One in Four New Occupational Therapists in India Feels Like a Fraud, Study Finds

A quiet crisis of confidence appears to be running through the early ranks of India’s occupational therapy profession. A new cross-sectional study published in Discover Social Science and Health reports that one in four early-career occupational therapists in India experiences impostor phenomenon at moderate-high to high intensity, a psychological pattern in which competent people persistently doubt their abilities and live with a gnawing fear of being exposed as frauds, despite objective evidence of their success. The research, conducted by a team at Yenepoya (Deemed to be University) in Mangalore, offers one of the first systematic looks at how this phenomenon manifests among occupational therapists in India, a professional group that has been largely overlooked in the expanding global literature on impostorism in healthcare.

Impostor phenomenon, first described by psychologists Pauline Rose Clance and Suzanne Imes in 1978, is not a formal psychiatric diagnosis but a well-documented psychological experience. People affected by it attribute their achievements to luck, timing, or deception rather than skill, and they live in fear that colleagues will eventually discover their supposed incompetence. In healthcare settings, the stakes of this pattern are considerable. Clinicians who doubt themselves may hesitate in decision-making, avoid seeking feedback, experience burnout, and disengage from professional growth. Early-career health professionals are considered especially vulnerable because they are navigating the demanding transition from supervised student to autonomous practitioner, a shift that confronts them with novel responsibilities, uncertain competence, and constant evaluation.

The research team, led by Fathimath Hisana and colleagues in the Department of Occupational Therapy at Yenepoya Faculty of Allied and Healthcare Professions, set out to measure how intensely impostor phenomenon affects occupational therapists in India with fewer than two years of clinical experience, and to identify the personal, occupational, and environmental factors that these professionals themselves believe drive the experience. The study recruited 100 participants through snowball sampling, a technique in which initial respondents refer additional eligible colleagues, a practical approach for reaching a dispersed professional population across the country.

Methodologically, the survey was built around the Leary Impostorism Scale, a widely used twenty-item instrument that asks respondents to rate statements about impostor-type feelings on a scale from ‘not at all true’ to ‘very true.’ Scores on this instrument place individuals along a continuum of impostor intensity, from low through moderate to high. To capture the contextual drivers of these feelings, the researchers supplemented the scale with constructs drawn from the Canadian Model of Occupational Performance and Engagement, a foundational framework in occupational therapy that conceptualizes how personal, occupational, and environmental dimensions interact to shape a person’s engagement in meaningful activity. The questionnaire was validated by experts before deployment, and the analysis combined descriptive statistics with Mann-Whitney U tests, a non-parametric statistical method suited to comparing scores between two independent groups when data are not normally distributed, to examine how impostor scores varied across demographic and professional characteristics.

The headline finding is stark in its simplicity: 25 percent of the surveyed early-career occupational therapists reported impostor phenomenon in the moderate-high to high intensity range. That figure aligns with a broader pattern documented across health professions, where studies of physicians, nurses, and allied health workers have repeatedly found that a substantial minority of trainees and new practitioners experience clinically meaningful impostor feelings. What distinguishes the new study is its focus on occupational therapy, a profession in which practitioners help patients regain the functional capacity for everyday life, and its grounding in the specific professional and cultural context of India, where workforce conditions, supervision structures, and recognition patterns may differ substantially from the Western settings where most impostor research has been conducted.

One demographic difference stood out with statistical significance. Female participants scored significantly higher than male participants on the impostorism measure, with a Mann-Whitney U statistic of 594 and a p-value of 0.046, a result that just crosses the conventional threshold of statistical significance at the 0.05 level. This finding echoes a large body of international literature suggesting that women in medicine and academia report impostor feelings more frequently and intensely than men, a disparity often attributed to gendered expectations, underrepresentation in leadership, and differential patterns of feedback and recognition. By contrast, the study found no significant differences in impostor scores based on age, educational qualification, or length of experience within the early-career window, suggesting that within this cohort, the experience of impostorism is not simply a function of being newest to the job but is distributed across the first two professional years.

Perhaps the most practically valuable contribution of the study lies in its catalog of perceived contributing factors, which the researchers organized around personal, occupational, and environmental dimensions. The most frequently endorsed factor, cited by 36 percent of participants, was fear of being perceived as inexperienced, a concern that speaks directly to the identity transition at the heart of early professional life. Close behind, at 35 percent, was physical exhaustion, linking impostor feelings to the tangible toll of demanding clinical work and long hours. People-pleasing tendencies, reported by 32 percent, reflect a personality-oriented contributor in which practitioners prioritize others’ approval over self-assessment, a pattern long associated with impostorism in the psychological literature. Transitional challenges, endorsed by 31 percent, capture the disorientation of moving from student roles to independent practice, while pressure to collaborate, cited by 30 percent, points to the interpersonal demands of multidisciplinary healthcare teams where new therapists must hold their own alongside senior colleagues from other professions.

Environmental factors also registered prominently. Limited professional opportunities were endorsed by 27 percent of respondents, and lack of recognition by 26 percent, findings that situate impostor feelings not merely as individual psychological quirks but as experiences shaped by the structural realities of the Indian allied health workforce. Where career ladders are short, roles are poorly defined, or achievements go unacknowledged, even competent practitioners may internalize the message that their work lacks value. The authors emphasize that these findings highlight the multifactorial nature of impostor phenomenon among early-career occupational therapists, with contributions from personal, occupational, and environmental sources, and they call for future research to examine the relative weight of each factor so that interventions can be targeted effectively.

The study’s implications extend beyond occupational therapy. If a quarter of new practitioners in one allied health profession report intense impostor feelings, the same dynamics are likely operating across the wider early-career health workforce in India and comparable settings. The identified contributors suggest concrete points of intervention. Mentorship programs and structured onboarding could directly address fear of inexperience and transitional challenges. Workload management and attention to fatigue could reduce the exhaustion component. Recognition systems, transparent career pathways, and team cultures that normalize questions from junior members could chip away at the environmental drivers. Because the study used a cross-sectional design, it captures a snapshot rather than a trajectory, and its sample of 100 participants recruited through snowball sampling, while adequate for exploratory analysis, limits generalizability and prevents causal inference. Self-reported perceived factors, moreover, reflect what practitioners believe drives their feelings rather than empirically verified causes.

Nevertheless, the research adds an important and underexplored population to the global map of impostor phenomenon, and it does so with a theoretically grounded instrument that bridges individual psychology and the occupational science framework central to the profession itself. For the occupational therapists who participated, and for the many colleagues they represent, the study offers a validating message: the sense of being a fraud is common, measurable, and shaped by identifiable forces, which means it can be named, studied, and ultimately addressed. As health systems worldwide confront burnout and attrition among young clinicians, understanding the psychological weight of the transition to practice, and the gendered and structural conditions that amplify it, may prove as important to workforce sustainability as any recruitment strategy. The Yenepoya team’s findings provide a data-driven starting point for that conversation in India, and a template for similar investigations in other allied health professions and regions where impostorism remains an unmeasured burden.

Subject of Research: Impostor phenomenon intensity and its perceived contributing factors among early-career occupational therapists in India

Article Title: Intensity of Impostor Phenomenon and Perceived Contributing Factors among Early-career Occupational Therapists in India

Article References: Hisana, F., KVP, H. H., Mufeeda, F., Afnan, F., & Pandey, L. (2026). Intensity of Impostor Phenomenon and Perceived Contributing Factors among Early-career Occupational Therapists in India. Discover Social Science and Health. https://doi.org/10.1007/s44155-026-00480-w

Image Credits: AI Generated

DOI: 10.1007/s44155-026-00480-w

Keywords: impostor phenomenon, occupational therapists, early-career professionals, India, mental health, occupational health, self-efficacy, burnout, healthcare workforce, occupational therapy, gender differences, Leary Impostorism Scale