Maybe some things aren’t intuitive. In traditional medical school there are always learners above you telling you what to do and what not to do. Dr. Smith likes it when the student does this. Dr. Jones hates it when the student does that. There’s nobody above you when you’re the first class to go through a brand new medical school. Of the nine students in my group, some intuitively know to work hard on the wards. Others, um, don’t. I’m shocked and dismayed at getting reports of a student leaving the hospital before the attending! The most s/he would do is NOTIFY the attending that s/he was done for the day. WTF? Student arriving late, leaving early, telling attendings they don’t want to [whatever] in the hospital because s/he has to study for the shelf exam! It’s not just one kid. All one kid cares about is the test. I was complaining to MSA that MSB actually walked out of a surgery! S/he wasn’t scrubbed in, but s/he left to do something else! MSA asked, “is that wrong?” YES! IT’S WRONG! Holy cow, it’s an honor and a privilege to be in the surgical suite. If you’re scrubbed in, you’d better scrub out only if you’re p physically ill. If you’re in the O.R. but not scrubbed in, you’d better have a f*ck*n good reason to leave, and you need to ASK PERMISSION TO BE EXCUSED for that f*ck*n good reason. A student should never say, “I’m done” on the wards. You’re never done. You’re just ready to ask what you can do next.