Understanding Impostorism in the Pediatric Surgeon.

Objectives: Impostor phenomenon (IP) is defined as feeling inadequacy, self-doubt, and the tendency to attribute achievement to external causes. We sought to examine IP rates among pediatric surgeons and to identify IP-associated factors, based on the hypothesis that pediatric surgeons experience imposterism, especially in the first few years of practice.

Design: Anonymous survey, including the validated Clance IP Scale (CIPS), distributed to pediatric surgeons. CIPS scores indicated degree of IP characteristics: 21-40= "few," 41-60="moderate," 61-80="frequent," 81-100="intense." Demographic, training, and practice-based characteristics were collected. Univariate statistics were used to compare differences between groups and logistic regression to further understand associations.

Setting: Survey study distributed via email to the American Pediatric Surgical Association (January 2023-February 2023).

Participants: 1129 surveys were sent. We received 337 responses (29.8%) and analyzed data from 319 respondents, after exclusion of incomplete responses and fellows.

Results: The median CIPS score for analyzed respondents was 52 (IQR 40-65), moderate imposterism. Female respondents were more likely to have IP compared to males (OR 3.52 [CI 2.13-5.73], p < 0.01). Junior attendings (<5y practice) had increased odds of IP (OR 2.88, CI 1.71-4.93) compared to midcareer and senior attendings (p < 0.001). Using multiple logistic regression, the addition of junior attending status plus female gender was even more predictive of imposterism [AUC 0.722; CI 0.661-0.782; p < 0.0001]. There was no relationship between IP and fellowship or practice-based characteristics.

Conclusions: IP is prevalent among pediatric surgeons, particularly junior surgeons, and females. We did not find a relationship with IP and fellowship or practice-based characteristics but did find higher IP in respondents who did not feel they had support in practice. We underscore both intrapersonal and interpersonal characteristics impact IP in the pediatric surgeon. We suggest interventions that foster inclusion and mentorship be employed to help mitigate possible negative outcomes of IP.