How healthy is ‘striving for excellence’?

According to the CanMEDS, physicians should demonstrate a lifelong commitment to excellence. However, striving for excellence might not be without risks. The first commandment of medicine, placing the best interests of patients at the centre of everything we do, could be put at risk, because excellent top doctors might imagine they are at the centre of the medical universe. Second, striving for excellence could cause burnout in medical students. Much research on burnout in medical students has identified causes in the students themselves. In this article, it is argued that the learning climate, especially the emphasis on excellence, may also contribute to the development of burnout in medical students. This is not a plea for all striving to cease, but always striving for excellence may not benefit every student. A supportive learning environment, on the other hand, is important for optimal learning, facilitates development of professionalism and presumably has a profound impact on student wellbeing.