Skip to main content
SpringerLink
Log in

Understanding and Overcoming the Psychological Barriers to Diversity: Imposter Syndrome and Stereotype Threat

  • Published:
Current Otorhinolaryngology Reports Aims and scope Submit manuscript

A Correction to this article was published on 11 May 2023

This article has been updated

Abstract

Purpose of Review

To define and describe imposter syndrome and stereotype threat with a focus on otolaryngology trainees and faculty. To describe how imposter syndrome and stereotype threat are detrimental to career advancement within otolaryngology. To identify individual, departmental, and systemic health system strategies to mitigate the effects of imposter syndrome and stereotype threat.

Recent Findings

Imposter syndrome can affect anyone but disproportionately affects women, underrepresented minorities, and trainees or early career faculty. In a similar way, stereotype threat can derail advancement opportunities and disproportionately affects certain groups within otolaryngology. Helpful mitigation strategies have been described in the literature and are more effective when individual, departmental, and systemic approaches are combined.

Summary

Self-development and joy in work rely on a positive, inclusive work environment. Mitigating burnout and stress includes addressing imposter syndrome and stereotype threat within otolaryngology, especially among groups that are more susceptible to these hindrances.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Change history

References

Papers of particular interest, published recently, have been highlighted as: •  Of importance •• Of major importance

  1. Clance PR, Imes SA. The impostor phenomenon in high-achieving women: dynamics and therapeutic intervention. Psychotherapy: Theory, Research and Practice. 1978;15(3):241–7.

  2. Leary MR, Patton KM, Orlando AE, Funk WW. The impostor phenomenon: self-perceptions, reflected appraisals, and interpersonal strategies. J Pers. 2000;68(4):725–56.

    Article  CAS  PubMed  Google Scholar 

  3. •• Shanafelt TD, Dyrbye LN, Sinsky C, Trockel M, Makowski MS, Tutty M, et al. Imposter phenomenon in US physicians relative to the US working population. Mayo Clin Proc. 2022;97(11):1981–93. This study demonstrated that physicians have increased disappointment in their accomplishments compared to workers in other fields, and that imposterism among physicians leads to increased burnout, increased suicidal ideation, and lower professional fulfillment.

  4. Villwock JA, Sobin LB, Koester LA, Harris TM. Impostor syndrome and burnout among American medical students: a pilot study. Int J Med Educ. 2016;7:364–9.

    Article  PubMed  PubMed Central  Google Scholar 

  5. • Medline A, Grissom H, Guisse NF, Kravets V, Hobson S, Samora JB, et al. From self-efficacy to imposter syndrome: the intrapersonal traits of surgeons. J Am Acad Orthop Surg Glob Res Rev. 2022;6(4). This study specifically evaluated surgeon’s levels of imposter syndrome, perfectionism, and assertiveness, and demonstrated that women and younger age were associated with higher levels of imposter syndrome and less assertiveness.

  6. •• Bravata DM, Watts SA, Keefer AL, Madhusudhan DK, Taylor KT, Clark DM, et al. Prevalence, predictors, and treatment of impostor syndrome: a systematic review. J Gen Intern Med. 2020;35(4):1252–75. This systematic review of imposter syndrome publications describes variable prevalence rates, but associates imposter syndrome with anxiety, depression, burnout, and impaired job performance.

  7. Deshmukh S, Shmelev K, Vassiliades L, Kurumety S, Agarwal G, Horowitz JM. Imposter phenomenon in radiology: incidence, intervention, and impact on wellness. Clin Imaging. 2022;82:94–9.

    Article  PubMed  Google Scholar 

  8. Liu RQ, Davidson J, Van Hooren TA, Van Koughnett JAM, Jones S, Ott MC. Impostorism and anxiety contribute to burnout among resident physicians. Med Teach. 2022;44(7):758–64.

    Article  PubMed  Google Scholar 

  9. Lin E, Crijns TJ, Ring D, Jayakumar P, The science of variation G. Imposter syndrome among surgeons is associated with intolerance of uncertainty and lower confidence in problem solving. Clin Orthop Relat Res. 2022.

  10. Freeman J, Peisah C. Imposter syndrome in doctors beyond training: a narrative review. Australas Psychiatry. 2022;30(1):49–54.

    Article  PubMed  Google Scholar 

  11. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York, NY, Springer Publishing Company, 1984.

  12. Steele CM. A threat in the air. How stereotypes shape intellectual identity and performance. Am Psychol. 1997;52(6):613–29.

  13. Shapiro JR, Neuberg SL. From stereotype threat to stereotype threats: implications of a multi-threat framework for causes, moderators, mediators, consequences, and interventions. Pers Soc Psychol Rev. 2007;11(2):107–30.

    Article  PubMed  Google Scholar 

  14. Milam LA, Cohen GL, Mueller C, Salles A. Stereotype threat and working memory among surgical residents. Am J Surg. 2018;216(4):824–9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. • Myers SP, Dasari M, Brown JB, Lumpkin ST, Neal MD, Abebe KZ, et al. Effects of gender bias and stereotypes in surgical training: a randomized clinical trial. JAMA Surg. 2020;155(7):552–60. Findings from this randomized clinical trial suggest that perception of pro-male bias increases career engagement among male surgical trainees but has no effect among female trainees. In addition, female surgical trainees with higher susceptibility to stereotype threat demonstrated decreased surgical skill performance when exposed to the threat trigger.

  16. • Trevino R, Poitevien P. Professional identity formation for underrepresented in medicine learners. Curr Probl Pediatr Adolesc Health Care. 2021;51(10):101091. This study presents evidence based strategies to address professional identity formation among underrepresented in medicine trainees.

  17. Burgess DJ, Joseph A, van Ryn M, Carnes M. Does stereotype threat affect women in academic medicine? Acad Med. 2012;87(4):506–12.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Fassiotto M, Hamel EO, Ku M, Correll S, Grewal D, Lavori P, et al. Women in academic medicine: measuring stereotype threat among junior faculty. J Womens Health (Larchmt). 2016;25(3):292–8.

    Article  PubMed  Google Scholar 

  19. Pronin E, Steele CM, Ross L. Identity bifurcation in response to stereotype threat: women and mathematics. J Exp Soc Psychol. 2004;40(2):152–68.

    Article  Google Scholar 

  20. Folkman S, Lazarus RS, Dunkel-Schetter C, DeLongis A, Gruen RJ. Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes. J Pers Soc Psychol. 1986;50(5):992–1003.

    Article  CAS  PubMed  Google Scholar 

  21. Folkman S, Moskowitz JT. Coping: pitfalls and promise. Annu Rev Psychol. 2004;55:745–74.

    Article  PubMed  Google Scholar 

  22. Mullangi S, Jagsi R. Imposter syndrome: treat the cause, not the symptom. JAMA. 2019;322(5):403–4.

    Article  PubMed  Google Scholar 

  23. Bell CM, Vest TA, White SJ. Dealing with doubt: overcoming impostor syndrome in new practitioners. Am J Health Syst Pharm. 2022;79(6):421–3.

    Article  PubMed  Google Scholar 

  24. Cader FA, Gupta A, Han JK, Ibrahim NE, Lundberg GP, Mohamed A, et al. How feeling like an imposter can impede your success. JACC Case Rep. 2021;3(2):347–9.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Cole TR, Carlin N. The suffering of physicians. Lancet. 2009;374(9699):1414–5.

    Article  PubMed  Google Scholar 

  26. Friedlaender GE. CORR Insights(R): Imposter syndrome among surgeons is associated with intolerance of uncertainty and lower confidence in problem solving. Clin Orthop Relat Res. 2022.

  27. Young V. Impostor syndrome institute. Resources 2023. Available from: https://impostorsyndrome.com/resources/infographics/.

  28. • Hutchison K. Four types of gender bias affecting women surgeons and their cumulative impact. J Med Ethics. 2020;46(4):236–41. This study describes how four types of gender bias (work conditions, career progression, climate, and work spaces) affect women surgeons.

  29. Bullock JL, Lockspeiser T, Del Pino-Jones A, Richards R, Teherani A, Hauer KE. They don't see a lot of people my color: a mixed methods study of racial/ethnic stereotype threat among medical students on core clerkships. Acad Med. 2020;95(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 59th Annual Research in Medical Education Presentations):S58–S66.

  30. Acker R, Healy MG, Vanderkruik R, Petrusa E, McKinley S, Phitayakorn R. Finding my people: effects of student identity and vulnerability to stereotype threat on sense of belonging in surgery. Am J Surg. 2022;224(1 Pt B):384–90.

  31. Sharp S, Hixson A, Stumpff J, Williamson F. Understanding the experiences of Black women medical students and residents: a narrative review. Front Public Health. 2022;10:879135.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Dunning D. The Dunning-Kruger effect: on being ignorant of one’s own ignorance. Adv Exp Soc Psychol. 2011;44:247–96.

    Article  Google Scholar 

  33. Mehdizadeh L, Sturrock A, Myers G, Khatib Y, Dacre J. How well do doctors think they perform on the General Medical Council’s Tests of Competence pilot examinations? A cross-sectional study. BMJ Open. 2014;4(2):e004131.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Cokley K, Smith L, Bernard D, Hurst A, Jackson S, Stone S, et al. Impostor feelings as a moderator and mediator of the relationship between perceived discrimination and mental health among racial/ethnic minority college students. J Couns Psychol. 2017;64(2):141–54.

    Article  PubMed  Google Scholar 

  35. • Ogunyemi D, Lee T, Ma M, Osuma A, Eghbali M, Bouri N. Improving wellness: defeating impostor syndrome in medical education using an interactive reflective workshop. PLoS One. 2022;17(8):e0272496. This study describes an interactive educational workshop about imposter syndrome, and demonstrates how this workshop can be used to increase knowledge about imposter syndrome.

  36. Haney TS, Birkholz L, Rutledge C. A workshop for addressing the impact of the imposter syndrome on clinical nurse specialists. Clin Nurse Spec. 2018;32(4):189–94.

    Article  PubMed  Google Scholar 

  37. • Campbell KM. Mitigating the isolation of minoritized faculty in academic medicine. J Gen Intern Med. 2022. This article describes how isolation among underrepresented in medicine faculty can manifest as imposter syndrome and affect work performance, as well as describes strategies to decrease isolation and promote an inclusive faculty environment.

  38. • Rivera N, Feldman EA, Augustin DA, Caceres W, Gans HA, Blankenburg R. Do I belong here? Confronting imposter syndrome at an individual, peer, and institutional level in health professionals. MedEdPORTAL. 2021;17:11166. This study describes an interactive workshop that identifies strategies to mitigate the effects of imposter syndrome at individual, peer, and institutional levels.

  39. Hinton AO Jr, Vue Z, Termini CM, Taylor BL, Shuler HD, McReynolds MR. Mentoring minority trainees: minorities in academia face specific challenges that mentors should address to instill confidence. EMBO Rep. 2020;21(10):e51269.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Baumann N, Faulk C, Vanderlan J, Chen J, Bhayani RK. Small-group discussion sessions on imposter syndrome. MedEdPORTAL. 2020;16:11004.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Cope A, Bezemer J, Mavroveli S, Kneebone R. What attitudes and values are incorporated into self as part of professional identity construction when becoming a surgeon? Acad Med. 2017;92(4):544–9.

    Article  PubMed  Google Scholar 

  42. Acker R, Healy MG, Vanderkruik R, Petrusa E, McKinley SK, Phitayakorn R. Eyes of the beholders: first-year medical students’ perceptions of surgeons and the field of surgery. Am J Surg. 2022;223(6):1026–32.

    Article  PubMed  Google Scholar 

  43. Seritan AL, Mehta MM. Thorny laurels: the impostor phenomenon in academic psychiatry. Acad Psychiatry. 2016;40(3):418–21.

    Article  PubMed  Google Scholar 

  44. Chandra S, Huebert CA, Crowley E, Das AM. Impostor syndrome: could it be holding you or your mentees back? Chest. 2019;156(1):26–32.

    Article  PubMed  Google Scholar 

  45. Neufeld A, Babenko O, Lai H, Svrcek C, Malin G. Why do we feel like intellectual frauds? a self-determination theory perspective on the impostor phenomenon in medical students. Teach Learn Med. 2022:1–13.

  46. LaDonna KA, Ginsburg S, Watling C. “Rising to the level of your incompetence”: what physicians’ self-assessment of their performance reveals about the imposter syndrome in medicine. Acad Med. 2018;93(5):763–8.

    Article  PubMed  Google Scholar 

  47. Shanafelt TD. Physician Well-being 2.0: Where are we and where are we going? Mayo Clin Proc. 2021;96(10):2682–93.

Download references

Funding

This study was funded by the Excellence in Research New Investigator Award through the Seattle Children’s Research Institute (JBV).

Author information

Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, University of Colorado School of Medicine, 12631 E 17th Ave, Rm 3110, Aurora, CO, 80045, USA

    Gabriela Heslop & Cristina Cabrera-Muffly

  2. Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Seattle, WA, USA

    Juliana Bonilla-Velez

  3. Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA, USA

    Juliana Bonilla-Velez

  4. Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, 98101, USA

    Juliana Bonilla-Velez

  5. Department of Otolaryngology-Head and Neck Surgery, University of California, UC Davis Medical Center, Sacramento, CA, USA

    Erynne A. Faucett

Authors
  1. Gabriela Heslop
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juliana Bonilla-Velez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erynne A. Faucett
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cristina Cabrera-Muffly
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cristina Cabrera-Muffly.

Ethics declarations

Conflict of Interest

Erynne A. Faucett reports payment from John Hopkins Department of Otolaryngology and support for attending/traveling to the following meetings: Academy Meetings in 2021 and 2022 and SENTAC 2021. The other authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The original online version of this article was revised: Table 1 is cited in the article, but the table itself is missed to be captured in the main text.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Heslop, G., Bonilla-Velez, J., Faucett, E.A. et al. Understanding and Overcoming the Psychological Barriers to Diversity: Imposter Syndrome and Stereotype Threat. Curr Otorhinolaryngol Rep 11, 63–70 (2023). https://doi.org/10.1007/s40136-023-00456-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40136-023-00456-3

Keywords

Search

Navigation