High Prevalence of Imposterism Among Female Harvard Medical and Dental Students
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Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 2Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 3Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 4Shapiro Institute for Education and Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 5Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA; 6Division of Renal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 7Division of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
J Gen Intern Med DOI: 10.1007/s11606-019-05441-5 © Society of General Internal Medicine 2019
between June and August 2018 using a web-based program (Qualtrics). The study was deemed exempt by the Institutional Review Boards of HMS and Massachusetts General Hospital.
IP Questionnaire igh Prevalence of Imposterism Among Female Harvard Medical and Dental Students David E. Leaf and Rebecca Karp Leaf contributed equally to this work.
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INTRODUCTION
The imposter phenomenon (IP) is a psychological construct characterized by feelings of inadequacy and an irrational fear of being discovered as a “fraud” by colleagues and superiors. IP limits performance and is associated with anxiety, burnout, and low selfesteem across multiple professions and academic spheres. First described by psychologists Clance and Imes in 1978, IP was initially found to affect high-achieving women who believed that they were not as intelligent or capable as others believed.1 There is a small literature on IP in academic medicine and dentistry; however, robust data is lacking and existing studies are limited by small sample sizes or use of non-validated survey instruments.2, 3 Here we report the largest study to date of IP among undergraduate medical and dental students, investigating risk factors for IP and focusing in particular on students with the highest levels of imposterism.
METHODS
Surveys were emailed to all Harvard Medical School (HMS) and Harvard School of Dental Medicine (HSDM) students (n = 753) Received September 7, 2019 Accepted September 26, 2019
Students were asked to complete the 20-question validated Clance Imposter Phenomenon Scale (CIPS), with responses scaled from 1 (not at all true) to 5 (very true). Higher scores on the CIPS are associated with greater feelings of imposterism. An example CIPS question is as follows: “I can give the impression that I’m more competent than I really am.” In order to emphasize those respondents with the highest degree of imposterism, we defined IP as a score of 80 or higher, which corresponds to “intense IP” in the original publication of CIPS.1
Statistical Analyses We used univariate and multivariable logistic regression to assess the association between student characteristics and IP. All comparisons were two tailed, with P < 0.05 considered significant.
RESULTS
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