This month, the IAMSE Publications Committee review is taken from the article titled Medical Students and the Imposter Phenomenon: A Coexistence Precipitated and Perpetuated by the Educational Environment?, published in Medical Science Educator (9 December 2022) by Thomas Franchi and Nigel Russell-Sewell.
Imposter phenomenon or syndrome is the persistent belief that one’s success is not a result of one’s own effort or skills. This psychological phenomenon is disproportionately prevalent among medical students and medical professionals. In this mixed-methods study, Franchi and Russell-Sewell examined how imposter feelings take hold and persist among medical students. They investigated whether the very environment designed to train medical students may inadvertently undermine students’ sense of belonging and self-efficiency.
Combining validated quantitative measures with focus interviews, the authors shed light on a phenomenon that is not only widespread but also deeply consequential for learner well-being and focus. In line with previous studies, a large proportion of medical students reported high levels of imposter phenomenon, with significant differences across gender and training stages. The qualitative data revealed that the educational environment, particularly assessment culture, can intensify comparison and self-doubt. The data suggest that how students are assessed may influence not only motivation and collaboration, but also their stress levels.
The study revealed that summative assessment that follows norm-referenced rankings rather than criterion-based standards (such as pass/fail) may convey unintended messages about competence. The authors note that the recent shift of the USMLE Step 1 examination to a pass/fail report reflects a growing recognition of these concerns and raise the question of whether medical students should apply similar principles to their own summative assessments.
Importantly, this article offers new insights and multiple recommendations to reshape the assessment culture and normalize psychological struggle as part of growth. For educators, leaders, and policymakers committed to learner well-being, Franchi and Russell-Sewell provide both compelling evidence base and an actionable framework to change.
Monzurul Roni, PhD
Teaching Associate Professor
Department of Health Sciences Education and Pathology
University of Illinois College of Medicine