Abstract
The imposter phenomenon, or imposter syndrome, is defined as an internal experience of feeling like an intellectual fraud, despite external evidence of an individual's accomplishments, and results in an inability to internalise a sense of success. It is common among high-achieving people, and appears to be more common in women and ethnic minorities. In this chapter, a systematic review of the literature will be presented on imposter syndrome in the medical profession. Topics covered include purported aetiology, implications (including the impact on mental health and career progression), limitations of research, potential coping strategies, and avenues for future research.
TopBackground
IP was first noticed during psychotherapeutic sessions with high-achieving women (Clance & Imes, 1978). It has since been described extensively in adolescents (Sakulku & Alexander, 2011), teachers, accountants (Byrnes & Lester, 2016), business professionals (Fried-Buchalter, 1992), and nurses (Christensen et al., 2016), but it is less well researched among doctors. Many doctors and medical students have described the syndrome anecdotally (Koven, 2017; Russell, 2017; “Simon Gilbody: The importance of being active,” 2017; Smith, 2003).
IP is increasingly being cited as a causative factor in the lack of women in senior leadership positions in the health services, to the extent that the Health and Care Women Leaders Network held a “tweetchat” (open online conversation on the social media platform Twitter) on the subject in March 2018 (Health & Care Women Leaders Network, 2018), with individuals sharing their experiences and advice on the topic using the hashtags (metadata tags) #ImposterSyndrome and #NHSwomen. Quotations from the tweetchat will be included in this chapter to illustrate how IP affects real people.
I have often felt that some success has been down to luck (right place/right time)… it’s difficult to shake, however, luck only gets you so far – the rest is down to you. The gremlins push me to be better, learn & improve! (he_reeves, 2018)
Key Terms in this Chapter
Micro-aggression: Subtle discriminatory actions and behaviours, both intentional and unintentional, that can accumulate over time, producing negative consequences.
Hashtag: Metadata tag on social media to link discussions according to topic.
Tweetchat: An open online conversation on the social media platform Twitter.
Conscientiousness: A measure of self-discipline, organisation, and a preference for planning.
Big Five Personality Traits: Otherwise known as the five-factor model. A classification system for personality traits based on factor analysis, which recognises five broad dimensions most often used to describe the human personality: neuroticism, conscientiousness, openness to experience, extraversion, and agreeableness.
Mindfulness: Being aware of present-moment experiences with a mental stance of receptivity and non-judgment.
Imposter syndrome: An internal experience of feeling like an intellectual fraud, despite external evidence of an individual’s accomplishments, and an inability to internalise a sense of success.
Active Coping: Being aware of a stressor, and attempting to reduce the negative outcome.
Neuroticism: A measure of one’s tendency towards negative emotions, including anxiety and depression.
Avoidant coping: Ignoring the stressor, and attempting to stay in denial.