Background: Impostor syndrome is common in demanding medical fields, however data on rheumatologists in some regions, such as Latin America, are limited. The Pan-American League of Associations for Rheumatology (PANLAR) integrates rheumatology scientific societies, health professionals, and patient groups from all countries across the Americas.

Objectives: This study aims to evaluate impostor syndrome and related factors among rheumatology professionals of PANLAR countries.

Methods: We conducted a multicenter, cross-sectional, observational study using an online survey distributed to rheumatologists and rheumatology residents across the American Continent. We classified the countries by regions: North America (Mexico, Canada and the United States); Bolivarian South America (Colombia, Ecuador, Venezuela, Peru, Bolivia); the Southern Cone (Brazil, Uruguay, Paraguay, Argentina and Chile) and Central America and the Caribbean (Guatemala, Honduras, El Salvador, Nicaragua, Costa Rica, Panama, Cuba and the Dominican Republic). Burnout was assessed with the single-item Mini-Z burnout measure. Impostor syndrome was assessed using the Clance Impostor Phenomenon Scale (validated Spanish and Portuguese versions). Impostor syndrome severity was classified as low (≤40), moderate (41–60), frequent (61–80), or intense (>80). We dichotomized impostor syndrome as frequent/intense vs. low/moderate. Descriptive statistics were used to summarize the data. Associations between impostor syndrome and covariates were examined using univariable and multivariable logistic regression analyses.

Results: A total of 551 participants from 19 Latin American countries were included. The overall median impostor score was 54 (IQR 39–70) and 335 (60.8%) professionals were classified with low/moderate and 216 (39.2%) with frequent/intense impostor syndrome (Table 1). Women represented 65.5% of the total sample, with a higher proportion of frequent/intense impostor syndrome compared with men (75.9% vs. 58.7%, OR 2.2, 95% CI 1.5–3.2). Participants aged 25–45 years comprised 53.9% of the total sample and accounted for 76.4% of those with frequent/intense impostor syndrome. Older age was inversely associated with frequent/intense impostor syndrome (OR 0.2, 95% CI 0.2–0.4), however having more than 10 years since graduation was associated with a higher likelihood of frequent/intense impostor syndrome (OR 3.9, 95% CI 2.7–5.6). In contrast, having ever held a leadership position was associated with a lower likelihood of frequent/intense impostor syndrome (OR 0.4, 95% CI 0.2–0.5). Participants with frequent/intense impostor syndrome had significantly higher burnout scores compared with those with low/moderate impostor syndrome (mean [SD] 1.8 [0.9] vs. 1.1 [0.8]; OR 7.7, 95% CI 5.6–9.3). No significant associations were observed for geographic region of birth, type of practice, involvement in teaching, research activities, or monthly income. In the adjusted multivariable analysis female sex (OR 1.8, 95% CI 1.2-2.9), younger age (OR 2.2, 95% CI 1.4-3.4), graduation time longer than 10 years (OR 1.6, 95% CI 0.9-2.6) and higher burnout scores (OR 2.2, 95% CI 1.7-2.9) remained associated with frequent/intense impostor syndrome. Having ever held a leadership position remained inversely associated (OR 0.6, 95% CI 0.4-0.9). Place of birth and income were not significantly associated with impostor syndrome (OR 1.07, 95% CI 0.86-1.32 and OR 0.98, 95% CI 0.83-1.15, respectively). Compared with men, women were more frequently at earlier career stages, less often in leadership roles, and overrepresented in lower-income groups (all p < 0.05). No gender differences were observed in education, teaching, research, or practice. Women had higher median impostor scores than men (56 [42–75] vs 46 [35–62], p<0.001) and scored higher across most impostor-related domains, including fear of evaluation, discomfort with praise, fear of being exposed as incompetent, tendency to remember failures, fear of failure, downplaying recognition, comparison with others, and worry about not succeeding (all p < 0.01). Women reported higher burnout scores (p<0.001).

Conclusions: Impostor syndrome is highly prevalent among rheumatology professionals in PANLAR countries and is strongly associated with female sex, younger age, longer time since graduation, and higher burnout levels, while leadership experience appears to be protective. These findings highlight the need for strategies to promote leadership development, address burnout, and support vulnerable groups, particularly women and early-career rheumatologists.

REFERENCES: NIL.

Acknowledgments: NIL.

Disclosure of Interests: None declared.