Avoiding conflict is generally a good thing, but that doesn’t mean avoidance is the best way to approach problems. You have to learn to stand up for yourself, to be assertive; I don’t think anything really taught me this quite like dealing with medical school Gunners.
Now let’s be clear: If you are in medical school at all, you are on the Gunner Spectrum. When I refer to Gunners in this context, I am referring to the person who always has to blurt out the answer, even if the question is directed at someone else. This person may consciously or unconsciously undermine you in front of an attending by correcting something you say about YOUR patient. This person may slip in to scrub in on YOUR surgery. This person is just overall very aggressive, can be condescending, and has no concept of the word “teamwork.”
There are a few different ways to respond to a Gunner, some much better than others. I would say the absolute worst way to deal with this person is to shrink back and let them take all your glory without a “fight.” After all, this is your education, too, and your opportunity to shine, learn and grow. In a close second to this reaction, however, is the “fight fire with fire” approach: you become a Gunner and engage in this fire fight, so to speak. Do this, and someone’s going to get hurt. All puns intended.
Why shouldn’t you shoot back?
It may give you some relief to know that the aggressive tendencies of Gunners is noticed by the entire team: students, residents, and even attendings. Nine times out of 10, this is seen as very unappealing and will not give this student any kind of advantage—especially if he or she is planning on interviewing at this program. Current residents won’t fight to have someone like this on their team when they are discussing potential candidates in rank meetings. So if you turn into that Gunner, you will be seen as the Gunner… you may even make the Gunner look better!
That said, pacifism isn’t always the best thing to do in this situation either. After all, you are literally paying money to be there and to learn, and you should be granted all of the same opportunities as other students. One of the biggest ways to learn in the hospital is to get involved in the patient care and on rounds. By being directly involved you will remember that case and learn exponentially more than if you are passively paying attention on rounds, for example. So basically, you can’t engage in petty "pissing contests," but you also shouldn’t just "take it."
So how do you deal with a Gunner?
Even though we all see Gunners as an unfortunate side of being in such a competitive field, I actually have learned over the years that it is the Gunners who have pushed me the hardest to be the best I can be. And that is exactly what I urge you to do. Instead of shrinking into the Gunner’s shadow, or even worse, throwing your OWN shade, simply step it up. Get to the hospital early, study at night, be prepared to discuss anything about your patient’s past medical history or current condition, have all the necessary things in your pocket for rounds, and most importantly, help your resident!
Believe it or not, it is possible to do all of these things without being a gunner. I know this to be true because I did all of my core rotations with one of the most compassionate, hard working, smart students at my school. He was always prepared, he paid attention to the details, and he did it with empathy and a fair amount of panache. He never stole anyone’s thunder, he always gave credit where credit was due, and he would alert you before rounds if he noticed something about your patient that you may have missed (instead of undermining you during rounds). He did all of this quietly, respectfully and without being what I consider to be a Gunner. So you can do that too.
What if a Gunner undermines me during rounds?
Don’t engage them during rounds. Simply say, “Nice catch, thank you,” and later on if you feel inclined, you can approach them about how what they did "wasn’t cool." Getting all flustered while it’s happening only makes you look less put together.
What if a Gunner steals my patient/surgery?
Don’t you dare just "let it go"—this is your learning opportunity. If they are already in it (already presenting, already scrubbed in), it will be really challenging to speak up in that moment, and it could interrupt the flow of the team and make YOU look bad. In that scenario, wait until after rounds/the procedure and stand up for yourself. Tell them that if in the future they want to take a patient because they are interested in this specific condition, please talk to you first. As much as you like getting off the hook sometimes, most of the time you are also hoping to have a rich learning experience, too.
What if these things keep happening despite all “Gunner Control” interventions?
Basically you have two choices: You can either let it go (which I don’t recommend unless it is at the end of a rotation), or approach the chief resident, or the senior on the team and ask them for advice. You don’t have to “tattle” to get your point across. You can say, “I am not sure how these miscommunications have been happening, but I feel like I haven’t had the opportunity to demonstrate my knowledge or present patients recently because for some reason, other students end up presenting them.” They will get the picture, for sure. Chances are, they have already noticed this, but they are too busy to care about petty disagreements between medical students. But if you bring it up and frame it as you losing learning opportunities, they will be on your side and make sure to give you opportunities to do the things you want to do. Be careful not to speak negatively about other team members; it just makes you look like a brat/tattle tale.
Everyone hates a Gunner, and it would be super easy to simply just complain about this person to your friends without actually confronting him/her. It also is really easy in the moment to become defensive and “fire back” at the Gunner; after all, the hospital can be like the Wild West! But neither of these are the right thing to do. Stand up for yourself in the face of a Gunner, and take the opportunity to step up your game and become an awesome and simultaneously positive medical student. Do this, and you will feel great, look great, and win the showdown!