Medical Students and the impostor phenomenon: a coexistence precipitated and perpetuated by the educational environment?

People who experience the impostor phenomenon have intense thoughts of fraudulence regarding their intellect or professional activities. This perception of illegitimacy leads sufferers to believe that success in their lives is attributable to some form of error. Despite the phenomenon having been thoroughly researched in a plethora of professional and educational environments, there remains a relative lack of insight into the impostor phenomenon amongst medical students. This research aimed to better understand the relationship between medical students and the impostor phenomenon, and subsequently to investigate whether their coexistence is precipitated and perpetuated by the educational environment. A cross-sectional study of medical students was conducted using a pragmatist approach, integrating quantitative and qualitative data, via a questionnaire, focus groups and interviews. The main quantitative measure used was the validated Clance Impostor Phenomenon Scale (CIPS), where higher scores indicate more marked impostor experiences. A total of 191 questionnaire responses were received, and 19 students attended a focus group or interview. The average CIPS score for the cohort was 65.81 ± 13.72, indicating that the average student had “frequent” impostor experiences. Of note, 65.4% of students were classed as having “clinically significant” impostor experiences and females scored 9.15 points higher than males on average (p < 0.0001). Examination rankings were frequently cited as a major contributing factor to students’ impostor feelings, and data revealed an increase of 1.12 points per decile that a student drops down the rankings (p < 0.05). Students’ quotes were used extensively to underpin the quantitative data presented and offer an authentic insight into their experiences. This study provides new insights and contributes to our understanding of the impostor phenomenon amongst medical students, and eight recommendations for practice are presented, which are intended to provide medical schools with opportunities for pedagogical innovation.