Kiss up, then kiss up more, and even more if you can pucker up enough. THE KEY is to remember that you are NOT judged clinically on how much you know, how well you communicate with patients or how good your diagnostic skills are (REMEMBER THIS)! But on how much you kiss up, how much scut you can do before anyone else, how many donuts you bring in in the morning, how much you smile and crack jokes, how many useless articles you can look up on a obscure and trivial topic brought up on rounds, how much energy and enthusiasm you have (EX: PLEASE, PLEASE give me another 90 year old septic nursing home patient at 3 AM, with big smile). Dont show off your knowledge either because in some cases this will make the residents feel stupid. You will lose in evals no matter what. Do all your work but not add any comments during morning rounds and you will be labeled as quiet and uninterested, should participate more. Talk to much and people will think you are loud, arrogant, trying to show people up. Things that worked for me: (1) BEST SUGGESTION: Study your butt off for miniboards. If you do well you are assured at least an above average grade. Get some decent evals and you might get an honors (2) Try to stay late. This shows an interest? You would be better off reading at home but thats how life works. (3) Constantly ask if there is anything else you can do to help the team out? Usually entails scut that a 3rd grader could do (4) Just because residents or attendings are nice to you DOES NOT MEAN that you will get a great eval. I think this is a function of their mood on any particular day, their standards, and how bitter they are in deep inside. A lot of times you wonder why you worked so hard to get their average eval (4) Help out on call. Dont go to sleep at 11PM if the resident is being swamped by consults in the ER. Help out! You can actually learn good stuff on call some of the time (foleys, iv lines, blood draws etc) (5) Dont ever talk about anyone. It gets around fast (6) Be a team player and take jokes all the time from more senior members who harass you. Dont have conflicts with anyone. Smile and go on or go to the bathroom and pretend to talk back... (7) In general nurses are bitter, overworked, and would prefer to ignore or be condescending to med students. Ignore this also and be nice. Remember that soon you will be giving them orders ( clean up Mr. Jones in room 754 stat) (8) Work hard! Dont sit around talking to classmates if there is work to be done (9) If you really want honors from evaluators then I suggest that you try to anticipate any problems before they happen and try to come up with solutions. Run the lab specimens over to micro/hematology, make calls to radiology too see if the ct scan has been done yet, arrange the ID consult, attend to Ms. Jones problem before the resident sees her, do a medline search and give them an article on an obscure problem (IN OTHER WORDS BE A GOOD ADMINISTRATIVE SECRETARY) Like I said before none of this involves your patient management skills, knowledge, or communication with patients. All this is coming from someone in the top 15% of her medical school class with top board scores. I just hate to have somebody else go through this blindly. I would love to hear from others. My intention is not to offend, but to give a truthful non-politically correct account of my opinion.