academic medicine: What of the minority tax? BMC Med Educ. 2015;15:6.
4. Hutchins HM, Rainbolt H. What triggers imposter phenomenon among academic faculty? A critical incident study exploring antecedents, coping, and development opportunities. Hum Res Dev Int. 2017;20:194–214.
5. Pololi LH, Evans AT, Gibbs BK, Krupat E, Brennan RT, Civian JT. The experience of minority faculty who are underrepresented in medicine, at 26 representative U.S. medical schools. Acad Med. 2013;88:1308–1314.
6. Hassouneh D, Lutz KF, Beckett AK, Junkins EP, Horton LL. The experiences of underrepresented minority faculty in schools of medicine. Med Educ Online. 2014;19:24768.