Impostor phenomenon among urologists in Saudi Arabia

Impostor phenomenon (IP) is the persistent inability to believe that one’s success is deserved or has been legitimately achieved due to one’s efforts or skills. It is associated with burnout, anxiety and depression and can negatively impact the lives of the affected individuals. This study aimed to determine the prevalence of IP among urologists in Saudi Arabia. A cross-sectional study was conducted among practicing urologists and urologists-in-training in Saudi Arabia between November and December 2022. A self-administered questionnaire comprising questions on the sociodemographic characteristics and the Clance impostor phenomenon scale (CIPS) was distributed through email to all registered urologists in the Saudi Commission for Health Specialties database. A total of 155 urologists (143 men and 12 women) were enrolled in this study. The majority of the urologists (44.5%) were consultants, and the prevalence of the impostor phenomenon in this study was 27.7%. Nearly half of the urologists (49.7%) presented moderate levels of the phenomenon, 23.9% of the urologists demonstrated high levels, and 20.6% presented low levels. Only 5.8% of the urologists showed intense levels of the phenomenon. The phenomenon was significantly more prevalent among those in training (p = 0.010) and less prevalent among those with a subspecialty in endourology (p = 0.016). The prevalence of the impostor phenomenon among urologists was 27.7%. It was more commonly seen in resident urologists, and those with a subspecialty in endourology were less likely to be affected by this phenomenon.

Impostor syndrome; Impostor phenomenon; Urologist; Saudi Arabia; Self-esteem

[1] Kolligian J Jr, Sternberg RJ. Perceived fraudulence in young adults: is there an “imposter syndrome”? Journal of Personality Assessment. 1991; 56: 308–326.

[2] Clance PR, Imes SA. The imposter phenomenon in high achieving women: dynamics and therapeutic intervention. Psychology and Psychotherapy: Theory, Research and Practice. 1978; 15: 241–247.

[3] Bravata DM, Watts SA, Keefer AL, Madhusudhan DK, Taylor KT, Clark DM, et al. Prevalence, predictors, and treatment of impostor syndrome: a systematic review. Journal of General Internal Medicine. 2020; 35: 1252–1275.

[4] Rankin J. The imposter phenomenon: if I’m so successful, why do I feel like a fake? Canadian Operating Room Nursing Journal. 1993; 11: 18–20.

[5] 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.

[6] Gottlieb M, Chung A, Battaglioli N, Sebok-Syer SS, Kalantari A. Impostor syndrome among physicians and physicians in training: a scoping review. Medical Education. 2020; 54: 116–124.

[7] Zaed I, Bongetta D, Della Pepa GM, Zoia C, Somma T, Zoli M, et al. The prevalence of imposter syndrome among young neurosurgeons and residents in neurosurgery: a multicentric study. Neurosurgical Focus. 2022; 53: E9.

[8] Villwock JA, Sobin LB, Koester LA, Harris TM. Impostor syndrome and burnout among American medical students: a pilot study. International Journal of Medical Education. 2016; 7: 364–369.

[9] Wilson GA. The imposter phenomenon and cataract surgery. Journal of Cataract and Refractive Surgery. 2022; 48: 1216.

[10] Armstrong MJ, Shulman LM. Tackling the imposter phenomenon to advance women in neurology. Neurology Clinical Practice. 2019; 9: 155–159.

[11] Bhama AR, Ritz EM, Anand RJ, Auyang ED, Lipman J, Greenberg JA, et al. Imposter syndrome in surgical trainees: clance imposter phenomenon scale assessment in general surgery residents. Journal of the American College of Surgeons. 2021; 233: 633–638.

[12] Leach PK, Nygaard RM, Chipman JG, Brunsvold ME, Marek AP. Impostor phenomenon and burnout in general surgeons and general surgery residents. Journal of Surgical Education. 2019; 76: 99–106.

[13] Deshmukh S, Shmelev K, Vassiliades L, Kurumety S, Agarwal G, Horowitz JM. Imposter phenomenon in radiology: incidence, intervention, and impact on wellness. Clinical Imaging. 2022; 82: 94–99.

[14] Chodoff A, Conayers L, Wright S, Levine R. “I never should have been a doctor”: a qualitative study of imposter phenomenon among internal medicine residents. BMC Medical Education. 2023; 23: 57.

[15] Kenneally AM, Schadler A, Cain J. Fixed mindset and imposter phenomenon: determining the correlation and prevalence among pharmacy students. Currents in Pharmacy Teaching and Learning. 2023; 15: 62–68.

[16] Thomas M, Bigatti S. Perfectionism, impostor phenomenon, and mental health in medicine: a literature review. International Journal of Medical Education. 2020; 11: 201–213.

[17] Alsaleem L, Alyousef N, Alkaff Z, Alzaid L, Alotaibi R, Shaik SA. Prevalence of self-esteem and imposter syndrome and their associated factors among King Saud university medical students. Journal of Nature and Science of Medicine. 2021; 4: 226–231.

[18] Mascarenhas VR, D’Souza D, Bicholkar A. Prevalence of impostor phenomenon and its association with self-esteem among medical interns in Goa, India. International Journal of Community Medicine and Public Health. 2019; 6: 355–359.

[19] Maqsood H, Shakeel HA, Hussain H, Khan AR, Ali B, Ishaq A, et al. The descriptive study of imposter syndrome in medical students. International Journal of Research in Medical Sciences. 2018; 6: 3431–3434.

[20] Almatrafi MI, Albarakati AF, Alsulami EA, Saleh RE, Alharbi MM, Shatla MM. Prevalence and severity of imposter syndrome among surgical and medical residents in Makkah, Saudi Arabia. Majmaah Journal of Health Sciences. 2022; 10: 85–94.

[21] Leach PK, Nygaard RM, Chipman JG, Brunsvold ME, Marek AP. Impostor phenomenon and burnout in general surgeons and general surgery residents. Journal of Surgical Education. 2019; 76: 99–106.

[22] Villwock JA, Sobin LB, Koester LA, Harris TM. Impostor syndrome and burnout among American medical students: a pilot study. International Journal of Medical Education. 2016; 7: 364–369.

[23] Ikbaal MY, Salim Musa N’. Prevalence of impostor phenomenon among medical students in a Malaysian private medical school. International Journal of Medical Students. 2018; 6: 66–70.

[24] Egwurugwu JN, Ugwuezumba PC, Ohamaeme MC, Dike EI, Eberendu I, Egwurugwu E, et al. Relationship between self-esteem and impostor syndrome among undergraduate medical students in a Nigerian university. International Journal of Brain and Cognitive Sciences. 2018; 7: 9–16.

[25] Kamarzarrin H, Khaledian M, Shooshtari M, Yousefi E, Ahrami R. A study of the relationship between self-esteem and the imposter phenomenon in the physicians of Rasht city. European Journal of Experimental Biology. 2013; 3: 363–366.

[26] Kimyon RS. Imposter syndrome. AMA Journal of Ethics. 2020; 22: E628–629.