BACKGROUND: Society expects physicians to perform perfectly but high levels of perfectionism are associated with symptoms of distress in medical students. This study investigated whether medical students admitted to medical school by different selection criteria differ in the occurrence of perfectionism. METHODS: Newly enrolled undergraduate medical students (n = 358) filled out the following instruments: Multidimensional Perfectionism Scale (MPS-H), Multidimensional Perfectionism Scale (MPS-F), Big Five Inventory (BFI-10), General Self-Efficacy Scale (GSE), Patient Health Questionnaire 9 (PHQ-9), and Generalized Anxiety Disorder 7 (GAD-7). Sociodemographic data such as age, gender, high school degrees, and the way of admission to medical school were also included in the questionnaire. RESULTS: The 298 participating students had significantly lower scores in Socially-Prescribed Perfectionism than the general population independently of their way of admission to medical school. Students who were selected for medical school by their high school degree showed the highest score for Adaptive Perfectionism. Maladaptive Perfectionism was the strongest predictor for the occurrence symptoms of depression and anxiety regardless of the way of admission. CONCLUSIONS: Students from all admission groups should be observed longitudinally for performance and to assess whether perfectionism questionnaires might be an additional useful instrument for medical school admission processes.