There’s a big difference from being a highly motivated medical student who is eager to learn and hoping to perform well on exams and being an overly competitive gunner who bullies their peers or shows them up at every turn.

As a resident who loves teaching his medical students, I’ve found that the former makes for an incredibly enjoyable rotation for myself while the latter can make my days unbearable. And it’s not just gunners. Students who are rude, lazy, unprofessional, and/or uninterested can be just as unpleasant.

Remember: At the end of the day, your clinical evaluation is a crucial factor in determining if you honor your rotation. And while the evaluation might be more or less important on certain rotations, I can personally attest that I have seen bad evaluations take honors from students with top tier shelf scores, and I have seen amazing evaluations lead to honors for students who may have underperformed on their shelf exam.

Fortunately, getting a good evaluation is not rocket science.

While it is always helpful to be intelligent and hard working, you can often times achieve a favorable review by being motivated, cheerful, and fun to be around. This is otherwise professionally referred to as: not being a douchebag.

So how do you do that? Here are some mostly serious things to avoid on a rotation and to laugh at if you just need a quick break from studying. (And yes, these are all things that I have either witnessed firsthand or have heard about from friends.)

First, let’s get the “don’ts” out of the way.

Don’t…

• • Publically argue with your resident especially if your argument is based around “a question I kind of remember from UWorld.”
  • Pimp your resident about Step 1 material that you think they may have forgotten.
  • Tell your resident that a patient has no surgical history when they’re staring at the sternotomy scar on said patient’s chest.
  • Accidentally perform a rectal exam when attempting to perform a pelvic exam. (If you do, don’t try to defend it.)
  • Ask when we are getting off especially not at 10 a.m. on your first day.
  • Correct your fellow student on rounds. It’s a surefire way to have a lot of really hard pimp questions coming your way.
  • Correct your resident when they are presenting on rounds. Chances are they are a lot busier than you and sometimes they just forget things. But trust me — they won’t forget that you did that.
  • Be entitled — most residents are doing the best they can to get you involved.
  • Talk bad about your fellow students.
  • Talk down to nurses. It’s a quick way to get a bad reputation.
  • Call yourself doctor.
  • Hit on a patient, or worse, ask them out on a date.
  • Show up late. If you do, own it.
  • Withhold important information from your fellow student.
  • Ask if you can scrub out to get food one hour in to a surgery.
  • Offer to hold your resident’s pager for consults and then delete all of the pages without writing them down. Your resident is the one that the ED will hate.

Also note:

• • Saying “I don’t know” or “I forgot to ask” is a whole lot better than telling a lie.
  • Asking, “Is there anything I can do?” fifteen times in a row IS more annoying than asking if you can just go home.
  • No, you cannot do a central line by yourself unsupervised. (Come on, man.)
  • On a rather special note, if your attending has an uncommon last name—say, for example, Carrubba. Think before saying something negative about that other Dr. Carrubba you worked with. (In my case, that other doctor’s my wife.)

And finally:

Don’t tell a patient they are likely dying. Especially if they aren’t.