Imposter syndrome widespread among surgical trainees, disproportionately affects women

Editor's Note

Nearly three-quarters of orthopedic surgery residents experience significant or intense imposter syndrome, with female trainees facing markedly higher risk, according to a study published April 7 in the Journal of Bone and Joint Surgery Open Access.

As detailed in the study, researchers surveyed 100 residents across seven US programs using the Clance Imposter Phenomenon Scale. They found 73% reported significant or intense symptoms of self-doubt and inadequacy despite objective success. On multivariable analysis, women were more than 5x as likely as men to report severe symptoms. Residents with lower Orthopaedic In-Training Examination scores and those outside of Western programs also showed higher rates of imposter syndrome.

The outlet notes imposter syndrome, long linked to burnout, reduced productivity, and lower career satisfaction, was highly prevalent across all demographic groups. While age, race, and training level did not predict severity, the findings point to the need for targeted support programs, especially for women and those with academic performance concerns.

A March 2025 scoping review in BMC Medical Education reinforces the scope of the problem across surgery more broadly. Reviewing 15 studies, the authors found imposter syndrome prevalence estimates ranging from 27.5% to nearly 100% among surgeons and trainees, with female surgeons consistently scoring higher than men. Imposter feelings were often tied to stereotypes, workplace bias, and professional inequities, particularly for women navigating credibility challenges and role expectations in surgery.

According to the review, imposter syndrome is associated with heightened rates of burnout, depression, anxiety, low self-esteem, and even elevated suicide risk among physicians. The literature also identified gaps, particularly around effective interventions. While mentorship, coaching, peer support, and resilience-focused education show promise, few structured programs have been formally evaluated for impact.

Together, these studies highlight imposter syndrome as both pervasive and consequential within surgical training and practice. Experts argue earlier recognition and targeted interventions—ranging from structured mentorship to mental health resources and inclusive program cultures—are essential to support surgeon well-being and long-term retention.