Exploring Sources of First- and Second-Year Medical Student Perceptions of the Ideal Physician

Abstract

Imposter phenomenon is linked to medical student burnout, which has significant implications for the physician workforce, patient care, and the healthcare system as a whole. One source of feeling like an imposter is comparing oneself to the expected image of an ideal physician, however, it is not well understood how physicians in training develop these ideals. In a sequential exploratory mixed methods study, Phase 1 conducted semi-structured focus groups (n=6) with first- and second-year medical students from Indiana University School of Medicine. Participants (n=22) were asked what attributes an ideal physician has, where these ideas came from, and if these expectations impacted their sense of belongingness in the field of medicine. Transcripts were analyzed using the framework method of thematic analysis. Participants in Phase 2 (n=131), who were from allopathic medical schools across the US, responded to a self-administered survey based on results of P1. Items on this survey included demographics, prior experiences in healthcare, habits/interactions with media, and the Clance Imposter Phenomenon Scale (CIPS). Descriptive statistics and chi-squared tests for independence were used to determine if there was an association between demographics and attributes or sources of the ideal physician. Hoeffding’s d correlations were used to examine correlations between television watching habits and CIPS. This study found two major themes with several subthemes: The Dynamic Ideal and Conceptualizing the Ideal. These themes describe how the ideal image of a physician is perceived by first- and second-year medical students. The statistical analyses found relatively few significant associations between variables; thus, the ideal physician depends on the individual lived experiences of medical students. This study demonstrated that while medical students do have preconceived ideas of what the ideal physician should be that stem from the sum of their lived experiences, there is no one-size-fits-all model. Educators can use these data to communicate with students who may be experiencing imposter feelings that these feelings are also a normal and expectable result of comparing oneself with an ideal type.