What is Imposter Syndrome?
Impostor syndrome is a psychological pattern of successful individuals attributing their achievements to luck, rather than their own intellect, performance, and skill.1-5 High-performing individuals feel like they are “impostors,” in their current positions and stress about being discovered as a fraud.1,2 People who experience impostor syndrome doubt their knowledge, competence, and abilities.1
Do pharmacy residents experience imposter syndrome?
The literature has consistently shown that pharmacy students and residents experience imposter syndrome. A study by Medina et al. demonstrated that impostor syndrome was common among pharmacy students and highlighted that it does not discriminate by education, age, gender, race/ethnicity, or year in school.3 In another study surveying pharmacy residents, the prevalence of imposter syndrome was significantly higher than other comparable groups.2
How does imposter syndrome present in a pharmacy resident?
Residents with imposter syndrome may display the following characteristics and behaviors while on rotations:
- Low Self-Confidence
- Delays in patient care because they second-guess their clinical judgement or feel paralyzed completing routine tasks.
- Little to no participation in topic discussions because they do not want to embarrass themselves or they feel they do not know enough about the topic. 1
- Working hours beyond a normal resident due to inefficiency from second-guessing themselves or questioning their work.
- Working hours beyond a normal resident due to perfectionism that stems from the fear of their preceptor discovering them as a fraud.
- A resident becoming alarmingly close to the duty hour maximum. They work harder to bridge the perceived gap in abilities.2
- Low Self-Esteem
- Constant apologizing for asking a question or needing assistance with a task.
- Unable to accept and fully believe praise due to their negative self-image.1
- Suffering Mental Health
- Anxious appearing.
- Easily progress to tearfulness when receiving positive or constructive feedback. When receiving positive feedback, the tears reflect relief. When receiving constructive feedback, the tears reflect fear and disappointment.
How to identify imposter syndrome in a resident?
Residency Program Directors or Resident Mentors can ask the pharmacy resident to complete a Clance IP Scale (CIPS) Questionnaire. The CIPS Questionnaire is a validated 20-point Likert scale questionnaire used to assess the presence of imposter syndrome characteristics and the extent to which the individual is suffering.4,5 Total scores are added and categorized into “few” (≤40), “moderate” (41-60), “frequent” (61-80), or “intense” (>80). The higher the score, the more likely imposter syndrome interferes with the resident’s performance.4,5
The Clance IP Scale Questionnaire can be found here: https://paulineroseclance.com/pdf/IPTestandscoring.pdf
How to help residents struggling with imposter syndrome?
- Ask them to confide in a pharmacy staff member whom they trust. (Ex. Resident Mentor).1
- Setup additional training time for specific tasks to reinforce concepts and boost their confidence.
- Encourage preceptors to work side-by-side with the resident to provide, 1) positive reinforcement of a task done well, 2) quick identification of when the resident needs more support, 3) tips for improved workflow and efficiency.
- Consider a referral to your company’s “Employee Assistance Program”
- Nurture the resident in recognizing their success by having them self-reflect on positive performance for the day. Discourage any negative self-talk and have them practice active listening during moments of praise.1
- Consider having the resident mentor a student or intern. They will realize they have knowledge to share and discover some of their strengths during the process. Mentoring someone is also very empowering.1
Have any of your residents suffered from imposter syndrome? As RPD or preceptor, how did you intervene and get them back on track? Please share your experience.
- Dymala K. How to Overcome Imposter Syndrome in Pharmacy. Pharmacy Times [Internet]. 2022 May [cited 2022 November 7]. Available from: https://www.pharmacytimes.com/view/how-to-overcome-imposter-syndrome-in-pharmacy
- Sullivan JB, Ryba NL. Prevalence of impostor phenomenon and assessment of well-being in pharmacy residents. Am J Health Syst Pharm. 2020 Apr 27;77(9):690-696. doi: 10.1093/ajhp/zxaa041. PMID: 32201891.
- Medina M, Maerten-Rivera J, Zhao Y, Henson B. Impostor Phenomenon in Undergraduates and Pharmacy Students at a Small Private University. American Am. J. Pharm. https://www.ajpe.org/content/early/2022/01/13/ajpe8672. Published January 1, 2022. Accessed November 7, 2022.
- Clance PR. The Impostor Phenomenon: When Success Makes You Feel Like a Fake. Toronto: Bantam Books; 1985.
- Holmes SW, Kertay L, Adamson LB, et al. Measuring the impostor phenomenon: a comparison of Clance’s IP scale and Harvey’s I-P scale. J Pers Assess. 1993;60(1):48-59.