Imposter Syndrome Among Orthopaedic Surgery Residents is Extremely Common and Disproportionately Affects Female Residents.

Abstract

Introduction: Imposter syndrome is a psychological phenomenon in which individuals experience persistent self-doubt and feelings of inadequacy despite achieving objective measures of success. This phenomenon is associated with lower job satisfaction, increased rates of burnout, and reduced productivity. Therefore, the purpose of this study was to determine the prevalence of imposter syndrome among orthopaedic surgery residents and determine whether specific individual or residency characteristics predict higher rates of imposter syndrome.

Methods: An anonymous survey was distributed to residents at 7 ACGME-accredited orthopaedic surgery residencies. Respondents provided deidentified demographic data and completed the Clance Imposter Phenomenon Scale (CIPS) assessment. CIPS scores were used to categorize imposter syndrome severity as none to mild, moderate, significant, or intense. Differences were calculated and compared using t-test and χ² analyses. Multivariable regression analysis was used to identify predictors of increased symptom severity.

Results: One hundred orthopaedic surgery residents completed the survey. Forty percent of respondents were female, and the mean age was 30.6 ± 2.8 years. The prevalence of significant or intense imposter syndrome was 73%. CIPS scores and significant or intense imposter syndrome did not vary by age, gender, sexual orientation, race/ethnicity, level of training, program region, research year, non-MD degrees, and Step 1, Step 2, or Orthopaedic In-Training Examination (OITE) scores on univariable analyses. On multivariable analysis, female residents were 5.64 (OR = 5.64 [1.04-30.63]) times more likely to have significant or intense imposter syndrome (p = 0.045). Residents at western programs were 0.13 (OR = 0.13 [0.02-0.90]) times as likely to experience significant or intense imposter syndrome (p = 0.039). In addition, women (estimate = 8.72 [1.41-16.04]; p = 0.0201) and those with OITE scores in the 0 to 25th (estimate = 11.92 [0.29-23.54]; p = 0.0446) and 51st-75th (estimate = 12.73 [2.79-22.67]; p = 0.0128) percentiles had higher CIPS scores.

Conclusions: Imposter syndrome is common among orthopaedic surgery residents, with 73% experiencing significant or intense symptoms. Female gender, lower OITE scores, and training in nonwestern regions predicted increased imposter syndrome severity. Targeted programs may help reduce burnout and improve career satisfaction and advancement.