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A Longitudinal Assessment of Professional Identity, Wellness, Imposter Phenomenon, and Calling to Medicine Among Medical Students



This study assessed changes in professional identity, wellness, imposter phenomenon, and calling to medicine over time in medical school.


Medical students from the first through third years anonymously completed four validated measures: Perceived Wellness Survey (PWS), Brief Calling Scale (BCS), Physician In-group Identification Scale (PID), and Clance’s Imposter Phenomenon Scale (CIP). Survey completion implied informed consent. The study was exempted by the university IRB.


All class of 2018 students (n = 110) returned surveys at the beginning of year 1; 58 completed surveys at the end of the preclinical years (post year 2, n = 44) and/or end of the third-year clerkship (post year 3, n = 35) and were analyzed. From pre to post preclinical years, there was a significant decrease in the PID. There were no statistically significant changes in the PWS, BCS, and CIP. From pre year 1 to post third-year clerkships, the PWS and PID decreased, the CIP increased, and the BCS did not change. Only 19% of students participated in all three survey administrations and this group was excluded from the analysis due to the low response rate.


Student wellness and sense of professional identity (in-group identity) dropped over 3 years of medical education, while imposter phenomenon increased. The BCS did not change over time. The decrease in identity as part of the physician community is concerning; future curriculum initiatives should focus on integration of professional identity into students’ individual identities and on initiatives to improve student well-being.

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  1. Epstein RM, Krasner MS. Physician resilience: what it means, why it matters and how to promote it. Acad Med. 2013;88:301–3.

    Article  Google Scholar 

  2. Wald HS, Anthony D, Hutchinson TA, Liben S, Smilovitch M, Donato AA. Professional identity formation in medical education for humanistic, resilient physicians: pedagogic strategies for bridging theory to practice. Acad Med. 2015;90(6):753–60.

    Article  Google Scholar 

  3. Royal College of Physicians of London. Doctors in society: medical professionalism in a changing world. London, UK: Royal College of Physicians of London; 2055.

    Google Scholar 

  4. Cruess RL, Cruess SR, Boudreau JD, Snell L, Steinert Y. Reframing medical education to support professional identity formation. Acad Med. 2014;89(11):1446–51.

    Article  Google Scholar 

  5. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med. 2006;81(4):354–73.

    Article  Google Scholar 

  6. Brazeau CMLR, Schroeder R, Rovi S, Boyd L. Relationships between medical student burnout, empathy, and professionalism climate. Acad Med. 2010;85(10):S33–6.

    Article  Google Scholar 

  7. McNeill KG, Kerr A, Mavor KI. Identity and norms: the role of group membership in medical student wellbeing. Perspect Med Educ. 2014;3(2):101–12.

    Article  Google Scholar 

  8. Duffy RD, Allan BA, Bott EM, Dik BJ. Does the source of a calling matter? External summons, destiny, and perfect fit. J Career Assess. 2014;22(4):562–74.

    Article  Google Scholar 

  9. Dik BJ, Duffy RD. Calling and vocation at work: definitions and prospects for research and practice. Couns Psychol. 2009;37(3):424–50.10.

    Article  Google Scholar 

  10. Yoon JD, Daley BM, Curlin FA. The association between a sense of calling and physician well-being: a national study of primary care physicians and psychiatrists. Acad Psychiatry. 2017;41(2):167–73.

    Article  Google Scholar 

  11. Jager AJ, Tutty MA, Kao AC. Association between physician burnout and identification with medicine as a calling. Mayo Clin Proc. 2017;92(3):415–22.

    Article  Google Scholar 

  12. Goodin JB, Duffy RD, Borges NJ, Ulman CA, D’Brot VM, Manuel RS. Medical students with low self-efficacy bolstered by calling to medical speciality. Perspect Med Educ. 2014;3(2):89–100.

    Article  Google Scholar 

  13. Borges NJ, Manuel RS, Duffy RD. Speciality interests and career calling to medicine among first-year medical students. Perspect Med Educ. 2013;2(1):14–7.

    Article  Google Scholar 

  14. Clance PR, O’Toole MA. The imposter phenomenon: an internal barrier to empowerment and achievement. Women Ther. 1987;6(3):51–64.

    Article  Google Scholar 

  15. Henning K, Ey S, Shaw D. Perfectionism, the impostor phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students. Med Educ. 1998;32(5):456–64.

    Article  Google Scholar 

  16. 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  Google Scholar 

  17. Harari MJ, Waehler CA, Rogers JR. An empirical investigation of a theoretically based measure of perceived wellness. J Couns Psychol. 2005;52(1):93–103.

    Article  Google Scholar 

  18. Dik BJ, Eldridge BM, Steger MF, Duffy RD. Development and validation of the calling and vocation questionnaire (CVQ) and brief calling scale (BCS). J Career Assess. 2012;20(3):242–63.

    Article  Google Scholar 

  19. Leach CW, van Zomeren M, Zebel S, Vliek MLW, Pennekamp SF, Doosje B, et al. Group-level self-definition and self-investment: a hierarchical (multicomponent) model of in-group identification. J Pers Soc Psychol. 2008;95(1):144–65.

    Article  Google Scholar 

  20. Chrisman SM, Pieper WA, Clance PR, Holland CL, Glickauf-Hughes C. Validation of the Clance imposter phenomenon scale. J Pers Assess. 1995;65(3):456–67.

    Article  Google Scholar 

  21. Pratt MG, Rochman KW, Kaufman Jerry B. Constructing professional identity: the role of work and identity learning cycles in the customization of identity in medical residents. Acad Manag J. 2006;49(2):235–62.

    Article  Google Scholar 

  22. Parkman A. The imposter phenomenon in higher education: incidence and impact. J High Educ Theory Pract. 2016;16(1):51–60.

    Google Scholar 

  23. Duffy RD, Manuel RS, Borges NJ, Bott EM. Calling, vocational development, and well being: a longitudinal study of medical students. J Vocat Behav. 2011;79(2):361–6.

    Article  Google Scholar 

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Correspondence to Valerie E. Houseknecht.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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This study was found to be exempt by the Wright State University IRB.

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Houseknecht, V.E., Roman, B., Stolfi, A. et al. A Longitudinal Assessment of Professional Identity, Wellness, Imposter Phenomenon, and Calling to Medicine Among Medical Students. Med.Sci.Educ. 29, 493–497 (2019).

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  • Medical student education
  • Professional identity
  • Wellness