Workplace Violence and the Impostor Phenomenon in Medicine: A US-Based Qualitative Study

Abstract

Physicians experience impostor phenomenon when they attribute their success to luck and fraudulence rather than ability or competence. They also experience workplace violence, including sexual and nonsexual harassment, discrimination, microaggression, and assault, among others. Using Weiner's attribution theory, this qualitative study interviewed US-based physicians experiencing impostor phenomenon to investigate its connection with workplace violence. Two research questions were examined: What are the different forms of workplace violence reported in medicine? How does workplace violence contribute to impostor phenomenon? Interested participants responded to an advertisement about a national study examining impostor phenomenon at a US-based medical conference (convenience sampling). After the interview, many participants shared the study information in their professional and social network, encouraging others to participate (snowball sampling). Data were analyzed using constant comparison and analytic induction. Sixty-three physicians completed the initial survey and were all invited for the interview. Thirty-five out of them interviewed and the rest did not respond to the invitation email. Of those 35 physicians, 19 (95% women; 79% white) between ages 30–59 years specifically reported experiencing impostor phenomenon when facing physical, verbal, racial, and/or gendered violence. Gendered violence included both gender-based assumption of position or competence and gender-based harassment. Impostor phenomenon occurred when women and men were treated differently; participants questioned their competency or belonging; and women saw fewer women physicians around them and other women perpetrating violence. The impostor phenomenon was attributed to an external experience of violence perpetrated by people of all genders and relationship types, including seniors and peers, physicians, patients, and nurses. Participants often could not control violence perpetration and instead, internalized the experience as their fault and lost a sense of belongingness at work. Findings, while not generalizable and based on a small sample, show that impostor phenomenon is not only affected by individualized internal mechanisms, but external environmental factors as well such as experiencing violence or seeing it happen to others. Future research should explore the role of race/ethnicity, sexual orientation, gender orientation, socioeconomic status, and generation status in shaping such experiences.