The 3rd year of medical school is an exciting time. The basic science classwork of the first two years is behind you and now you get to see and care for real patients. You are that much closer to becoming a full fledged doctor!

Having been a medical student and having worked with medical students as an intern, resident, fellow, and attending I saw plenty of students who succeeded as well as those that struggled during their clinical years. Here are tips that helped me to succeed as a medical student during my 3rd and 4th year rotations as well as attributes and characteristics of medical students that impressed me as I have worked with them during my medical career.

While some advice may seem obvious, it is amazing how many medical students either do not care or just do not know how important it is to be on time or to be polite.

1. Be on time.
2. Better yet, be a few minutes early.
3. Be prepared.
4. Be polite.
5. Be respectful.
6. Be liked.
7. Learn names. If you know the names of your team and nurses, they are more likely to remember you and help you out.
8. Be a team player.
9. Don’t put other students down and don’t correct other students during rounds, ie don’t be a “gunner” (see below for tips on how to avoid becoming a gunner).
10. Don’t be annoying.
11. Be positive but not excessively positive.
12. Don’t complain.
13. Be engaged.
14. Be interested or at least try to show interest no matter the specialty you are rotating through.
15. Be honest. Don’t lie about the specialty you plan on going into just to gain favor from your resident or attending.
16. Be professional.
17. Dress appropriately.
18. Ask good questions.
19. Ask questions when appropriate.
20. Study, study, study so that you are prepared to ask good questions and answer questions that will be asked of you.
21. If you don’t have the answer to a question, admit it and commit to researching the topic. Be sure to report on your findings later.
22. Know as much as you can about your patients and their disease processes.
23. Practice presenting your patients.
24. Limit the amount of time you are on your phone. While you may be studying, others will assume you are on Instagram and/or disinterested with the rotation.
25. Look for opportunities to help the team.
26. No one likes “scut” work but residents and attendings appreciate it when med students offer to help.
27. During down time, limit the amount of activity which may be perceived as boredom, ie personal phone calls, social media, etc.
28. Don’t pull out your phone to check your texts and emails when your resident or attending is speaking.
29. During down time study for shelf exams, follow up on your patients labs and imaging, learn about your patients and their diseases.
30. Don’t take criticism personally. Take the opportunity to learn and improve on the experience.
31. Learn from your mistakes. Don’t let your mistakes stress you out.
32. Learn from the experiences of other classmates and 4th year students. Know what to expect from each rotation, including what to expect from the attendings and residents you may encounter.
33. Have the right pocket books. Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine and Dr. Pestana’s Surgery Notes: Top 180 Vignettes for the Surgical Wards
34. Know how you will be evaluated and graded for the rotation.
35. Understand that life is not fair and that grading is very subjective during the clinical rotations of your 3rd and 4th years.
36. Meet with you attending and/or resident mid way through your rotation to ask for specific feedback.
37. During this meeting, you should ask your attending and/or resident how you can improve. If the answer is nonspecific, push for 3 things that you can do to improve on this rotation and write them down.
38. Work on those 3 goals during the second half of the rotation. Towards the end of the rotation, meet with your attending and/or resident to thank them for all they have taught you. Then remind them that you worked on those 3 items that they recommended which has really improved your learning and experience on this rotation.
39. Be available and be visible. Don’t disappear.
40. If asked to do something your response should be,”Yes, I got it!” or, “I’ve never done that before. Will you teach me so I can do it next time?” Make sure to do it the next time the opportunity arises.

Your 3rd year of medical school will be both mentally and physically exhausting. As you follow the advice above, hopefully your 3rd year of medical school will also be a rewarding and educational experience. Memories will be made. Whether they are positive or negative memories is up to you.

Be proactive about your medical education. By getting involved, working hard, and having a positive attitude you will learn important skills to become a physician.

What is a Gunner?

Please understand that there is a distinction between a proactive and engaged student who wants to learn and succeed versus the “gunner.”

A gunner is a medical student who is so overly ambitious that they are willing to belittle and throw others under the bus so that they can boost their own image and self worth. To the medical school gunner, nothing is more important than becoming the teacher’s pet to get the best grades and they will do it at the expense of their classmates without hesitation.

A gunner will often lie about how much they study and put down their classmates for trying too hard or studying too much, a term I call a “closet gunner.” A times a gunner will resort to underhanded tactics to sabotage their classmates, all in an effort to move their way up the grading curve.

Gunners are not uncommon in medical school. I get it. The same traits that drive us to succeed, helped all of us type A personalities to get through the hyper-competitive process of the medical school application process. Unfortunately, excessive type A traits also lead students into becoming gunners.

I still recall when I asked a classmate where a review session would be held in preparation for an upcoming test. I did not know the other student well, but figured since we were in the same small group, he could help me out. To my dismay, the time and location he provided me for the study session were both wrong and it was later revealed that he was a gunner.

How to Avoid Becoming a Gunner

If you are a gunner, it’s never too late to turn back. If others perceive you to be a gunner, there are ways to erase that perception. Below are some tips that will help any medical student to avoid becoming a gunner:

1. Don’t brag about your academic achievements, especially about your grades and your Step 1 score.
2. Don’t ask your professor or attending too many questions in one setting. Give others a chance to participate.
3. Don’t answer a question intended for someone else.
4. Don’t pretend that you to never have to study for tests to get good grades.
5. Don’t criticize others for studying.
6. Don’t be a jerk when correcting someone else’s mistake.
7. Don’t undermine your classmates.
8. Don’t be prideful. Be humble in your accomplishments. If you really don’t need to study to ace a test, good for you, but keep it to yourself.
9. Don’t become jealous of someone else’s success. Instead you should celebrate the accomplishments of your peers.
10. Don’t lie. Whether it be about an upcoming test or assignment, or to cover up a poor grade, or it is something you forgot to do on your patient, your lies will catch up with you and you will one day be caught in your deception.
11. Don’t “pimp” your peers (ask them questions that you already know the answer to) in order to look smart, especially if it is in front of your resident or attending. This will never help you gain favor.
12. Don’t take credit for the work of others.
13. Don’t “steal” patient’s and cases from other students.
14. Don’t mislabel someone who works hard and gets good grades for a gunner. A gunner is someone who will step all over you to get ahead.