BACKGROUND: The prevalence of imposter phenomenon (IP) and its risk factors among orthopaedic surgery residents remains poorly understood. The purpose of this study was to determine the prevalence of IP, burnout, and suicidal ideation among orthopaedic surgery residents. Secondarily, we aimed to identify risk factors associated with higher levels of IP. METHODS: An anonymous survey including the Clance Imposter Phenomenon Survey (CIPS) was distributed to orthopaedic surgery residents. CIPS scores were compared using t-tests and one-way analyses of variance, and multivariable logistic regression was used to identify risk factors. RESULTS: Forty-two orthopaedic surgery residents were surveyed. Significant or intense IP was reported by 23 respondents (54.8%), with women (P <
0.002), those who experienced burnout within the past 5 years (P = 0.002), those who experienced suicidal ideation (P = 0.003), and those with a research year during medical school (P = 0.018) reporting higher levels of IP. Residents with a gap year before medical school were 4.85 times more likely to experience significant or intense IP (95% confidence interval, 1.063 to 22.107, P = 0.041). Among respondents, 15 (35.7%) were experiencing burnout, 26 (61.9%) experienced burnout over the past 5 years, 3 (7.1%) experienced suicidal ideation during their lifetime, and one (2.4%) experienced suicidal ideation during residency. CONCLUSION: Significant or intense IP was reported by 54.8% of orthopaedic surgery residents, with higher levels reported by women, those with a research year during medical school, those who experienced burnout within the past 5 years, and those with a history of suicidal ideation.