A Qualitative Study of the Imposter Phenomenon in Emergency Medicine Residents

Imposter Phenomenon (IP), characterized by feelings of self-doubt and fear of being exposed as a fraud, is common among physicians and has been associated with burnout, anxiety, and suicidal ideation. Although IP has been studied in trainees in other fields of medicine, it has not yet been explored specifically in Emergency Medicine (EM) residents, whose unique role in the medical system may predispose them to IP feelings. To better understand the IP experience in EM trainees, this qualitative study explored IP in EM residents with high IP scores.

A convenience sample of EM residents from a single academic institution was recruited based on Clance Imposter Phenomenon Score (CIPS) >60. Qualitative data were generated through one-on-one semi-structured interviews, and key themes were identified using reflexive thematic analysis.

Eleven residents participated in the study. Analysis revealed three major categories of themes: (1) roots of IP included early training experiences, social comparison, and a mismatch between self-perception and objective performance; (2) effects of IP included self-doubt, expectation, variations over time, and positive impacts; and (3) mitigators of IP included acknowledgment and destigmatization, self-reflection, structured feedback, and peer support systems.

This qualitative study identified themes related to the experience of IP in EM residents. Findings suggest that targeted interventions, such as specialty-specific preparatory courses, reflective practices, improved feedback, and fostering supportive residency cultures, may help mitigate IP's negative effects. These insights can inform efforts to address IP in EM trainees.