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Defining success in medicine: why perfectionism is not the answer
  1. Kathrine S Rallis1,
  2. Yuxiao Alice Wang1,
  3. Jack Barton2
  1. 1School of Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
  2. 2School of Medicine, St George's University of London, London, UK
  1. Correspondence to Miss Kathrine S Rallis, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London E1 2AD, UK; k.s.rallis{at}

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Perfectionism comprises internally motivated beliefs that striving for perfection and being perfect are important. Self-oriented perfectionists have exceedingly high personal standards, strive for perfection, expect to be perfect and are highly self-critical of themselves if they fail to meet these expectations, often with devastating consequences.1 2

Perfectionism is a set of internally motivated beliefs that being perfect is important. A perfectionist has extremely high self-standards and is highly self-critical if they fall short of these. Yet, today, calling someone a perfectionist has become somewhat of a cliché, especially within medicine. It may even be considered an aspiration or a desirable trait. This is of course a fallacy.

Medical schools inevitably select students based on perfectionist traits.3 4 Yet, while perfectionism is a common indicator of success among high achievers as well as of conscientiousness, which is a predictor of job performance,4 5 it is also a well-established mediator of psychological distress.6 High maladaptive perfectionism is associated with cognitive distortions which contribute to higher levels of stress, anxiety, depression, imposter syndrome and burnout.6 7 Perfectionism is independently associated with negative mental health effects and is one of the strongest predictors of psychological distress, anxiety and depression among medical students.8 Hence, it may even be considered a contributor to the higher prevalence of mental health disorders including burnout and suicide among medical students and doctors.3 8

One may argue that when it comes to perfectionism, we must realise these irrational …

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  • Contributors KSR conceptualised and wrote the Letter; YAW and JB contributed to the drafting and revision of the letter.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.