Introduction

Many students experience imposter syndrome1 during their transition to medical school.1 This is often magnified for students from underrepresented backgrounds.1,2 Because imposter syndrome can negatively affect resilience and self-efficacy,1,3,4 it is important to address. Strategies for preventing imposter syndrome is less well-known1,3 though early studies show that social and institutional support can help.1 We created a post-baccalaureate pathway program for pre-medical students from tribal, rural, and/or medically underserved areas with built-in social, academic, and psychological support aimed to mitigate students’ experiences with imposter syndrome.

Methods

PROMIS2U (Pre-Matriculation Readiness for Ongoing Medical Student Support) was created in 2020 and enrolled its first cohort in Fall 2021. Supported through a combination of a federal grant and institutional funds, the program aims to identify students from medically underserved communities in Utah who are interested in remaining in the state to provide primary care to patients in medically underserved areas. Students who apply to the Spencer Fox Eccles School of Medicine (SFESOM) at the University of Utah and meet specified criteria but who are not accepted are referred to PROMIS2U. Selected students spend one year engaging in clinical shadowing and completing foundational science and population health coursework, while getting to know the medical school faculty, students, and curriculum. During this postbaccalaureate year, students are also assigned a dedicated peer mentor, tutor, learning specialist, and wellness practitioner.

The program is in its third year of enrolling students. The first cohort was comprised of four students, the second had eight, and the current cohort has six. The first two cohorts of students participated in two focus groups during their post-baccalaureate year and completed three surveys regarding imposter syndrome, belonging, and academic success. The current cohort has completed one survey Fall 2023 and will complete surveys December 2023 and May 2024. They will also complete focus groups in Spring 2024.

Results

All students in the first two cohorts have successfully matriculated to medical school and have successfully completed their courses thus far.

The participation rate for all surveys and focus groups has been 100%. Focus group findings indicate students experienced imposter syndrome and a lack of belonging at the beginning of their postbaccalaureate years but faculty and staff helped them overcome these feelings. They specifically mentioned the benefit of a wellness practitioner. Students also reported that working with peer mentors and tutors improved their experience. A summer course that students participated in before the school year started also helped build confidence going into fall semester. The surveys provide additional evidence of improvement over the year. We observed a 10% decrease in Imposter Syndrome coupled with increases in Ability Belonging (11%), Academic Self-efficacy (18%), and Resilience (10%). syndrome stood out with a significant improvement in response.

Conclusions

The evaluation of postbaccalaureate programs has focused primarily on academic success, with less attention paid to socio-emotional well-being. Our program prioritizes both. Data collected to date demonstrates that providing students with academic and non-academic resources can help them decrease feelings of imposter syndrome and increase belonging, self-efficacy, and resilience.