Burnout and impostor phenomenon among emergency physicians in Japan: a multicenter cross-sectional study

Abstract Background Impostor phenomenon and burnout have been reported to negatively affect emergency physicians (EPs). This study aimed to determine the prevalence of burnout and the proportion of Japanese EPs exceeding the Clance Impostor Phenomenon Scale (CIPS) cutoff for the impostor phenomenon, and factors associated with these outcomes, among Japanese EPs. Methods We performed cross-sectional questionnaire research in 34 Japanese emergency departments (EDs). We administered the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and CIPS, and examined their associations with ED- and EP-level factors using mixed-effects logistic regression with a random intercept for ED to account for clustering of physicians within departments. Results In total, 307 EPs (70.4%) participated in the survey. In MBI-HSS, 64 (20.8%), 69 (22.5%), and 197 (64.2%) EPs had a severe degree of emotional exhaustion (EE), depersonalization, and personal accomplishment (PA), respectively; and 34 (11.1%) EPs scored severely across all three components. In CIPS, 92 (30.0%) EPs had a higher value than the cutoff. In the multivariable analysis of MBI-HSS, severe EE scores were associated with average sleep period (odds ratio [OR], 0.708; 95% confidence interval [CI], 0.505–0.995; P = 0.046), and reduced PA scores were associated with a younger age (OR, 0.971; 95% CI, 0.946 − 0.998; P = 0.035). Regarding CIPS, high CIPS scores correlated with a younger age (OR, 0.951; 95% CI, 0.917–0.985; P = 0.006). Conclusions Our results revealed that 11.1% of Japanese EPs met the study-defined criteria for severe scores across all three MBI-HSS subscales. Furthermore, 30.0% of the participants exceeded the CIPS cutoff, a proportion that appeared broadly similar to that reported in other studies, despite the presence of more severe PA scores. A reduced sleep period and a younger age were each associated with selected indicators of reduced well-being. These findings suggest potential implications for ED management, such as the importance of attention to sleep opportunities and support for younger EPs. However, further evaluation is required before specific recommendations can be made.