{"paper_id":"1c5b589d-92f8-4e7e-98c9-4ec7e5eba8fa","body_text":"A Cross-sectional study Evaluating the Prevalence of Imposter Syndrome Across Different Years of Medical Education (MBBS) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Cross-sectional study Evaluating the Prevalence of Imposter Syndrome Across Different Years of Medical Education (MBBS) Umaima Cheema, Fatima Qureshi, Shamikha Cheema, Ahmad Khan, Muhammad Ammar Khalid, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7829497/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Imposter syndrome, also known as the imposter phenomenon or fraud syndrome, is defined by the lack of confidence in one’s skills and intellect among high-achieving individuals. Medical professionals are considered to be one of the victims of this syndrome, with limited information about the imposter syndrome and its correlation with medical education and other demographics. The study aims to assess which year of medical education has the highest prevalence of imposter syndrome. Methods: The study design was a quantitative cross-sectional and data were collected via purposive sampling. 326 participants were included from 1 st year to the final-year of MBBS students in the study. The Young Imposter Scale (YIS), including the eight items, was used to perform the dichotomous assessment of imposter syndrome. Statistical analysis was done through IBM SPSS Statistics 2025, and ANOVA was applied. Results: 114 out of 326 students (35.0%) answered “Yes” for five or more questions. Out of the 114, 23 belonged to the 1 st year, 19 from the 2 nd year, 27 from the 3 rd year, 23 from the 4 th year and 22 students belonged to the final year. Among the groups, third-year students had the highest mean IS presence (0.3710) followed closely by fourth-year students. Second-year students had the lowest prevalence of IS, although the differences were not statistically significant. Conclusions: Imposter Syndrome showed slightly higher prevalence in third-year students and the lowest prevalence among second-year students, suggesting an increasing self-doubt among medical students in later academic years. The findings highlight the need for particular attention to the middle stages of medical education. psychology mental health anxiety fear self-doubt Introduction Imposter syndrome, also known as the imposter phenomenon or fraud syndrome, is defined by the lack of confidence in one’s skills and intellect among high-achieving individuals. It can lead to a continuous sense of fear and anxiety and an apprehension of being considered a fraud without any substantial reason. [1] First described in 1978 by Clance and Imes, it is a syndrome prevalent among many high-achieving professionals despite having gone through the same assessments and acquired the same qualifications as their peers. Clance originally stated that the syndrome is more prevalent among women. [2] Medical professionals are among the victims of this syndrome. A study on American medical students showed that almost half of female students and a quarter of male students experienced imposter syndrome. In addition to that, imposter syndrome was found to be associated with burnout components of exhaustion, cynicism, and depersonalization. [3] Similarly, another study (Jayne et al.) stated the correlation between imposter syndrome and those underrepresented in medicine in predominantly white institutes and historically black institutes. [4] There is still limited information about imposter syndrome and its correlation with medical students from various years of study and whether it is associated with certain demographics or geographic characteristics. Imposter syndrome, if not correctly identified and taken care of, can affect one’s ability to perform their tasks as a medical professional. Despite being described in 1978, there is no formal definition or criteria available in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5). However, Clance stated characteristics of the imposter cycle, perfectionism, super-heroism, atychiphobia (fear of failure), denial of competence, and achievemephobia as features of imposter syndrome. [1] Imposter syndrome is an area of further research and intervention. Changes need to be devised to help those suffering from it successfully and to avoid increased incidences of burnout, anxiety, and depression among high-achieving individuals. OBJECTIVES To determine the prevalence of imposter syndrome among medical students. To get an idea regarding which year of medical education has the highest prevalence of imposter syndrome. LITERATURE REVIEW Do medical students have imposter syndrome? Does it affect the mental health and academic performance of medical students and what coping mechanisms should be effective in mitigating its impact? Remarkable academic performance and exceptional achievements are not enough to overcome “The Imposter Syndrome,” which is described as “An internal sensation of intellectual phoniness in persons who feel fraudulence and worthlessness” [5]. The terminology \"Imposter syndrome\" was used in their essay by Pauline R. Clance and Suzanne A. Imes in 1978. They described imposter syndrome as a feeling, primarily internal, of artificiality or fakeness. Clinically, the most frequently occurring symptoms are depression, feeling of worthlessness or not being enough, anxiety and low self-esteem [6]. In this chapter, the literature was explored from different research for the critical analysis of the question regarding “the prevalence of Imposter syndrome among medical students,” Which had the purpose to find out the research methods, research outcomes, theories, and their practice with implications. The overall goal and the purpose of the study literature was to find the Distribution of imposter syndrome among medical students. Searching databases was used in a consistent, structured manner. PubMed/Medline, EBSCO Host, and Google Scholar were used to explore the literature. Keywords used were Imposter syndrome, imposter, The Imposter Syndrome, and imposter phenomenon. A total of 978 articles were extracted. After using the filter, 567 articles were found. Furthermore, excluding articles more than five years old and without English results in 99 articles. Case studies and case reports are excluded, resulting in 56 articles that were present in the literature. Previous studies have highlighted the fact that imposter syndrome has a high incidence in medical students. The students suffering from imposter syndrome included students with great versatility, regardless of the semesters they attended during the pre-internship period. Some facts were found to be associated with imposter syndrome, including late marriages or not being married, not providing for their families and not practicing any physical activities. There was also a link between imposter syndrome and the diagnosis of depression, high levels of stress and use of anti-depressants [7]. Despite having no known etiology, it is reported to be more prevalent in women as compared to men and is more commonly found among students of healthcare. Students with imposter syndrome were reported to have exhaustion, cynicism, and depersonalization, which also fall within the domain of burnout syndrome. [8,9] Out of the medical students and residents who reported identifying as impostors, most were women and international medical graduates, especially those starting a new career or job in their lives [10]. Co-founder of the Imposter Syndrome Institute, Valerie Young, described that imposter syndrome is the result of “unrealistic, unsustainable expectations of what it means to be competent”. [11] As failure is a part of the learning process, it is high time to address this issue, which is so prevalent among not only medical students but also residents, surgical trainees, and mentors. [12] The Clance Imposter Phenomenon Scale (1985) and the Harvey Impostor Phenomenon Scale (1981) were developed in efforts to identify imposters among non-imposters but have unfortunately not been widely adopted by medical schools or healthcare jobs as a tool of assessment to help those who might be dealing with imposter syndrome. [13-15]. The psychological experience of self-doubt and a sense of being a fraud despite being competent is called imposter syndrome. Mostly found in high achievers and more specifically among international medical colleges. According to research, this issue relates to other psychological factors such as self-esteem, reflecting the evaluation of one's worth and competency. Cultural and genetic factors also influence societal norms and expectations. This syndrome leads to increased anxiety and stress due to fear of failure. [16] This study highlights the issue of imposter syndrome among Healthcare professionals. They often feel more burnout and non-satisfying behavior due to self-doubt and inadequacy that ultimately affects mental health. The author discusses the importance of sharing experiences that provide reassurance. Mentorship, counseling, etc., can provide authenticity. Understanding its impact on patients’ care is essential for quality health care and provider stress [17]. This study discusses the importance of small discussions and a safe and supportive environment among professionals to confront imposterism, feelings of being a lost person, despite being successful. Structured narratives and participants gained highlights for coping. The role of peer support and mentorship in mitigating imposter syndrome is so important. Dialogues and connections among small groups lead to professional growth. Collaborative interventions by harnessing shared experiences offer a promising approach to addressing such psychological barriers [18]. Methodology The study design was cross-sectional, descriptive. The study was conducted in a top-ranking public medical College of Lahore in May 2024. The participants included in the study were 326, including the 1st year to final-year MBBS students from both genders enrolled in the university. Sample size was calculated using the prevalence estimate of 35.0%, a 95% confidence interval and a 5% margin of error. With a population size of around 1700, the calculated minimum sample size required was 314 participants. The exact formula used was: n = Z 2 ×p×(1 − p)​/d 2 Where, n = required sample size Z = standard normal value corresponding to desired confidence level (1.96 for 95% CI) p = estimated prevalence (in proportion form, e.g., 0.35 for 35%) d = margin of error (in proportion form, e.g., 0.05 for 5%) Z = 1.96 p = 0.35 1 − p = 0.651 d = 0.05 We collected responses from 326 students to ensure validity and reliability. Response rate was 100%. The study setting was a public medical college in Lahore, Pakistan. The sampling technique was a convenient non-probability type. After taking informed consent, all the students were briefly introduced to the study and were asked to fill in the anonymous printed questionnaires. Young Imposter Scale (YIS), including the eight items, was used to do the dichotomous assessment of imposter syndrome, whether present or absent [ 2 ]. It is in the form of a question with options listed as either yes or no. A student was considered to have Imposter syndrome if he/she answered \"Yes\" to 5 or more questions. Statistical analysis was done through SPSS Version 2025 software (IBM SPSS Statistics 2025). The analysis was done to find out the overall prevalence of imposter syndrome in medical students as a whole and at various years of their medical education. Also, ANOVA was applied to determine which year of medical education has the highest prevalence of Imposter Syndrome (IS). Results Three hundred and twenty-six (326) students were enrolled in the study and were thus asked to return the completed 08-item questionnaire. Three hundred and twenty-six (326) students returned the questionnaires, so the response rate was 100%. Out of these 326 students, 185 were females (56.7%) and 141 were males (43.3%). The overall mean age of the participants was 24.08 ± 1.051 years, whereas the mean age was 20.98 ± 1.66, and the students belonged to all five years of medical education, with a percentage of 20% each from every year. Year-wise analysis of the answers to all eight questions by respondents was done by ANOVA, as given in Table 4 . The students who answered “Yes” for at least five out of eight questions were considered positive for Imposter Syndrome. One hundred and fourteen (114) out of 326 students (35.0%) answered “Yes” for five or more questions. Out of the 114 students positive for imposter syndrome, 23 (20%) belonged to the 1st year, 19 (16.7%) belonged to the 2nd year, 27 (23.7%)) to the 3rd year, 23 (20%) from the 4th year, and 22 (19.2%) students belonged to the final year. Thus, imposter syndrome order was found to be: Final Year < 2nd year < 1st and 4th year < 3rd year Gender-wise Young Imposter Scores are given in Table 1 , and imposter syndrome scores and their prevalence across various demographics have been demonstrated below (Table 2 - Table 5 ). Table 1 Young’s Imposter Scale (YIS) questionnaire No. Question Answer Yes/No Males % Females % 1 Do you secretly worry that others will find out that you are not as bright and capable as they think you are? Yes 107 80 No 78 61 2 Do you sometimes shy away from challenges because of a nagging self-doubt? Yes 55 58 No 130 83 3 Do you tend to chalk your accomplishments up to being a fluke, no big deal, or the fact that people just like you? Yes 119 71 No 66 70 4 Do you hate making a mistake, being less than fully prepared, or not doing things perfectly? Yes 71 43 No 114 98 5 Do you tend to feel crushed even by constructive criticism, seeing it as evidence of your ineptness? Yes 127 89 No 58 52 6 When you do succeed, do you think, “Phew! I fooled them this time, but I may not be that lucky next time.”? Yes 138 104 No 47 37 7 Do you believe that other people (students, colleagues, competitors) are smarter and more capable than you? Yes 53 45 No 132 96 8 Do you live in fear of being found out, discovered, or unmasked? Yes 136 88 No 49 53 Table 2 Demographic Characteristics of Participants Characteristic Value Total participants 326 Female 185 (56.7%) Male 141 (43.3%) Mean age (years) 20.98 ± 1.66 Year distribution Approx. 20% from each year (To get approximately an equal number of responses across all five years of medical education) Table 3 Prevalence of Imposter Syndrome by Year and Gender Group N with IS Total N Prevalence (%) Overall 114.0 326 35.0 1st year 23.0 72 31.9 2nd year 19.0 55 34.5 3rd year 27.0 74 36.5 4th year 23.0 62 37.1 Final year 22.0 63 34.9 Table 4 Comparison of Imposter Syndrome Scores Across Years Year Mean IS score ± SD ANOVA p-value (95% CI) 1st 11.68 ± 1.81 0.781 (NS) 2nd 11.85 ± 1.95 0.781 (NS) 3rd 11.54 ± 2.42 0.781 (NS) 4th 11.79 ± 2.06 0.781 (NS) Final 11.97 ± 1.83 0.781 (NS) Table 5 Distribution of Imposter Syndrome Scores Score Range Frequency Percent (%) Cumulative (%) 8 16 4.9 4.9 9 29 8.9 13.8 10 49 15.0 28.8 11 61 18.7 47.5 12 57 17.5 65.0 13 47 14.4 79.4 14 31 9.5 89.0 15 23 7.1 96.0 16 13 4.0 100.0 A one-way ANOVA confirmed that there were no significant differences in IS scores across academic years. The effect of year of study on IS scores was not statistically significant, F(4, 321) = 0.44, p = 0.781. Post hoc comparisons using Tukey’s HSD indicated that no pairwise differences between year groups were significant (all p > 0.97; e.g., first-year vs. final-year p = 0.996). Thus, students in all year levels reported comparable levels of impostor feelings. An independent-samples t-test was conducted to examine gender differences in IS scores. Female students showed a higher mean IS score than males, but this difference did not reach statistical significance. The mean IS score for females (mean ≈ 12, SD ≈ 2) was only slightly above that of males (mean ≈ 12, SD ≈ 2), and the independent t-test was non-significant, t(324) ≈ 1.2, p > 0.20 (n.s.). In terms of IS prevalence, a higher proportion of female students (roughly 35–40%) screened positive for IS than male students (approximately 25–30%), but this difference in proportions was marginally significant at best. Overall, the inferential results indicate no strong evidence of gender-based differences in impostor syndrome in this cohort ( Supplementary tables 1–9 ). Thus, across all analyses, no statistically significant variation in impostor syndrome scores was found by academic year or gender. Numerically, IS scores were highest in the final year of study (mean ~ 11.97) and lowest in the third year (mean ~ 11.54), but these differences were trivial and not significant. Thus, the results suggest a consistent prevalence of impostor syndrome (~ 35%) throughout the undergraduate years, with students reporting moderate levels of impostor feelings on average, and no meaningful differences between different year cohorts or between male and female students in this sample. Discussion The findings of this cross-sectional study provide valuable insights into the prevalence and distribution of imposter syndrome (IS) among medical students across different years of their MBBS program. With an overall prevalence of 35.0% among the 326 participants, the study highlights the significant psychological burden that imposter syndrome imposes on medical students, particularly as they are promoted to higher classes. The higher prevalence observed in third-year students (23.7%) compared to other years highlights the potential association of IS with different years of medical education. One important factor contributing to the increased prevalence of imposter syndrome in third-year students may be the start of clinical rotations, which begin this year [ 19 ]. This change marks a critical phase where students move from theoretical learning to hands-on patient care, exposing them to real-world clinical responsibilities and direct interaction with patients, their families, and healthcare teams. The sudden increase in responsibility, coupled with the pressure to perform competently in a high-stakes environment, may amplify feelings of self-doubt, inadequacy, and fear of being exposed as fraudulent, which are features of imposter syndrome. These findings align with a previous study conducted in Pakistan by Maqsood et al, which found that third-year students have a high prevalence and degree of IS severity [ 20 ]. Another potential contributor to the higher prevalence of imposter syndrome in later years is the increasing pressure to prepare for foreign exams such as the United States Medical Licensing Examination (USMLE), particularly the USMLE Step 1 exam [ 21 ]. As students approach their final years, many begin intensifying their preparation for these competitive examinations, which are critical for pursuing residency and career opportunities abroad. The rigorous preparation, coupled with the fear of failure and comparison to peers or international standards, may intensify feelings of intellectual phoniness and worthlessness. This aligns with Valerie Young’s perspective that IS stems from unrealistic and unsustainable expectations of competence, particularly in high-stakes academic and professional contexts [ 22 ]. The statistically insignificant differences in IS prevalence across years, as indicated by the ANOVA results (F = 0.121, p = 0.975 for presence; F = 0.439, p = 0.781 for score), suggest that while third-year students may experience a slightly higher burden, imposter syndrome is an issue faced at all stages of medical education. This widespread distribution highlights the need for interventions to address IS throughout the curriculum, rather than just focusing on specific years. The association of IS with burnout components such as exhaustion, cynicism, and depersonalization, as noted in the literature review [ 23 ], highlights its potential to negatively impact not only students’ mental health but also their academic performance. This is particularly concerning given the link between IS and depression, high stress levels, and antidepressant use, as reported by Campos et al. [ 7 ]. The use of the Young Imposter Scale (YIS) with its dichotomous (Yes/No) format and a cutoff of five or more affirmative responses for diagnosing IS provides a practical tool for screening, but its simplicity may limit its ability to understand the complex psychological experiences of students. The lack of a formal diagnostic criterion for IS in the DSM-5, as noted in the literature review [ 1 ], further complicates its assessment and management. Even so, the study's high response rate (100%) and the fact that students from all five years are included make the results more reliable and applicable to this institution. To lessen the impact of imposter syndrome, the findings suggest the importance of implementing structured support mechanisms, such as mentorship, peer support groups, and counseling [ 17 , 18 ]. Creating a safe and supportive environment where students can openly discuss their self-doubt and share experiences could reduce feelings of isolation and phoniness [ 24 ]. Additionally, integrating IS awareness and coping strategies into the medical curriculum, particularly during the transition to clinical rotations and exam preparation phases, could help students build resilience and realistic self-perceptions of competence. Faculty training to recognize and address IS, along with the adoption of well-recognized tools like the Clance Imposter Phenomenon Scale or Harvey Impostor Phenomenon Scale, could further enhance early intervention efforts [ 25 ]. The limitations of this study are its cross-sectional design, which doesn't allow for cause-and-effect conclusions, and the use of convenience sampling, which could lead to bias and make it harder to apply the results to other medical institutions or geographic regions. The focus on a single public medical college in Lahore, Pakistan, also restricts the ability to explore geographic or cultural variations in IS prevalence. Moreover, use of more specific and refined scales like Clance Imposter Scale (CIS) should be used to determine severity of imposter syndrome among medical students. Future longitudinal studies, including medical students from different institutions, years of study, and demographic backgrounds, are needed to better understand IS and its correlation with clinical exposure, exam preparation, and cultural factors. In conclusion, the prevalence of imposter syndrome among medical students, particularly peaking in the third year, reflects the psychological challenges associated with the transition to clinical rotations and preparation for high-stakes foreign exams like the USMLE. The findings emphasize the urgent need to prioritize mental well-being alongside academic excellence, ensuring that medical students are equipped with the tools and support to navigate self-doubt and thrive in their professional development. Imposter syndrome needs to be addressed through targeted interventions. This could not only enhance student well-being but also improve patient care by reducing burnout and fostering confident healthcare professionals. Conclusion Imposter Syndrome showed a slightly higher prevalence in third-year students and the lowest prevalence among second-year students, suggesting an increasing self-doubt among medical students in later academic years. The findings highlight the need for particular attention to the middle and final stages of medical education. The statistically insignificant distribution of imposter syndrome and its high prevalence among medical students stress the need to focus on students' mental well-being as we focus on their academic well-being. Declarations Funding : The study received no funding. Clinical trial number: Not applicable. Consent to Publish declaration: Not applicable Data availability: The datasets generated and analysed during the current study are available from the corresponding author on reasonable request. Ethical consideration : Ethical standards were followed. Consent was taken from each participant, and anonymity and privacy were respected. Consent to Participate: Informed consent was obtained from all individual participants included in the study. Consent to publish: The authors, as well as the participants, declare no conflicts of interest and provide consent to publish. Ethical approval/ IRB approval: As consent was obtained from each participant and anonymity and data privacy were ensured, the need for obtaining ethical approval was waived by the ethical committee of research, innovation & commercialization at the King Edward Medical University, Lahore. Conflict of Interest : None Acknowledgement : None Author Contribution : Umaima Cheema did the analysis and conceptualized the study; Fatima Qureshi wrote the introduction and literature review; Shamikha Cheema wrote the literature review and reviewed the manuscript; Ahmed Khan wrote the discussion; Muhammad Ammar Khalid and Hafiz Mohammad Haris wrote the results, conclusion, and literature review; Razia Sultana reviewed the manuscript and prepared the final draft. 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BMC Med Educ. 2024 Jan 8;24(1):43. doi: 10.1186/s12909-023-04984-w. PMID: 38191382; PMCID: PMC10775670. https://crl.acrl.org/index.php/crl/article/view/24984/32850 Additional Declarations No competing interests reported. Supplementary Files SUPPLEMENTARYDATA.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-7829497\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":545540685,\"identity\":\"ba6db076-9068-4d32-8f61-255fab1da7fe\",\"order_by\":0,\"name\":\"Umaima 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08:40:51\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":782797,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-7829497/v1/bd61e619-fe9b-41c7-a303-2c1ffa756d73.pdf\"},{\"id\":96079126,\"identity\":\"122d08f4-86f8-48b0-9951-f02efe1d5b04\",\"added_by\":\"auto\",\"created_at\":\"2025-11-17 11:09:55\",\"extension\":\"docx\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":31422,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"SUPPLEMENTARYDATA.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-7829497/v1/3191bd88930d3d24b11489cb.docx\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"A Cross-sectional study Evaluating the Prevalence of Imposter Syndrome Across Different Years of Medical Education (MBBS)\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eImposter syndrome, also known as the imposter phenomenon or fraud syndrome, is defined by the lack of confidence in one’s skills and intellect among high-achieving individuals. It can lead to a continuous sense of fear and anxiety and an apprehension of being considered a fraud without any substantial reason. [1] First described in 1978 by Clance and Imes, it is a syndrome prevalent among many high-achieving professionals despite having gone through the same assessments and acquired the same qualifications as their peers. Clance originally stated that the syndrome is more prevalent among women. [2]\\u003c/p\\u003e\\n\\u003cp\\u003eMedical professionals are among the victims of this syndrome. A study on American medical students showed that almost half of female students and a quarter of male students experienced imposter syndrome. In addition to that, imposter syndrome was found to be associated with burnout components of exhaustion, cynicism, and depersonalization. [3] Similarly, another study (Jayne et al.) stated the correlation between imposter syndrome and those underrepresented in medicine in predominantly white institutes and historically black institutes. [4]\\u003c/p\\u003e\\n\\u003cp\\u003eThere is still limited information about imposter syndrome and its correlation with medical students from various years of study and whether it is associated with certain demographics or geographic characteristics. Imposter syndrome, if not correctly identified and taken care of, can affect one’s ability to perform their tasks as a medical professional. Despite being described in 1978, there is no formal definition or criteria available in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5). However, Clance stated characteristics of the imposter cycle, perfectionism, super-heroism, atychiphobia (fear of failure), denial of competence, and achievemephobia as features of imposter syndrome. [1]\\u003c/p\\u003e\\n\\u003cp\\u003eImposter syndrome is an area of further research and intervention. Changes need to be devised to help those suffering from it successfully and to avoid increased incidences of burnout, anxiety, and depression among high-achieving individuals.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eOBJECTIVES\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cul\\u003e\\n \\u003cli\\u003eTo determine the prevalence of imposter syndrome among medical students.\\u003c/li\\u003e\\n \\u003cli\\u003eTo get an idea regarding which year of medical education has the highest prevalence of imposter syndrome.\\u003c/li\\u003e\\n\\u003c/ul\\u003e\"},{\"header\":\"LITERATURE REVIEW\",\"content\":\"\\u003cp\\u003eDo medical students have imposter syndrome? Does it affect the mental health and academic performance of medical students and what coping mechanisms should be effective in mitigating its impact? Remarkable academic performance and exceptional achievements are not enough to overcome “The Imposter Syndrome,” which is described as “An internal sensation of intellectual phoniness in persons who feel fraudulence and worthlessness” [5]. The terminology \\\"Imposter syndrome\\\" was used in their essay by Pauline R. Clance and Suzanne A. Imes in 1978. They described imposter syndrome as a feeling, primarily internal, of artificiality or fakeness. Clinically, the most frequently occurring symptoms are depression, feeling of worthlessness or not being enough, anxiety and low self-esteem [6].\\u003c/p\\u003e\\n\\u003cp\\u003eIn this chapter, the literature was explored from different research for the critical analysis of the question regarding “the prevalence of Imposter syndrome among medical students,” Which had the purpose to find out the research methods, research outcomes, theories, and their practice with implications. The overall goal and the purpose of the study literature was to find the Distribution of imposter syndrome among medical students.\\u003c/p\\u003e\\n\\u003cp\\u003eSearching databases was used in a consistent, structured manner. PubMed/Medline, EBSCO Host, and Google Scholar were used to explore the literature. Keywords used were Imposter syndrome, imposter, The Imposter Syndrome, and imposter phenomenon. A total of 978 articles were extracted. After using the filter, 567 articles were found. Furthermore, excluding articles more than five years old and without English results in 99 articles. \\u0026nbsp;Case studies and case reports are excluded, resulting in 56 articles that were present in the literature. Previous studies have highlighted the fact that imposter syndrome has a high incidence in medical students. The students suffering from imposter syndrome included students with great versatility, regardless of the semesters they attended during the pre-internship period. Some facts were found to be associated with imposter syndrome, including late marriages or not being married, not providing for their families and not practicing any physical activities. There was also a link between imposter syndrome and the diagnosis of depression, high levels of stress and use of anti-depressants [7].\\u003c/p\\u003e\\n\\u003cp\\u003eDespite having no known etiology, it is reported to be more prevalent in women as compared to men and is more commonly found among students of healthcare. Students with imposter syndrome were reported to have exhaustion, cynicism, and depersonalization, which also fall within the domain of burnout syndrome. [8,9] Out of the medical students and residents who reported identifying as impostors, most were women and international medical graduates, especially those starting a new career or job in their lives [10].\\u003c/p\\u003e\\n\\u003cp\\u003eCo-founder of the Imposter Syndrome Institute, Valerie Young, described that imposter syndrome is the result of “unrealistic, unsustainable expectations of what it means to be competent”. [11] As failure is a part of the learning process, it is high time to address this issue, which is so prevalent among not only medical students but also residents, surgical trainees, and mentors. [12] The Clance Imposter Phenomenon Scale (1985) and the Harvey Impostor Phenomenon Scale (1981) were developed in efforts to identify imposters among non-imposters but have unfortunately not been widely adopted by medical schools or healthcare jobs as a tool of assessment to help those who might be dealing with imposter syndrome. [13-15].\\u003c/p\\u003e\\n\\u003cp\\u003eThe psychological experience of self-doubt and a sense of being a fraud despite being competent is called imposter syndrome. Mostly found in high achievers and more specifically among international medical colleges. According to research, this issue relates to other psychological factors such as self-esteem, reflecting the evaluation of one's worth and competency. Cultural and genetic factors also influence societal norms and expectations. This syndrome leads to increased anxiety and stress due to fear of failure. [16]\\u003c/p\\u003e\\n\\u003cp\\u003eThis study highlights the issue of imposter syndrome among Healthcare professionals. They often feel more burnout and non-satisfying behavior due to self-doubt and inadequacy that ultimately affects mental health. \\u0026nbsp;The author discusses the importance of sharing experiences that provide reassurance. Mentorship, counseling, etc., can provide authenticity. Understanding its impact on patients’ care is essential for quality health care and provider stress [17]. This study discusses the importance of small discussions and a safe and supportive environment among professionals to confront imposterism, feelings of being a lost person, despite being successful. \\u0026nbsp; Structured narratives and participants gained highlights for coping. The role of peer support and mentorship in mitigating imposter syndrome is so important. Dialogues and connections among small groups lead to professional growth. Collaborative interventions by harnessing shared experiences offer a promising approach to addressing such psychological barriers [18].\\u003c/p\\u003e\"},{\"header\":\"Methodology\",\"content\":\"\\u003cp\\u003eThe study design was cross-sectional, descriptive. The study was conducted in a top-ranking public medical College of Lahore in May 2024. The participants included in the study were 326, including the 1st year to final-year MBBS students from both genders enrolled in the university. Sample size was calculated using the prevalence estimate of 35.0%, a 95% confidence interval and a 5% margin of error. With a population size of around 1700, the calculated minimum sample size required was 314 participants. The exact formula used was:\\u003c/p\\u003e\\u003cp\\u003en\\u0026thinsp;=\\u0026thinsp;Z\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026times;p\\u0026times;(1\\u0026thinsp;\\u0026minus;\\u0026thinsp;p)​/d\\u003csup\\u003e2\\u003c/sup\\u003e\\u003c/p\\u003e\\u003cp\\u003eWhere,\\u003c/p\\u003e\\u003cp\\u003en\\u0026thinsp;=\\u0026thinsp;required sample size\\u003c/p\\u003e\\u003cp\\u003eZ\\u0026thinsp;=\\u0026thinsp;standard normal value corresponding to desired confidence level (1.96 for 95% CI)\\u003c/p\\u003e\\u003cp\\u003ep\\u0026thinsp;=\\u0026thinsp;estimated prevalence (in proportion form, e.g., 0.35 for 35%)\\u003c/p\\u003e\\u003cp\\u003ed\\u0026thinsp;=\\u0026thinsp;margin of error (in proportion form, e.g., 0.05 for 5%)\\u003c/p\\u003e\\n\\u003ch3\\u003eZ = 1.96\\u003c/h3\\u003e\\n\\u003cp\\u003ep\\u0026thinsp;=\\u0026thinsp;0.35\\u003c/p\\u003e\\u003cp\\u003e1\\u0026thinsp;\\u0026minus;\\u0026thinsp;p\\u0026thinsp;=\\u0026thinsp;0.651\\u003c/p\\u003e\\u003cp\\u003ed\\u0026thinsp;=\\u0026thinsp;0.05\\u003c/p\\u003e\\u003cp\\u003eWe collected responses from 326 students to ensure validity and reliability. Response rate was 100%. The study setting was a public medical college in Lahore, Pakistan. The sampling technique was a convenient non-probability type. After taking informed consent, all the students were briefly introduced to the study and were asked to fill in the anonymous printed questionnaires. Young Imposter Scale (YIS), including the eight items, was used to do the dichotomous assessment of imposter syndrome, whether present or absent [\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e]. It is in the form of a question with options listed as either yes or no. A student was considered to have Imposter syndrome if he/she answered \\\"Yes\\\" to 5 or more questions. Statistical analysis was done through SPSS Version 2025 software (IBM SPSS Statistics 2025). The analysis was done to find out the overall prevalence of imposter syndrome in medical students as a whole and at various years of their medical education. Also, ANOVA was applied to determine which year of medical education has the highest prevalence of Imposter Syndrome (IS).\\u003c/p\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eThree hundred and twenty-six (326) students were enrolled in the study and were thus asked to return the completed 08-item questionnaire. Three hundred and twenty-six (326) students returned the questionnaires, so the response rate was 100%. Out of these 326 students, 185 were females (56.7%) and 141 were males (43.3%). The overall mean age of the participants was 24.08\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.051 years, whereas the mean age was 20.98\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.66, and the students belonged to all five years of medical education, with a percentage of 20% each from every year.\\u003c/p\\u003e\\u003cp\\u003eYear-wise analysis of the answers to all eight questions by respondents was done by ANOVA, as given in Table \\u003cspan refid=\\\"Tab4\\\" class=\\\"InternalRef\\\"\\u003e4\\u003c/span\\u003e. The students who answered \\u0026ldquo;Yes\\u0026rdquo; for at least five out of eight questions were considered positive for Imposter Syndrome. One hundred and fourteen (114) out of 326 students (35.0%) answered \\u0026ldquo;Yes\\u0026rdquo; for five or more questions. Out of the 114 students positive for imposter syndrome, 23 (20%) belonged to the 1st year, 19 (16.7%) belonged to the 2nd year, 27 (23.7%)) to the 3rd year, 23 (20%) from the 4th year, and 22 (19.2%) students belonged to the final year. Thus, imposter syndrome order was found to be:\\u003c/p\\u003e\\n\\u003ch3\\u003eFinal Year \\u003c 2nd year \\u003c 1st and 4th year \\u003c 3rd year\\u003c/h3\\u003e\\n\\u003cp\\u003eGender-wise Young Imposter Scores are given in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e, and imposter syndrome scores and their prevalence across various demographics have been demonstrated below (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e\\u003cb\\u003e-\\u003c/b\\u003e Table\\u0026nbsp;\\u003cspan refid=\\\"Tab5\\\" class=\\\"InternalRef\\\"\\u003e5\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eYoung\\u0026rsquo;s Imposter Scale (YIS) questionnaire\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"5\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eNo.\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" 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char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e107\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e80\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eNo\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e78\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e61\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e2\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eDo you sometimes shy away from challenges because of a nagging self-doubt?\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eYes\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e55\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e58\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eNo\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e130\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e83\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e3\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eDo you tend to chalk your accomplishments up to being a fluke, no big deal, or the fact that people just like you?\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eYes\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e119\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e71\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eNo\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e66\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e70\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e4\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eDo you hate making a mistake, being less than fully prepared, or not doing things perfectly?\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eYes\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e71\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e43\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eNo\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e114\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e98\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e5\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eDo you tend to feel crushed even by constructive criticism, seeing it as evidence of your ineptness?\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eYes\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e127\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e89\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eNo\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e58\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e52\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e6\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eWhen you do succeed, do you think, \\u0026ldquo;Phew! I fooled them this time, but I may not be that lucky next time.\\u0026rdquo;?\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eYes\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e138\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e104\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eNo\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e47\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e37\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e7\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eDo you believe that other people (students, colleagues, competitors) are smarter and more capable than you?\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eYes\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e53\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e45\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eNo\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e132\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e96\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e8\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eDo you live in fear of being found out, discovered, or unmasked?\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eYes\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e136\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e88\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eNo\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e49\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e53\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eDemographic Characteristics of Participants\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"2\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eCharacteristic\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eValue\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003eTotal participants\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e326\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003eFemale\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e185 (56.7%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003eMale\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e141 (43.3%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003eMean age (years)\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e20.98\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.66\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003eYear distribution\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eApprox. 20% from each year (To get approximately an equal number of responses across all five years of medical education)\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003ePrevalence of Imposter Syndrome by Year and Gender\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"4\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eGroup\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eN with IS\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eTotal N\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003ePrevalence (%)\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003eOverall\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e114.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e326\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e35.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e1st year\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e23.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e72\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e31.9\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e2nd year\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e19.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e55\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e34.5\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e3rd year\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e27.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e74\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e36.5\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e4th year\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e23.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e62\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e37.1\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003eFinal year\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e22.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e63\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e34.9\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab4\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 4\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eComparison of Imposter Syndrome Scores Across Years\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"3\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eYear\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eMean IS score\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eANOVA p-value (95% CI)\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e1st\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e11.68\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.81\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.781 (NS)\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e2nd\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e11.85\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.95\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.781 (NS)\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e3rd\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e11.54\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.42\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.781 (NS)\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e4th\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e11.79\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.06\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.781 (NS)\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003eFinal\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e11.97\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.83\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.781 (NS)\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab5\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 5\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eDistribution of Imposter Syndrome Scores\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"4\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eScore Range\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eFrequency\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003ePercent (%)\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eCumulative (%)\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e8\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e16\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e4.9\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e4.9\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e9\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e29\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e8.9\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e13.8\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e10\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e49\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e15.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e28.8\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e11\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e61\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e18.7\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e47.5\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e12\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e57\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e17.5\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e65.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e13\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e47\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e14.4\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e79.4\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e14\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e31\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e9.5\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e89.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e15\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e23\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e7.1\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e96.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u003cb\\u003e16\\u003c/b\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e13\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e4.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e100.0\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003eA one-way ANOVA confirmed that there were no significant differences in IS scores across academic years. The effect of year of study on IS scores was not statistically significant, F(4, 321)\\u0026thinsp;=\\u0026thinsp;0.44, p\\u0026thinsp;=\\u0026thinsp;0.781. Post hoc comparisons using Tukey\\u0026rsquo;s HSD indicated that no pairwise differences between year groups were significant (all p\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.97; e.g., first-year vs. final-year p\\u0026thinsp;=\\u0026thinsp;0.996). Thus, students in all year levels reported comparable levels of impostor feelings.\\u003c/p\\u003e\\u003cp\\u003eAn independent-samples t-test was conducted to examine gender differences in IS scores. Female students showed a higher mean IS score than males, but this difference did not reach statistical significance. The mean IS score for females (mean\\u0026thinsp;\\u0026asymp;\\u0026thinsp;12, SD\\u0026thinsp;\\u0026asymp;\\u0026thinsp;2) was only slightly above that of males (mean\\u0026thinsp;\\u0026asymp;\\u0026thinsp;12, SD\\u0026thinsp;\\u0026asymp;\\u0026thinsp;2), and the independent t-test was non-significant, t(324)\\u0026thinsp;\\u0026asymp;\\u0026thinsp;1.2, p\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.20 (n.s.). In terms of IS prevalence, a higher proportion of female students (roughly 35\\u0026ndash;40%) screened positive for IS than male students (approximately 25\\u0026ndash;30%), but this difference in proportions was marginally significant at best. Overall, the inferential results indicate no strong evidence of gender-based differences in impostor syndrome in this cohort (\\u003cb\\u003eSupplementary tables 1\\u0026ndash;9\\u003c/b\\u003e).\\u003c/p\\u003e\\u003cp\\u003eThus, across all analyses, no statistically significant variation in impostor syndrome scores was found by academic year or gender. Numerically, IS scores were highest in the final year of study (mean\\u0026thinsp;~\\u0026thinsp;11.97) and lowest in the third year (mean\\u0026thinsp;~\\u0026thinsp;11.54), but these differences were trivial and not significant. Thus, the results suggest a consistent prevalence of impostor syndrome (~\\u0026thinsp;35%) throughout the undergraduate years, with students reporting moderate levels of impostor feelings on average, and no meaningful differences between different year cohorts or between male and female students in this sample.\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThe findings of this cross-sectional study provide valuable insights into the prevalence and distribution of imposter syndrome (IS) among medical students across different years of their MBBS program. With an overall prevalence of 35.0% among the 326 participants, the study highlights the significant psychological burden that imposter syndrome imposes on medical students, particularly as they are promoted to higher classes. The higher prevalence observed in third-year students (23.7%) compared to other years highlights the potential association of IS with different years of medical education.\\u003c/p\\u003e\\u003cp\\u003eOne important factor contributing to the increased prevalence of imposter syndrome in third-year students may be the start of clinical rotations, which begin this year [\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e]. This change marks a critical phase where students move from theoretical learning to hands-on patient care, exposing them to real-world clinical responsibilities and direct interaction with patients, their families, and healthcare teams. The sudden increase in responsibility, coupled with the pressure to perform competently in a high-stakes environment, may amplify feelings of self-doubt, inadequacy, and fear of being exposed as fraudulent, which are features of imposter syndrome. These findings align with a previous study conducted in Pakistan by Maqsood et al, which found that third-year students have a high prevalence and degree of IS severity [\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e].\\u003c/p\\u003e\\u003cp\\u003eAnother potential contributor to the higher prevalence of imposter syndrome in later years is the increasing pressure to prepare for foreign exams such as the United States Medical Licensing Examination (USMLE), particularly the USMLE Step 1 exam [\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e]. As students approach their final years, many begin intensifying their preparation for these competitive examinations, which are critical for pursuing residency and career opportunities abroad. The rigorous preparation, coupled with the fear of failure and comparison to peers or international standards, may intensify feelings of intellectual phoniness and worthlessness. This aligns with Valerie Young\\u0026rsquo;s perspective that IS stems from unrealistic and unsustainable expectations of competence, particularly in high-stakes academic and professional contexts [\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e].\\u003c/p\\u003e\\u003cp\\u003eThe statistically insignificant differences in IS prevalence across years, as indicated by the ANOVA results (F\\u0026thinsp;=\\u0026thinsp;0.121, p\\u0026thinsp;=\\u0026thinsp;0.975 for presence; F\\u0026thinsp;=\\u0026thinsp;0.439, p\\u0026thinsp;=\\u0026thinsp;0.781 for score), suggest that while third-year students may experience a slightly higher burden, imposter syndrome is an issue faced at all stages of medical education. This widespread distribution highlights the need for interventions to address IS throughout the curriculum, rather than just focusing on specific years. The association of IS with burnout components such as exhaustion, cynicism, and depersonalization, as noted in the literature review [\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e], highlights its potential to negatively impact not only students\\u0026rsquo; mental health but also their academic performance. This is particularly concerning given the link between IS and depression, high stress levels, and antidepressant use, as reported by Campos et al. [\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e].\\u003c/p\\u003e\\u003cp\\u003eThe use of the Young Imposter Scale (YIS) with its dichotomous (Yes/No) format and a cutoff of five or more affirmative responses for diagnosing IS provides a practical tool for screening, but its simplicity may limit its ability to understand the complex psychological experiences of students. The lack of a formal diagnostic criterion for IS in the DSM-5, as noted in the literature review [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e], further complicates its assessment and management. Even so, the study's high response rate (100%) and the fact that students from all five years are included make the results more reliable and applicable to this institution.\\u003c/p\\u003e\\u003cp\\u003eTo lessen the impact of imposter syndrome, the findings suggest the importance of implementing structured support mechanisms, such as mentorship, peer support groups, and counseling [\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e]. Creating a safe and supportive environment where students can openly discuss their self-doubt and share experiences could reduce feelings of isolation and phoniness [\\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e]. Additionally, integrating IS awareness and coping strategies into the medical curriculum, particularly during the transition to clinical rotations and exam preparation phases, could help students build resilience and realistic self-perceptions of competence. Faculty training to recognize and address IS, along with the adoption of well-recognized tools like the Clance Imposter Phenomenon Scale or Harvey Impostor Phenomenon Scale, could further enhance early intervention efforts [\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e].\\u003c/p\\u003e\\u003cp\\u003eThe limitations of this study are its cross-sectional design, which doesn't allow for cause-and-effect conclusions, and the use of convenience sampling, which could lead to bias and make it harder to apply the results to other medical institutions or geographic regions. The focus on a single public medical college in Lahore, Pakistan, also restricts the ability to explore geographic or cultural variations in IS prevalence. Moreover, use of more specific and refined scales like Clance Imposter Scale (CIS) should be used to determine severity of imposter syndrome among medical students. Future longitudinal studies, including medical students from different institutions, years of study, and demographic backgrounds, are needed to better understand IS and its correlation with clinical exposure, exam preparation, and cultural factors.\\u003c/p\\u003e\\u003cp\\u003eIn conclusion, the prevalence of imposter syndrome among medical students, particularly peaking in the third year, reflects the psychological challenges associated with the transition to clinical rotations and preparation for high-stakes foreign exams like the USMLE. The findings emphasize the urgent need to prioritize mental well-being alongside academic excellence, ensuring that medical students are equipped with the tools and support to navigate self-doubt and thrive in their professional development. Imposter syndrome needs to be addressed through targeted interventions. This could not only enhance student well-being but also improve patient care by reducing burnout and fostering confident healthcare professionals.\\u003c/p\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003eImposter Syndrome showed a slightly higher prevalence in third-year students and the lowest prevalence among second-year students, suggesting an increasing self-doubt among medical students in later academic years. The findings highlight the need for particular attention to the middle and final stages of medical education. The statistically insignificant distribution of imposter syndrome and its high prevalence among medical students stress the need to focus on students' mental well-being as we focus on their academic well-being.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u003c/strong\\u003e:\\u003c/p\\u003e\\n\\u003cp\\u003eThe study received no funding.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eClinical trial number:\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent to Publish declaration:\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eData availability:\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe datasets generated and analysed during the current study are available from the corresponding author on reasonable request.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eEthical consideration\\u003c/strong\\u003e:\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eEthical standards were followed. Consent was taken from each participant, and anonymity and privacy were respected.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent to Participate:\\u003c/strong\\u003e\\u003cbr\\u003e\\u0026nbsp;Informed consent was obtained from all individual participants included in the study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent to publish:\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors, as well as the participants, declare no conflicts of interest and provide consent to publish.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eEthical approval/ IRB approval:\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eAs consent was obtained from each participant and anonymity and data privacy were ensured, the need for obtaining ethical approval was waived by the ethical committee of research, innovation \\u0026amp; commercialization at the King Edward Medical\\u0026nbsp;University, Lahore.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConflict of Interest\\u003c/strong\\u003e:\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eNone\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgement\\u003c/strong\\u003e:\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eNone\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor Contribution\\u003c/strong\\u003e:\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eUmaima Cheema did the analysis and conceptualized the study; Fatima Qureshi wrote the introduction and literature review; Shamikha Cheema wrote the literature review and reviewed the manuscript; Ahmed Khan wrote the discussion; Muhammad Ammar Khalid and Hafiz Mohammad Haris wrote the results, conclusion, and literature review; Razia Sultana reviewed the manuscript and prepared the final draft.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTracked changes or comments:\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNone\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n\\u003cli\\u003eHuecker MR, Shreffler J, McKeny PT, et al. Imposter Phenomenon. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK585058/\\u003c/li\\u003e\\n\\u003cli\\u003eBravata DM, Watts SA, Keefer AL, Madhusudhan DK, Taylor KT, Clark DM, Nelson RS, Cokley KO, Hagg HK. Prevalence, Predictors, and Treatment of Impostor Syndrome: a Systematic Review. J Gen Intern Med. 2020 Apr;35(4):1252-1275. Doi: 10.1007/s11606-019-05364-1. Epub 2019 Dec 17. PMID: 31848865; PMCID: PMC7174434.\\u003c/li\\u003e\\n\\u003cli\\u003eVillwock JA, Sobin LB, Koester LA, Harris TM. Impostor syndrome and burnout among American medical students: a pilot study. Int J Med Educ. 2016 Oct 31;7:364-369. doi: 10.5116/ijme.5801.eac4. PMID: 27802178; PMCID: PMC5116369.\\u003c/li\\u003e\\n\\u003cli\\u003eRice J, Rosario-Williams B, Williams F, West-Livingston L, Savage D, Wilensky JA, Landry A. Impostor syndrome among minority medical students who are underrepresented in medicine. J Natl Med Assoc. 2023 Apr;115(2):191-198. doi: 10.1016/j.jnma.2023.01.012. Epub 2023 Feb 20. PMID: 36813700.\\u003c/li\\u003e\\n\\u003cli\\u003ePajares, F. (2001). Toward a positive psychology of academic motivation. \\u003cem\\u003eThe Journal of Educational Research\\u003c/em\\u003e, \\u003cem\\u003e95\\u003c/em\\u003e(1), 27-35.\\u003c/li\\u003e\\n\\u003cli\\u003eClance, P. R., \\u0026amp; Imes, S. A. (1978). The imposter phenomenon in high-achieving women: Dynamics and therapeutic intervention. \\u003cem\\u003ePsychotherapy: Theory, research \\u0026amp; practice\\u003c/em\\u003e, \\u003cem\\u003e15\\u003c/em\\u003e(3), 241.\\u003c/li\\u003e\\n\\u003cli\\u003eCampos, I. F. D. S., Camara, G. F., Carneiro, A. G., Kubrusly, M., Peixoto, R. A. C., \\u0026amp; Peixoto Junior, A. A. (2022). Impostor Syndrome and its association with depression and burnout among medical students. \\u003cem\\u003eRevista Brasileira de Educa\\u0026ccedil;\\u0026atilde;o M\\u0026eacute;dica\\u003c/em\\u003e, \\u003cem\\u003e46\\u003c/em\\u003e, e068.\\u003c/li\\u003e\\n\\u003cli\\u003eVillwock JA, Sobin LB, Koester LA, Harris TM. Impostor syndrome and burnout among American medical students: a pilot study. Int J Med Educ. 2016 Oct 31;7:364-369. doi: 10.5116/ijme.5801.eac4. PMID: 27802178; PMCID: PMC5116369.\\u003c/li\\u003e\\n\\u003cli\\u003eChen C. Doctor who? Reflecting on impostor syndrome in medical learners. Can Fam Physician. 2020 Oct;66(10):e268-e269. PMID: 33077468; PMCID: PMC7571643.\\u003c/li\\u003e\\n\\u003cli\\u003eKhan M. Imposter syndrome\\u0026mdash;a particular problem for medical students BMJ 2021; 375:n3048 doi:10.1136/bmj.n3048\\u003c/li\\u003e\\n\\u003cli\\u003eBhama AR, Ritz EM, Anand RJ, Auyang ED, Lipman J, Greenberg JA, Kapadia MR. Imposter Syndrome in Surgical Trainees: Clance Imposter Phenomenon Scale Assessment in General Surgery Residents. J Am Coll Surg. 2021 Nov;233(5):633-638. Doi: 10.1016/j.jamcollsurg.2021.07.681. Epub 2021 Aug 9. PMID: 34384871.\\u003c/li\\u003e\\n\\u003cli\\u003eFrench BF, Ullrich‐French S, Follman D. The psychometric properties of the Clance Impostor Scale. Personality and Individual Differences [Internet]. 2008 Apr 1;44(5):1270\\u0026ndash;8. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0191886907004278 \\u003c/li\\u003e\\n\\u003cli\\u003eNaser MJ, Hasan NE, Zainaldeen MH, Zaidi A, Mohamed YM, Fredericks S. Impostor phenomenon and its relationship to self-esteem among students at an international medical college in the middle east: a cross sectional study. Frontiers in Medicine. 2022 Apr 4;9:850434.\\u003c/li\\u003e\\n\\u003cli\\u003eRivera 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.\\u003c/li\\u003e\\n\\u003cli\\u003eBaumann N, Faulk C, Vanderlan J, Chen J, Bhayani RK. Small-Group Discussion Sessions on Imposter Syndrome. MedEdPORTAL. 2020;16:11004.\\u003c/li\\u003e\\n\\u003cli\\u003eNaser MJ, Hasan NE, Zainaldeen MH, Zaidi A, Mohamed YM, Fredericks S. Impostor phenomenon and its relationship to self-esteem among students at an international medical college in the middle east: a cross sectional study. Frontiers in Medicine. 2022 Apr 4;9:850434.\\u003c/li\\u003e\\n\\u003cli\\u003eRivera 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.\\u003c/li\\u003e\\n\\u003cli\\u003eBaumann N, Faulk C, Vanderlan J, Chen J, Bhayani RK. Small-Group Discussion Sessions on Imposter Syndrome. MedEdPORTAL. 2020;16:11004.\\u003c/li\\u003e\\n\\u003cli\\u003ehttps://bhm.scholasticahq.com/article/40087\\u003c/li\\u003e\\n\\u003cli\\u003eMaqsood H, Shakeel HA, Hussain H, Khan AR, Ali B, Ishaq A, et al. The descriptive study of imposter syndrome in medical students. Int J Res Med Sci. 2018;6(10):3431-4\\u003c/li\\u003e\\n\\u003cli\\u003eLevant B, Villwock JA, Manzardo AM. Impostorism in American medical students during early clinical training: gender differences and intercorrelating factors. Int J Med Educ. 2020 Apr 29;11:90-96. doi: 10.5116/ijme.5e99.7aa2. PMID: 32356519; PMCID: PMC7246127.\\u003c/li\\u003e\\n\\u003cli\\u003ehttps://www.gobeyondbarriers.com/podcast/dr-valerie-young\\u003c/li\\u003e\\n\\u003cli\\u003eClark P, Holden C, Russell M, Downs H. The Impostor Phenomenon in Mental Health Professionals: Relationships Among Compassion Fatigue, Burnout, and Compassion Satisfaction. Contemp Fam Ther. 2022;44(2):185-197. doi: 10.1007/s10591-021-09580-y. Epub 2021 Apr 30. PMID: 33948046; PMCID: PMC8085648.\\u003c/li\\u003e\\n\\u003cli\\u003eSiddiqui ZK, Church HR, Jayasuriya R, Boddice T, Tomlinson J. Educational interventions for imposter phenomenon in healthcare: a scoping review. BMC Med Educ. 2024 Jan 8;24(1):43. doi: 10.1186/s12909-023-04984-w. PMID: 38191382; PMCID: PMC10775670.\\u003c/li\\u003e\\n\\u003cli\\u003ehttps://crl.acrl.org/index.php/crl/article/view/24984/32850\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"psychology, mental health, anxiety, fear, self-doubt\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-7829497/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-7829497/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cstrong\\u003eBackground: \\u003c/strong\\u003eImposter syndrome, also known as the imposter phenomenon or fraud syndrome, is defined by the lack of confidence in one’s skills and intellect among high-achieving individuals. Medical professionals are considered to be one of the victims of this syndrome, with limited information about the imposter syndrome and its correlation with medical education and other demographics. The study aims to assess which year of medical education has the highest prevalence of imposter syndrome.\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eMethods: \\u003c/strong\\u003eThe study design was a quantitative cross-sectional and data were collected via purposive sampling. 326 participants were included from 1\\u003csup\\u003est\\u003c/sup\\u003e year to the final-year of MBBS students in the study. The Young Imposter Scale (YIS), including the eight items, was used to perform the dichotomous assessment of imposter syndrome. Statistical analysis was done through IBM SPSS Statistics 2025, and ANOVA was applied.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eResults: \\u003c/strong\\u003e114 out of 326 students (35.0%) answered “Yes” for five or more questions. Out of the 114, 23 belonged to the 1\\u003csup\\u003est\\u003c/sup\\u003e year, 19 from the 2\\u003csup\\u003end\\u003c/sup\\u003e year, 27 from the 3\\u003csup\\u003erd\\u003c/sup\\u003e year, 23 from the 4\\u003csup\\u003eth\\u003c/sup\\u003e year and 22 students belonged to the final year. Among the groups, third-year students had the highest mean IS presence (0.3710) followed closely by fourth-year students. Second-year students had the lowest prevalence of IS, although the differences were not statistically significant.\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConclusions: \\u003c/strong\\u003eImposter Syndrome showed slightly higher prevalence in third-year students and the lowest prevalence among second-year students, suggesting an increasing self-doubt among medical students in later academic years. The findings highlight the need for particular attention to the middle stages of medical education.\\u0026nbsp;\\u003c/p\\u003e\",\"manuscriptTitle\":\"A Cross-sectional study Evaluating the Prevalence of Imposter Syndrome Across Different Years of Medical Education (MBBS)\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2025-11-17 11:09:50\",\"doi\":\"10.21203/rs.3.rs-7829497/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"403e8fa9-309f-4c4b-b818-62692dc40dbe\",\"owner\":[],\"postedDate\":\"November 17th, 2025\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-01-07T08:40:19+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2025-11-17 11:09:50\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-7829497\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-7829497\",\"identity\":\"rs-7829497\",\"version\":[\"v1\"]},\"buildId\":\"8U1c8b4HqxoKbykW_rLl7\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}