This article provides practical tips for medical students to navigate theatre etiquette, engage with teams and gain valuable surgical experience.
I am the kind of person who needs a set of alarms ringing every two minutes just to get out of bed. This meant that when I scrubbed into my first surgery – with my phone alarms all accidentally set two hours late – they went off one after another for 15 minutes straight, right in the middle of the procedure. This did little to help my orthopaedic surgeon navigate his complex hip revision, and was a moment I’ll never forget.
Medical students in theatres: a forever meme
Medical students in theatres are the subject of many medical memes. The experience is universal: anyone not used to theatre etiquette can easily break the sterile field and undo lots of careful hard work – and medical students are often the most junior person in the room. Consequently, students are told to not touch anything. Many end up standing in the corner of the room and, in doing so, miss precious learning opportunities to safely assimilate into teams and learn from the unique experiences theatres offer.
The truth is, everyone has been in the same shoes and still makes simple mistakes. If this weren’t the case, we wouldn’t be drawing arrows marking the correct surgical site, checking patients’ wristbands or repeatedly counting surgical swabs in teams of two. Not knowing how to navigate a foreign environment is not an indication to remain uninvolved, but rather an indication to learn how to get involved safely. After all, it’s better to learn as a student, rather than as a doctor when the job is needing done.
So, what can medical students do to grow from a wallflower into a valued, active member of the team? Actor Tom Hanks once said that a good rule he uses is to “show up on time, know the text, and have an idea” (www.youtube.com/watch?v=gV_PSbMzSeM). While medical students are (arguably) not actors, this ‘Hanks Triad’ offers a simple and practical framework for making the most of theatre rotations.
Show up on time
“Being able to show up on time means coming in early.”
As evidenced from my opening statement, not everyone is an early bird, but coming in early offers important advantages. It gives you plenty of time to get changed, and to be in the right place at the right time for the surgical brief. Introducing yourself at the brief gives you a voice, and also means people see and know who you are. This also means that keen teachers will be sure to involve you and, just by showing up, you open doors for yourself!
Punctuality reflects professionalism. Demonstrating a respect for people’s time is a simple way to make a positive first impression. Being present during the downtime before the case also gives you an opportunity to build rapport with the surgical team. All this helps inspire confidence in you to get you involved – enabling you to build your surgical e-logbook early (www.elogbook.org/).
Know the text
“Have an idea of what is going on and what everyone’s goals are – even if it is just to help a buddy move.”
Start by understanding the indication and goals of the procedure. A foundational idea about what is going on allows you to ask meaningful questions and to engage in discussion. People are more inclined to teach if you show initiative.
Some great resources to do this include:
- Passmed (https://passmedicine.com) – to find out and consolidate high yield concepts.
- OpenEvidence (www.openevidence.com) – a fast and effective way of filling in knowledge gaps with good prompting.
- Zero to Finals (https://zerotofinals.com) – free, excellent resource for your foundational framework.
Please note: some content on this site may be outdated or inaccurate. It is recommended only as a general overview or learning aid, and should not be cited in formal reports or clinical documentation.
Honourable mentions include:
- TeachMeSurgery (https://teachmesurgery.com) – for detailed revision to build on the basics.
- ENTSHO.com (https://entsho.com) – to make sense of ENT-related clinical decision making.
Now, to “help a buddy move”, you first need to know who the buddies are. Be sure to proactively introduce yourself, learn everyone’s names and understand what their roles are. It takes an entire team to keep patients safe and the theatre clean.
Lastly, having an idea of what is going on requires some situational awareness. This includes recognising that especially complex parts of the procedure may not be the best time to ask questions, since they require greater focus on the patient and the surgery. Being able to read the room in this way is something people especially value, and it will help you warm up to the team and understand the flow of the theatre.
Have an idea
“Have an idea on how to move things a little farther down the line.”
Having an idea means learning how to safely add value to any team you join by being aware and proactively helpful. Medical students don’t have fixed roles, and this can make people feel out of place. On the contrary, I would argue that this flexibility is your greatest strength. Having the competencies to move between surgery, anaesthetics, theatre support and circulating roles is not something many people have, and offers the chance of a comprehensive, holistic understanding of both operative and perioperative care.
With the surgical team: demonstrate you are trainable.
When you are taught something – such as cutting with the scissors tip, ‘bridging’ to steady your hand – apply it right away. Keen teachers really appreciate keen students. If they see you can learn, they will want to keep teaching you. Having solid fundamental surgical skills as a medical student is very noticeable, and will invite further involvement and opportunities to learn more advanced techniques.
Outside the surgical field: look for small, safe ways to help.
Start by helping with tasks at the end of cases, where there is less opportunity for error – such as wiping down the banana board or clearing equipment. Demonstrating intent to be intuitively helpful is something people really appreciate, and is how you can quickly assimilate into teams.
Closing
So now you have a bulletproof guide to get everything right… right? Unfortunately, it is in the nature of medicine that everyone will get things wrong from time to time. What truly matters is the ability to be receptive to feedback, acknowledge mistakes unashamedly and grow from them. Equally important is resilience and a willingness to contribute – qualities that matter far more than your orthopaedic surgeon knowing the K-pop song you use as your ringtone.
You don’t stop learning in medicine, which is why the word ‘doctor’ comes from docere – ‘to teach’ [1]. Operating theatres have historically been spaces for watching and learning [2,3]. So, medical students should never feel that they do not belong in theatres. Take charge of your own learning, get involved, and most importantly, double-check you’ve set your alarms for the right time!
References
1. Merriam-Webster. The History of ‘Doctor’.
https://www.merriam-webster.com/
wordplay/the-history-of-doctor
2. University of Dundee Museum Services. Operating Theatre Design.
https://app.dundee.ac.uk/museum/exhibitions/
medical/operation/operation7/index.html
3. ILS Hospitals. Why an operation theatre is called so.
https://ilshospitals.com/blog/why-an
-operation-theater-is-called-so/
[Links last accessed December 2025]
Declaration of competing interest: None declared.
