and depression. Those affected may attribute their accomplishments to luck or happenstance rather than earned merit and may wonder if they have fooled others into believing they are authentically competent.3,6


Once imposter syndrome settles in, it can perpetuate a self-reinforcing cycle. This dynamic may produce feelings of excessive anxiety, poor self-esteem, self-doubt, frustration and depression. Those affected may attribute their accomplishments to luck or happenstance rather than earned merit and may wonder if they have fooled others into believing they are authentically competent.


The impostor cycle Those affected by impostor syndrome experience a familiar and troubling cycle of professional dysfunction. Their sense of inadequacy can lead to an attempt to compensate via overwork and a rigid adherence to perfectionism. This hard work usually pays dividends in demonstrable success and peer approval, which leads to a transient sense of accomplishment and worthiness. However, these feelings are short-lived and eventually the individual returns to focusing on their self-perceived inadequacy. Common professional setbacks can also accelerate the cycle—for example, medical errors or poor patient outcomes can be devastating to affected practitioners and amplify feelings of guilt, unworthiness and self-doubt.3


Many are often not aware of the cycle and may be reluctant to discuss their feelings with peers for fear of being judged or undermining their own hard-won achievements. This fear of being judged not only makes it difficult to discuss feelings but can also lead to professional isolation and fewer opportunities for peer support and mentoring.


Studies suggest that as much as 70% of the population has experienced symptoms of impostorism at some point in their life, most often as a response to a new environment or relationship. For some the condition is transient, but for many others the cycle


Poor outcomes; Errors


Fear of inadequacy


Transient sense of


success or worthiness


Figure 1.


Dysfunctional cycle


of impostor syndrome


Compensation with overwork (or self sabotage)


Burnout; Anxiety; Depression


Approval Accomplishment


Once imposter syndrome settles in, it can perpetuate a self-reinforcing cycle. This dynamic may produce feelings of excessive anxiety, poor self-esteem, self-doubt, frustration and depression.


becomes chronic. It is believed to exist almost equally in men and women, though it may be expressed quite differently between the genders.1,4


In one study, men who suffered from impostor syndrome often sought situations where they were less likely to be viewed as “frauds” and compared themselves to peers who were less qualified. This scenario can protect an individual’s self-esteem but impairs their ability to fulfill their full potential.5-7


In


contradistinction, the study showed that women more often delve deeply into competitive spaces but are constantly plagued by feelings of inadequacy. Again, this impairs professional enjoyment and development.


Impostor syndrome and IR The pervasiveness of impostor syndrome within the radiology and IR workforce is unclear. However, a


study published in November 2021 found that in one academic radiology group, 83% of respondents to a survey reported experiencing impostorism. In this group, there was a high correlation between impostorism and professional burnout.9,11


The number of impacted


individuals may be the same in IR, as evidenced by an informal online survey performed by Robert K. Ryu, MD, FSIR, in which 87% of 277 respondents identified feelings of impostorism.7


This


indicates that impostorism in IR may be rampant but is largely unacknowledged and untreated.


In general, those affected by impostorism have lower career satisfaction than those who do not but demonstrate much deeper levels of organizational commitment.8 However, they struggle to market themselves, which impacts their salaries and professional development.


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