Noticing a bit of "gunning" during pre-rotation experiences. Is this what I'm supposed to be like during 3rd year?

[CuriousMDStudent]

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So at my school, we have a class called "pre-rotation experiences" which are experiences where you get to interview a patient and practice H&P and presentation skills. We do this during our first 2 years just so we get some experience on what this is like before we go into our 3rd and 4th years. There are no tests and it's just a P/F class.

I've noticed a bit of "gunning" during these experiences. I don't even know how to describe it. I try to be a team player/nice but when our attending comes to assign us patients the other people in my group call dibs on patients, jump at opportunities to present first, and etc. I always end up taking the last patient or last opportunity to present.

The attending doesn't seem to care or be annoyed by this and I'm beginning to wonder if I am supposed to be a bit more like this during my third year rotations. Is this a way of showing initiative? What if me going last all the time shows that I'm not trying hard enough? I don't know if I'm overthinking this. I'm just so curious on why the other students (5) in this class are constantly calling dibs on patients or competing to present first. The class isn't even graded, what the heck? I just go. Learn what I can and leave.

 

[operaman]

Always a difficult balance between being interested and engaged and being annoyingly over the top.

I don’t see volunteering to present first or taking interest in a particular patient to be gunning per se. The alternative where nobody speaks up or picks up a new patient seems much worse in my view.

In the end there’s less competition around this kind of thing simply due to the logistics of a clinical service. Students typically follow X number of patients and once one of yours is discharged then you’re up for the next admission. Also, if one of yours becomes a dispo rock with no active issues, it’s not unreasonable to ask if you can pick up an additional patient; most residents and attendings will probably have you stop following someone once the learning part is done. But you may have to speak up for yourself at times.

You do need to show initiative and remaining quiet so as not to offend your fellow students’ sensibilities will probably reflect negatively on you. Not a bad idea to practice that now before the grades actually matter.

 

[CuriousMDStudent]

Always a difficult balance between being interested and engaged and being annoyingly over the top.

I don’t see volunteering to present first or taking interest in a particular patient to be gunning per se. The alternative where nobody speaks up or picks up a new patient seems much worse in my view.

In the end there’s less competition around this kind of thing simply due to the logistics of a clinical service. Students typically follow X number of patients and once one of yours is discharged then you’re up for the next admission. Also, if one of yours becomes a dispo rock with no active issues, it’s not unreasonable to ask if you can pick up an additional patient; most residents and attendings will probably have you stop following someone once the learning part is done. But you may have to speak up for yourself at times.

You do need to show initiative and remaining quiet so as not to offend your fellow students’ sensibilities will probably reflect negatively on you. Not a bad idea to practice that now before the grades actually matter.

Okay this is why I made the post. I'll try to show more initiative. I was essentially always quiet to be polite. Thanks @operaman!

 

[5yewy5r]

It can be like this if there are too many med students (>3), especially in pre-clinical when people can be a bit clueless. In my experience, it usually gets better during rotations where your team will have 2-3 med students max. In that case, overt "gunner" behavior generally comes off as a pretty bad look to the residents.

You impress on rotations by being polite, friendly, and proactive when it comes to your learning. Proactive can mean different things based on rotation and resident expectations, but it generally entails looking up topics related to your patients on your own and keeping it in the back of your mind for when it is appropriate, or trying to familiarize yourself with specific skills via observation or asking to participate (within reason). Stepping on other med students' toes in an effort to stand out is usually pretty obvious and cringy to anyone who is watching.

That said, all of this goes out the window if your upper-level resident/attending are unreasonable and burnt out. There are some truly unfathomable people out there based on the stories I have heard... but I've had the good fortune of generally running into normal human beings during my rotations.

 

[Melchizedek]

So at my school, we have a class called "pre-rotation experiences" which are experiences where you get to interview a patient and practice H&P and presentation skills. We do this during our first 2 years just so we get some experience on what this is like before we go into our 3rd and 4th years. There are no tests and it's just a P/F class.

I've noticed a bit of "gunning" during these experiences. I don't even know how to describe it. I try to be a team player/nice but when our attending comes to assign us patients the other people in my group call dibs on patients, jump at opportunities to present first, and etc. I always end up taking the last patient or last opportunity to present.

The attending doesn't seem to care or be annoyed by this and I'm beginning to wonder if I am supposed to be a bit more like this during my third year rotations. Is this a way of showing initiative? What if me going last all the time shows that I'm not trying hard enough? I don't know if I'm overthinking this. I'm just so curious on why the other students (5) in this class are constantly calling dibs on patients or competing to present first. The class isn't even graded, what the heck? I just go. Learn what I can and leave.

The word "gunner" has been completely twisted in its recent years from its original meaning.

Are they purposely feeding you wrong information?
Are they actively telling you the wrong time/place to be?
Are they cutting into your presentations to add their own thoughts?
Are they putting you down in front of your evaluators?
Are they hoarding study material/ripping out pages from your textbook?

If they're not actively going out of their way to be a detriment to you and your learning, then they're not gunners. They're med students eager to get a taste of the job, especially if this is your pre-clinical years. You're paying tuition to learn so you should be active in getting your money's worth. If that means that people call dibs on cases they think are interesting or they haven't seen yet, that's proactive learning. If they're constantly taking cardio/orth/whatever cases and not giving anyone else a chance, then thats a little annoying but still not quite gunner level.

Attendings/residents notice gunners and will actively call them out if they're being a pain. I've seen it happen. One of my attendings made it a point to specifically comment on how my clerkship partner and I worked as a team and exact quote "You guys aren't gunners or anything which is great", which showed me that he was making an effort to pay attention to that. I can only imagine a few scenarios where an attending isn't paying attention/doesn't care and misses the attitude, but there should be residents/interns that are less jaded and more vigilant. If there's NOBODY policing that kind of behavior then that is a problem you should discuss with the coordinator of that course/clerkship because someone has to say something to the true gunners.