Table 2 Themes linked to the impostor phenomenon among MD-PhD students

Professional-identity formation

“We were viewed as a special group, not good enough to take care of people [as medical students] and [a] dilettante doing research, but not as much or as well as other doctoral students. I discounted my achievements with self-deprecating thoughts like, ‘I networked my way into getting accepted, I didn’t deserve this. I’m not good enough.’” (John)

I wouldn’t do well because no one in my family was in medicine, and my undergraduate degree wasn’t competitive enough for me to compete in medical school. (Maya)

I was always studying on my own. I did not have any support. There was a lot of social exclusion, some students work together in groups, and they never invite or reach out to other [MD-PhD] students. (William)

Fear of evaluation

“I believe that when I eventually fail, people would say, ‘Oh, he failed. He messed up, dropped the ball. This is who he truly is. He doesn’t deserve this.’” (Samuel)

When you first start out, you get asked all these really basic questions, sometimes about different orders and stuff for nurses. A big part of the impostor phenomenon is questioning your ability and competence when you don’t have experience, the right answers, or the ability to say things confidently. (Thomas)

I try to hide my weaknesses in the research side of things because I haven’t done as much research as others in my program. I think they [faculty] don’t realize how weak I am in that area. I think I’m weak. That could also be impostor phenomenon. (Lucy)

Minority status

“There are very few Native American physicians and physician-scientists. The health issues of Native Americans are poorly understood. I was admitted because I’m Native American and a diverse student. I am an affirmative action admit, that is why I feel like an impostor. (Maya)

Sometimes, the patient questions people who are underrepresented more than other doctors, that tendency where people, based on appearances, have different expectations for them. That’s where that sense of being an impostor comes from. (Samuel)

I definitely know that it [my minority status] is being considered since it helps the grant look good when it has been used to promote diversity. (Samuel)

Program-transition experiences

“During transition points, you’re rusty at whatever you’re transitioning to.” (Samuel)

The transition between being in a [preclinical] classroom, having very set goals, and this is a test that you’re gonna study for. This is what’s gonna be on the test. Here’s the date. That, as opposed to being in the lab. It’s just like hey, here’s a project. Go make it work. That is very different. (Thomas)

[Reintegrating into medical school was] really hard on me, because I had forgotten a lot of clinical knowledge. Sometimes I’ll hear a drug name and I’m like, ‘Oh, my God. I know that’s a common drug and everyone knows it, but I don’t remember, exactly, what it is, and I have to look it up.’ That probably, definitely, adds to the challenge. Just being rusty. (Samuel)