Imposter Syndrome(IS), also called the Imposter phenomenon, was described by Clance and Imes in 1978[1, 2]. It is defined as “the inability to internalize achievement and a tendency to attribute success to external factors such as luck, error, or personal connections”[3]. People with IS struggle with accurately attributing their performance to their actual competence. The problem of accepting success often leads the individual to feel like an imposter and to get a sense of fraudulence. The pathognomonic characteristics of IS are the imposter cycle, perfectionism, superheroism, fear of failure(Atychiphobia), denial of competence, and fear of success(achievemephobia)[4]. In light of Bandura’s self-efficacy theory (i.e., The belief in one’s innate ability to achieve desired goals), IS may have devastating effects on a sufferer’s self-efficacy and personal or academic success[5, 6].
Seventy percent of people identify themselves as impostors at least once in their lives[7]. Although IS was first described in highly successful professional women, the progressively increasing literature has documented IS among men and women in every professional setting and among multiple ethnic and racial groups[8]. Although IS has been studied and reported in other disciplines, medicine has a limited grasp of IS, and the data in the field of medicine has grown slowly. However, due to high expectations and perfectionism during education and practice of medicine, those medical students, residents, physicians, and all HCPs are at considerable risk of IS[3, 9]. In addition, because of the high academic performance and the intense competition in the field of medicine, every physician, irrespective of the academic title, may experience IS more intensely. The other reasons that have been speculated are constantly evolving knowledge of medicine and the physicians’ being surrounded by intelligent and successful colleagues[10]. It may result in problems in their ability to perform in their professional roles[11].
Most of the studies in the literature have focused on early-career physicians, such as medical students and residents. However, the incidence of IS in medical professionals ranges from 22% to 70.3%[3, 8, 11-14]. There are numerous parameters defined as risk factors for IS. The gender, the training phase shift from preclinic to clinic, the difficulty of clinical learning, and competency-related factors have been associated with increased risk for IS[8, 11, 15, 16]. In addition, it is more prevalent among people transitioning into new careers[11]. However, it is a part of professional identity formation in which individuals internalize a specific profession's core values and beliefs. In terms of medical education, it is defined as “a representation of self, achieved in stages over time during which the characteristics, values, and norms of the medical profession are internalized, resulting in an individual thinking, acting, and feeling like a physician[17]. During the process of professional identity formation, in every step of medical training, the physicians experience IS due to the increasing necessity of autonomy and responsibility [18].
The IS may result in psychological distress, emotional suffering, and significant mental health issues, such as persistent dysphoric stress, anxiety, and depression[19]. In addition, it may cause low self-esteem, maladaptive perfectionism, poor sleep quality, quitting training, and suicidal ideas[13, 20]. It has also been associated with Burnout(BO), characterized by the emotional exhaustion of individuals in their careers, depersonalization toward other individuals, and a decrease in the sense of personal accomplishments[21]. The BO is a critical issue in health care professionals caring for cancer patients. The frequency of BO in medical oncologists (MOs) ranges from 32% to 86%[22, 23]. In the literature, the MOs who are younger, female, and unmarried are more prone to BO. High mortality rates and a higher number of cancer patients are important risk factors for BO[22, 24]. The increased risk of BO in physicians with IS has been reported [25]. However, no data in the literature evaluating the impact of IS in MO on BO exists.
The IS has been primarily studied in medical students and residents in the medical profession. The risk factors and clinical impacts on these early career physicians have been partially understood. However, the issues specific to more senior physicians, in whom different dynamics are present, have not been studied. As a subspecialty of internal medicine, medical oncology has a long educational process. It takes approximately 12-14 years to be a MO. In internal residency and fellowship, the candidates start new careers, and a new learning process begins in those new steps. In addition, further positions in academia may increase the risk of IS in MOs. The clinical indicators and outcomes of IS in MOs have not been studied in the literature. The study aimed to evaluate the factors associated with IS and its association with BO in MOs.