The relationship between perfectionism, self-compassion, and repetitive negative thinking with job burnout in medical students during internship

Medical students are highly susceptible to psychological pressures, including perfectionism and burnout. This study investigated the relationship between perfectionism, self-compassion, repetitive negative thinking, and job burnout among medical internship students. A total of 148 participants from Guilan province were selected using Morgan’s sampling table and completed standardized questionnaires, including the Perfectionism Scale, Self-Compassion Scale, Repetitive Negative Thinking Scale, and Burnout Scale. Data were analyzed using descriptive statistics and Partial Least Squares Structural Equation Modeling (PLS-SEM). The results showed that perfectionism positively predicted repetitive negative thinking (β = 0.412, t = 6.292, p < 0.001) and burnout (β = 0.328, t = 4.998, p < 0.001), and negatively predicted self-compassion (β = −0.741, t = 23.666, p < 0.001). Self-compassion, in turn, negatively predicted repetitive negative thinking (β = −0.646, t = 12.048, p < 0.001) and burnout (β = −0.460, t = 7.608, p < 0.001). Repetitive negative thinking positively predicted burnout (β = 0.675, t = 12.436, p < 0.001). The model explained 55.0% of the variance in self-compassion, 42.7% in repetitive negative thinking, and 45.9% in burnout; predictive Q² values for the three endogenous constructs were 0.487, 0.398, and 0.412, respectively. Overall goodness-of-fit (GOF) = 0.5141. The structural model demonstrated acceptable reliability, convergent and discriminant validity, and strong explanatory power, confirming the hypothesized relationships. These findings highlight the dual role of self-compassion and repetitive negative thinking as mediators in the perfectionism–burnout pathway. Perfectionism indirectly increases burnout by reducing self-compassion and enhancing repetitive negative thinking, underscoring the importance of addressing these mechanisms in preventive interventions. Programs designed to foster self-compassion, challenge maladaptive perfectionistic standards, and reduce ruminative and worry-related thought patterns may help protect medical students from burnout and promote their psychological well-being and academic success.