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MD-PhD programs are time-intensive, competitive, and include multiple transitions between clinical and research phases. The impostor phenomenon (IP) is an “internal experience of intellectual phoniness” among some high-achievers who attribute their success to fraudulence, luck, or others. This study aimed to understand how MD-PhDs experience IP during training. In 2017-2018, nine participants from seven programs experiencing moderate to intense IP, as determined through a survey, were interviewed. Data were analysed thematically. Four themes related to IP emerged: competition and lack of belonging, competency development and self-judgment, minority status, and transition challenges. IP manifested in tangible ways (e.g., procrastination and underperformance on tests) and became profound due to minority status and first-generation college status.