Risk factors
Studies suggest that IS is a problem early in the physician training process. There is limited information on IS among physicians in practice.
Because transitions represent a risk factor for IP, the frequent rotation between clerkships and being a “perpetual novice” during medical school training may contribute to the high prevalence. Qualitative studies suggest that, once in practice, other professional experiences (for example, unfavorable patient outcomes, patient complaints, rejection of grants or manuscripts, and poor teaching evaluations or patient satisfaction scores) may contribute to IP.
Impact on doctors
Several methods have been used to classify how much the phenomenon interferes with a person’s life. The Clance Impostor Phenomenon Scale is a 20-item scale that asks respondents to indicate how well each item characterizes their experience on a 5-point scale. Options range from “not at all” to “very true.” The sum of responses to the individual items is used to create an aggregate score (IP score). The higher the score, the more frequently and seriously IP interferes with a person’s life.
A simplified version of the IP score was used in a study of 3,237 U.S. doctors that investigated the association between IS and burnout among doctors and to compare their rates of IS with those of other professionals.
Mean IP scores were higher for female physicians than for male physicians (mean, 10.91 vs. 9.12; P < .001). Scores decreased with age and were lower among those who were married or widowed.
With respect to professional characteristics, IP scores were greater among those in academic practice or who worked in the Veterans Affairs medical system and decreased with years in practice.
The highest IP scores were among pediatric subspecialists, general pediatricians, and emergency medicine physicians. Scores were lowest among ophthalmologists, radiologists, and orthopedic surgeons. IP has been independently associated with the risk of burnout and low professional fulfillment.
Lessening the impact
An article commenting on the study highlighted the following expert practice strategies that doctors can use to reduce the impact of IS in their professional life.
- Review and celebrate feats that have led to your professional role.
- Share concerns with trusted colleagues who can validate your accomplishments and normalize your feelings by reporting their own struggles with IS.
- Combat perfectionism by accepting that it is okay to be good enough when meeting the challenges of a demanding profession.
- Exercise self-compassion as an alternative to relying on an external locus of self-worth.
- Understand that IS may be common, especially during transitions, such as when entering medical school, graduate medical training, or starting a new career.
This article was translated from Univadis Italy. A version appeared on Medscape.com.