Quiet Doubts: Exploring the Relationship between Introversion, Demographic Characteristics, and Imposter Phenomenon among Canadian Medical Students, Residents and Practicing Physicians

Introduction: Medicine often privileges extroverted traits such as confidence, assertiveness, and decisiveness. This ‘extrovert ideal’ may disadvantage introverted trainees and physicians, increasing vulnerability to imposter phenomenon (i.e., persistent feelings of inadequacy and self-doubt). However, the relationship between introversion and imposter phenomenon remains poorly understood, particularly among marginalized demographic groups who may already be more susceptible to imposter feelings. This study explored associations between introversion, imposter phenomenon, and demographic factors among Canadian undergraduate medical students (UGME), postgraduate residents (PGME), and practicing physicians.

Methods: We conducted a cross-sectional survey. Introversion was measured using the McCroskey Introversion Scale and imposter phenomenon using the Clance Imposter Phenomenon Scale (CIPS). Demographic variables included gender, disability status, race/ethnicity, sexuality, first-generation medical student status, and training level (UGME, PGME, and practicing physicians).

Results: The final sample included 578 participants. Multiple linear regression showed that higher introversion scores were associated with higher CIPS scores (B = 0.68, 95% CI [0.52, 0.84], p < 0.001). Participants identifying as women (B = 6.18 [3.28, 8.80], p < 0.001) or disabled (B = 4.93 [1.91, 7.95], p = 0.001) also reported higher CIPS scores. UGME students reported higher CIPS scores than practicing physicians (B = 3.74 [0.46, 7.01], p = 0.03). No significant interactions were observed between introversion and demographic variables.

Discussion: Higher introversion was associated with greater imposter phenomenon across all stages of medical training and practice. Women, individuals with disabilities, and UGME trainees also reported greater imposter phenomenon. These findings highlight the need for further research into factors underlying the relationship between introversion and imposter phenomenon in medicine, and how professional cultures may shape imposter phenomenon experiences across diverse groups of trainees and physicians.