How to not be a "gunner"?

[seminoma]

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Up until this block I haven't been on a service with another M3, which is why I'm asking this question so far into the year (i.e. it wasn't an issue before).

Basically I do (or try to) everything that good M3s are supposed to do, unfortunately I think a lot of people interpret this as being a jerk gunner. I show up early, take new patients, read overnight progress notes, preround, formulate my own plans, push myself to carry as many patients as I can, etc. The student I'm currently paired with shows up on time or a few minutes late, doesn't do anything other than what the resident/attending tells her to do, etc.

So, while I don't want to make my classmate look bad for her sake, I also don't want to come across as trying to make her look bad because that would obviously reflect poorly on me.

Suggestions? Specific example being that I had 3 patients today and my classmate had 0. When a new patient popped up on the list our attending looked at us and said "who wants to take this one?" Obviously it's my classmates "turn", but they didn't say anything.. they just looked away and tried not to make eye contact. I didn't want to seem like I was avoiding work so I volunteered after a few seconds of awkward silence. But then later in the day my resident pulled me aside and told me I shouldn't be so eager because it's making my classmate miss out and that I'm not being a team player...

 

[Psai]

Just do what you're doing. Some people do a lot, some people do the bare minimum. Don't let other people drag you down or change your ways. The thing that irritated me the most about other m3s was when the attending would ask questions and the other students would practically jump up to answer it. Bro if you don't know the answer, then stfu and let me answer it. Don't just shout out whatever crap is living in your head. Don't round on other people's patients. Don't steal patients or procedures. Don't be condescending or try to make someone look bad when they're presenting. Don't interrupt and be a jerk. Don't volunteer to do things for the other students' patients like call consults. That's what I can think for now. You seem to be a cool guy so I wouldn't worry about it too much

 

[Mad Jack]

You're doing fine. You do you. Don't worry about what other people think and just be the best student you can.

 

[stepone2015]

Just an addition to the above, one thing I learned early on working with other M3's is do not answer every question posed to students just because you know the answer. If I get one right, I'll hesitate answering the next question to let the other M3(s) get a chance. If you jump to answer everything, even if you're right, you will look like a jackass to seniors and be hated by your peers.

There's a student from another school I rotated with who loved doing that ****. Also, when a student would ask the attending a question, this derp would jump in to answer for the attending. Doesn't matter if you have a 280 on all Steps, if everyone hates you, you don't match well.

 

[madchemist89]

I show up early, take new patients, read overnight progress notes, preround, formulate my own plans, push myself to carry as many patients as I can, etc.

At my school, you fail if you don't do these things. You have no need to worry about looking like an overachiever here. These things are required to even begin to care for patients.

 

[byaaaaaaah23]

Somewhat related: what about bringing in presentations to rounds without being asked? Are you guys doing this? An MS4 has done this a few times but I'm hesitating to do so because our new attending seems like he would get annoyed by extra stuff like that. I don't want the residents who have been here the whole time to think I'm lazy or uninterested though. Seems like it would be different if they were asking us to do stuff like that but I can't tell/third year has made me super paranoid about everything.

 

[Psai]

Somewhat related: what about bringing in presentations to rounds without being asked? Are you guys doing this? An MS4 has done this a few times but I'm hesitating to do so because our new attending seems like he would get annoyed by extra stuff like that. I don't want the residents who have been here the whole time to think I'm lazy or uninterested though. Seems like it would be different if they were asking us to do stuff like that but I can't tell/third year has made me super paranoid about everything.

Wtf? Tell that try hard to knock it off

 

[stepone2015]

Somewhat related: what about bringing in presentations to rounds without being asked? Are you guys doing this? An MS4 has done this a few times but I'm hesitating to do so because our new attending seems like he would get annoyed by extra stuff like that. I don't want the residents who have been here the whole time to think I'm lazy or uninterested though. Seems like it would be different if they were asking us to do stuff like that but I can't tell/third year has made me super paranoid about everything.

That's a classic gunner move.

 

[22031 Alum]

That's a classic gunner move.

I wouldn't be so quick to say that about the MS4 on service. He/she is on the rotation for a different purpose and may have been given different expectations than the third years. MS3's don't get directly compared to MS4's anyway.

 

[seminoma]

Thanks all!

 

[Mr. Mojo Risin]

@seminoma, if you're worried about it I would try talking with the other student. Otherwise, you're doing all the right things. I don't know how close you are with her, if at all, but maybe some icebreaker conversation could go a long way to make sure you guys are on the same page. Something to the effect of "so how do you want to divvy up new patients?" could be all that is needed to get her to realize what she's doing and make sure you don't look like a jerk next time. Kill two birds with one stone. I wouldn't necessarily go straight to saying "I have X patients currently, why don't you take this one?" in front of your attending and/or residents. S/he is most likely aware of the other student's behavior, so just try to not overdo it in front of them.

Anyways, I hope this helps. I haven't had this problem with other classmates or students yet, but it's certainly a possibility given the number of personalities that we are exposed to working in this environment. After all, learning how to communicate and work with different personalities is a big part of medical training, especially at our stage of training. Cheers, man.

 

[madchemist89]

You should talk to the m4 and ask for guidance. A good m4 will help you navigate your hospital culture and give you helpful tips.

 

[byaaaaaaah23]

You should talk to the m4 and ask for guidance. A good m4 will help you navigate your hospital culture and give you helpful tips.

Yeah good idea. I think the problem is just that my team is kind of hard to read.

 

[Gambler 101]

I just try to be honest with my fellow classmates. If I'm showing up early, I'll let them know what time I'm going to be there (they can show up whenever they want). I've implemented a turn system for taking new patients and consults. We will tell each other if something cool comes up on imaging and teach each other. If someone has a particular interest in say Neuro or cardio, they get the patient. Writing notes, calling consults, etc on someone else's patients is totally unacceptable. If my classmate asks for my help, I'll help. If an attending asks a question, we take turns answering. I don't think you're doing anything explicitly wrong, but you should try to put a system in place. It helps your classmates, makes you guys look professional, and avoids conflict.

 

[Mr. Mojo Risin]

I just try to be honest with my fellow classmates. If I'm showing up early, I'll let them know what time I'm going to be there (they can show up whenever they want). I've implemented a turn system for taking new patients and consults. We will tell each other if something cool comes up on imaging and teach each other. If someone has a particular interest in say Neuro or cardio, they get the patient. Writing notes, calling consults, etc on someone else's patients is totally unacceptable. If my classmate asks for my help, I'll help. If an attending asks a question, we take turns answering. I don't think you're doing anything explicitly wrong, but you should try to put a system in place. It helps your classmates, makes you guys look professional, and avoids conflict.

I've also found this approach to be favorable on my inpatient rotations thus far. It was particularly useful on peds because we all had our fair share of asthma, bronchiolitis, etc. but there was also plenty of random pathology that meshed well with our interests. We all learned from each other. Taking turns answering questions hasn't always been feasible depending on the attending and their style of teaching.