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Data from Steam — Steam Web API Terms of Use. Last updated .
| Achievement | How to unlock | Unlocked by | Rarity |
|---|---|---|---|
| The (Fourth) New Gold Standard | Earn 81 Gold Stars | 1% | Very rare |
| De-Lux Suite | — | 1% | Very rare |
| Sick-in-the-Mud | Complete Wave 18 at Mudbury Festival | 1% | Very rare |
| Intensive Car Unit | Earn 1 Star at each hospital in Speedy Recovery | 1.1% | Very rare |
| Besterizer | Send 100 cured patients through the Yesterizer in Clockwise-above-Thyme | 1.2% | Very rare |
| Complete R.E.M.I. X versions of Mitton University, Tumble & Flemington | 1.3% | Very rare | |
| Earn 72 Gold Stars | 1.3% | Very rare | |
| Earn 1 Star at each hospital in A Stitch In Time | 1.4% | Very rare | |
| Cure a patient with Lightheadedness, Beheadedness, Hotheadedness, and Byteheadedness in Clockwise-above-Thyme | 1.5% | Very rare | |
| Earn 1 Star at each hospital in Culture Shock | 1.5% | Very rare | |
| Earn 1 Star at each hospital in Off The Grid | 1.5% | Very rare | |
| Earn 1 Star at each hospital in Close Encounters | 1.6% | Very rare | |
| Expose 50 Alien Infiltrators | 1.7% | Very rare | |
| Earn 63 Gold Stars | 1.7% | Very rare | |
| Complete R.E.M.I. X versions of Hogsport, Lower Bullocks & Flottering | 1.9% | Very rare | |
| Receive the highest possible Eco Rating | 2% | Very rare | |
| — | 2.1% | Very rare | |
| Earn 1 Star at each hospital on Pebberley Island | 2.1% | Very rare | |
| Cure a patient in the Herb Garden | 2.2% | Very rare | |
| Cure a patient with Frogborne | 2.2% | Very rare | |
| Earn 54 Gold Stars | 2.3% | Very rare | |
| Cure 100 patients from time portals in a single year | 2.7% | Very rare | |
| — | 2.7% | Very rare | |
| Earn 1 Star at each hospital in the Pointy Mountains | 3.2% | Very rare | |
| — | 3.4% | Very rare | |
| Train a World-Class Surgeon | 3.5% | Very rare | |
| Earn 45 Gold Stars | 3.6% | Very rare |