Setting and Problem
Resident physicians are at high risk for impostor syndrome: inaccurate, devaluing self-assessments that limit feelings of adequacy. Estimated syndrome prevalence among residents approaches 75% and is greater in women and minorities. Consequences may include burnout, social isolation, and fear of asking for help or admitting failures. Numerous factors contribute, including frequent transitions, variable expectations, and new environments. Not to supplant efforts addressing root causes of impostor syndrome, but to serve adjunctively, we created a forum to openly acknowledge the issue through a peer lens.
Intervention
Empathy Rounds is an event featuring respected resident panelists being vulnerable and sharing themed personal stories with an audience of peers. The goals of Empathy Rounds include peer normalization of imperfection and recognition of shared struggles to target impostor syndrome and nurture the resident community. Hearing peers being vulnerable can drive recognition that audience members are not alone and that they share work-related emotions, doubts, and fears.
At our pilot event, 3 recruited panelists and a facilitator—all residents from across postgraduate years and specialties—engaged with an exclusively resident audience under the theme “Transitions in Training,” where they candidly shared personal impacts of challenging situations. Importantly, Empathy Rounds are not intended as a morbidity and mortality conference to assign blame or drive process improvement. Instead, they are designed for panelists to reflect on their experience of an experience and open up about uncertainties, struggles, and coping strategies—recognizing their way might not be right or wrong but has been their journey. Panelist stories were varied and included powerlessness on a care team, uncertainty making the “right” code status recommendation in patients who later died, antidepressant use, unexpected family loss and pregnancy, and a residency leave of absence.
The 1-hour event replaced 1 of 2 previously scheduled all-resident meetings, whose historically addressed grievances included whether the peanut butter in the lounge should be crunchy or creamy. Because of the content substitution at a preexisting meeting, the audience took no additional time or preparation for the event. The event had pre-allocated continental breakfast items and coffee, but their inclusion was not strictly necessary for the gathering. Logistically, it required only a space reservation, chairs, a microphone, cups of water, and facial tissues.
Outcomes to Date
The term “resident wellness” is encumbered with rhetorical baggage following a well-intentioned history of interventions that effectively amount to victim-blaming. Often, wellness activities convey “residents would be better if they would do…” a combination of yoga, reflective writing, or some other new to-do list item, often without addressing underlying issues. Aside from listening, we did not ask residents to do anything or ambitiously offer panaceas but simply sought acknowledgement and validation. “Wellness” through Empathy Rounds passively de-emphasizes resilience, work-life balance, or hours worked. Rather than turning to faculty or administration, it relies on peers to deliver a genuine message.
Of the 45 attendees (representing 35% of graduate medical education trainees on any rotation at any site), 12 (27% of attendees) completed a voluntary survey, with 100% supporting continuation of Empathy Rounds. While our graduate medical education department is small, the event framework can be easily scoped depending on program needs and sizes. Future work could include quantification with the Clance Impostor Phenomenon Scale, proactive coupling with simulations addressing common scenarios, or integration with longitudinal peer support programs.
Empathy Rounds represents an adaptable framework intended to combat impostor syndrome and its potential consequences through peer support, with normalization of vulnerability and emotional disclosure.