Very little. In some instances, there is no difference between a gunner and an asshole. It really depends on the gunner.
A word of advice to all you "gunners" out there: Most of us hate you. No offense, I'm sure you're a nice person deep down. But no one wants to sit there while the same asshole every day in lecture raises his hand and asks some mundane question just to prove they were listening. And no one likes the person who is constantly shouting out the answers to prove that he knows them before anyone else has a chance to even think through the question. We get it, you're smart. Congratulations. And in third year, no one likes the person that is constantly bringing up their patient for examples to prove that they have patients, or asking a million questions, or bringing in articles every single day.
So how, you might ask, can you shine without being considered an asshole?
I'm not telling people to just give up and not try, or not try to look good or make a good impression, or prove your worth or be an excellent doctor/student. But people can tell when you are genuinely interested and when you really just want to show yourself off.
Here are some examples of asshole moves:
Anytime you ask a question starting by saying "when you say blah blah blah do you really mean blah blah blah" and then running off on some tangential aspect of whatever topic was being discussed. No one likes that. Also, ask your question loud enough for everyone to hear will you? And if class has already gone over ten minutes, and you have a question, just go up and ask the lecturer before they leave will you? Don't make us all sit through the answer. If we have the same question, we'll ask the lecturer ourselves, thanks.
It's all well and good to know the answers to questions, and of course in small groups we all want to show that we know the answer. And sometimes, you're like me and you only know the answer once every blue moon and by golly you are going to scream out that answer because damn it you finally know something! That's cool. Filling awkward silences while the facilitator tries to get someone to answer the question, also cool. But sitting in the back (or up front or to the side or wherever) and shouting out every answer "Sarcoidosis!" "Cirrhosis!" "Gentamycin!" before anyone else can get a chance is a douchebag move. Stop. Stop now.
Bringing in an article about something you learned while on a rotation is a good way to show you are interested. But bringing in articles every single day even on topics someone else was supposed to look up to show that you know more than them, that's not cool.
So here is what it really breaks down to. Yes, we all want to shine. Some of us are genuinely interested. Some of us know the answers to everything. But before you do something, think to yourself: How does this make the other students around me look? Am I doing this so that I look good or so that everyone around me looks bad? If you're brown nosing to the point where you know you're actually making everyone else around you, who are also working hard, look like complete idiots just so that you'll look better, you're an asshole. If you're on a team with another student on rotations, yes you want to show that you are dedicated and yes you want that honors, but you don't need to come in on your day off to "help" or stay late even though your resident told you to leave. You don't need to bring in articles for the other student on your team about something they had questions on and show it to them in front of the attending.
It's all about motive here people. Most people can tell when someone is full of shit. You don't need to try and impress everyone. You should just be able to impress people by being yourself. So look at your motive before doing something, gunners. Are you asking that question because you really want to know the answer, and think it will benefit everyone else to hear it, or do you just want to show people you are smart enough to have questions? Did you really need to show up on your day off to check on that one patient because you really honestly were worried about them, or did you want your resident to see that you were there so they think "wow, look how dedicated that medical student is?" Are your fellow classmates rolling their eyes when you answer yet another question that is asked? That's usually a good sign that you have crossed the line into douche-dom, and that people are talking crap about you instead, which means you've failed in your mission to shine.
It's a fine line to balance, between showing your amazing and having your lips permanently sewn to someone's ass. We all find ourselves at one time or another shamelessly showing off our knowledge. But the honest truth is, if you are genuinely and honestly interested in what you are doing, working hard, and being your best, people are going to notice that. You don't have to shove it in their faces.
Remember, we're all in this to help people, not make everyone completely crazy. And also remember that the people you are in medical school with are going to be your collegues one day, and if they hate you, they're not going to refer patients to you, or ask you to consult with them, or ask you to do some kind of awesome research with them. If they can't stand you now, they won't like you later.
I remember first year hating this one gunner in my class so much, and I already hated medical school as it was, and I didn't feel like I was in control of anything, and I didn't have anyone to talk to about my hatred of medical school. So instead I found other people who also hated this kid, and we became friends just because we all would sit and talk shit about what a douchebag overacheiving brown nosing full of shit guy he was. There was not a single thing to like about him, he was constantly trying to make other people feel inferior so that he could have some kind of edge over everyone else. And one day, he's going to be an amazing doctor. But you know what? So am I. And I won't have had to show off and put other people down to get there. And my classmates are going to want to work with me in the future. Well, probably not all of them. I'm sure some of them hate me too, it's how it happens, and is fairly inevitable I would say. But still, no one sneers at me as they call me a gunner. And yes, I failed the boards so maybe I'm not someone to talk. But I've also had residents tell me that I'm working at an intern level already. So put that in your back pocket and sit on it.
Seriously, don't be an asshole...
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