Same here, for what it's worth. I see this kind of thing regularly, and the message it sends is similar to the guy wearing a black sack suit 3 sizes too big - "this is my first time dressing like a big boy and I have no idea what I'm doing."
The difference is that by this point (medical school/residency), most guys have had to don a tie for many occasions, likely since adolescence. They've probably had over a decade to learn how to tie a reasonably nice knot, and still couldn't be bothered to figure it out yet.