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Everything you need to know about THE IMPOSTER SYNDROME

According to Pauline Rose Clance, in 1985, "Imposter phenomenon has been defined as an internal experience of intellectual phoniness marked by the inability of an individual to internalize professional successful experiences despite having objective evidence of such achievements." Addressing the concept of Imposter Phenomenon is more important now than ever, as apart from the pool of research conducted in the West that vouch for its prevalence in medical students, is the fact that in the light of the Covid-19 pandemic, medical students, especially in the final years of their medical education have been devoid of hands on medical posting experiences which may sow the seeds of this phenomenon.

Statistics to prove the prevalence of Imposter Syndrome amongst medical students

In a study of 477 medical, dental, nursing, and pharmacy students, it was found by Henning et al that the prevalence of Imposter Syndrome was 30%. While Oriel et al. in 2004 surveyed 255 family medicine residents and found that about one-third had Imposter Syndrome. Qureshi et al. in the year 2016, conducted a study to analyse the prevalence of Imposter Syndrome, amongst medical students in Lahore. The study sample consisted of 143 MBBS students in their final year of medical school. The results suggested that out of the study sample, 47.5 percent of students were found to have imposter tendencies.

While these studies reflect the findings from other countries, a study on similar lines was conducted in India, by D’Souza and Bicholkar in 2018.The study sample consisted of 150 medical interns from a medical college in Goa. The results indicated that out of the study population, 41.3 % showed high imposter characteristics, followed by 44.7 % who showed moderate imposter characteristics. This being a study from India, echoes the importance of studying this phenomenon and how its roots spread out into affecting self esteem.

The Imposter Cycle

by Pauline Rose Clance (1985)

  1. The cycle of imposter phenomenon begins with the assignment of an achievement- oriented task, such as a college test or a project in the job firm. Individuals with imposter characteristics develop anxiety related to these tasks.

  2. As a reaction to this anxiety, these individuals may proceed to either over prepare or initiate procrastination which is succeeded by a frantic preparation.

  3. After the completion of the task, there is a short lived sense of accomplishment.

  4. Although they receive good grades or a positive feedback on their work, individuals with imposter tendencies attribute the cause of the positive result to outside forces and not their own competence, while rejecting positive messages about their hard work.

  5. The ones who over-prepare initially tend to be in the imposter cycle when the task at hand and the efforts invested are not in tandem, their ideal results and the results received are never in concordance, while the ones who procrastinate initially get into the imposter cycle as they attribute most of their success to luck.

  6. These factors, reinforce and maintain their feelings of perceived fraudulence, self doubt and anxiety, and gets reflected onto the next achievement related task, and the cycle follows (Clance 1985; Thompson et al., 2000; Casselman, 1991; Clance & Imes, 1978 as cited in Sakulku & Alexander,2011)

Diagram illustrating the Impostor Cycle based on Clance (1985). The cycle begins with the assignment of achievement related tasks.

Five types of Imposters:

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  • The Perfectionist’s primary focus is on “how” something is done. This includes how the work is conducted and how it turns out. One minor flaw in an otherwise stellar performance or 99 out of 100 equals failure and thus shame.

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  • The Expert is the knowledge version of the Perfectionist. Here, the primary concern is on “what” and “how much” you know or can do. Because you expect to know everything, even a minor lack of knowledge denotes failure and shame.

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  • The Soloist cares mostly about “who” completes the task. To make it on the achievement list, it has to be you and you alone. Because you think you need to do and figure out everything on your own, needing help is a sign of failure that evokes shame.

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  • The Natural Genius also cares about “how” and “when” accomplishments happen. But for you, competence is measured in terms of ease and speed. The fact that you have to struggle to master a subject or skill or that you’re not able to bang out your masterpiece on the first try equals failure which evokes shame.

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  • The Superwoman/Superman/Super Student measures competence based on “how many” roles they can both juggle and excel in. Falling short in any role — as a parent, partner, on the home-front, host/hostess, friend, volunteer — all evoke shame because they feel they should be able to handle it all — perfectly and easily.

How to Manage Imposter Feelings:

  1. Break the silence. Shame keeps a lot of people from “fessing up” about their fraudulent feelings. Knowing there’s a name for these feelings and that you are not alone can be tremendously freeing.

  2. Separate feelings from fact. There are times you’ll feel stupid. It happens to everyone from time to time. Realize that just because you may feel stupid, doesn’t mean you are.

  3. Recognize when you should feel fraudulent. A sense of belonging fosters confidence. If you’re the only or one of a few people in a meeting, classroom, field, or workplace who look or sound like you or are much older or younger,of a certain gender, race or colour, then it’s only natural you’d sometimes feel like you don’t totally fit in. Instead of taking your self-doubt as a sign of your inability, recognize that it might be a normal response to being on the receiving end of social stereotypes about competence and intelligence.

  4. Accentuate the positive. The good news is being a perfectionist means you care deeply about the quality of your work. The key is to continue to strive for excellence when it matters most, but do forgive yourself for the mistakes, after all you are only human.

  5. Develop a healthy response to failure and mistake making. Henry Ford once said, “Failure is only the opportunity to begin again more intelligently.” Instead of beating yourself up for falling short, do what players on the losing sports team do and glean the learning value from the loss and move on reminding yourself, “I’ll get ’em next time.”

  6. Develop a new script. Become consciously aware of the conversation going on in your head when you’re in a situation that triggers your Impostor feelings. This is your internal script.

  7. Visualize success. Do what professional athletes do. Spend time beforehand picturing yourself making a successful presentation or calmly posing your question in class.

  8. Reward yourself. Break the cycle of continually seeking and then dismissing validation outside of yourself by learning to pat yourself on the back.


Clance, P. (2013). Dr. Pauline Rose Clance - Imposter Phenomenon. Retrieved from

Henning, K., Ey, S., & Shaw, D. (1998). Perfectionism, the impostor phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students. Medical education, 32(5), 456-464.

Mascarenhas, V. R., D’Souza, D., & Bicholkar, A. (2019). Prevalence of impostor phenomenon and its association with self-esteem among medical interns in Goa, India. Int J Community Med Public Health, 6(1), 355-359.

Oriel, K., Plane, M. B., & Mundt, M. (2004). Family medicine residents and the impostor phenomenon. FAMILY MEDICINE-KANSAS CITY-, 36(4), 248-252.


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