My advisor at Barry told me simply: "be on time...
be interested... and read ahead." That's really all you need to do to have success on clinical rotations.
At the end of the day, it's a job. Nothing more, nothing less. Rule #1 is punctuality; yeah, that usually goes without saying but it's also an instant dealbreaker for people who can't seem to figure it out. Another unwritten - but highly important IMO - rule is to "dress the part." This could be as simple as having a clean, pressed, buttoned white coat over your scrubs and shaving in the morning... or as time consuming as having to iron shirts, slacks, etc if the program has students were business dress. Either way, it's another simple thing that is commonly taken for granted yet can get you "crossed off the list" or marked down quickly if you fail to do it. Yeah, you work long hours. Yeah, you were up late reading... but medicine's a professional service, and you have to meet the standards. No patient in the clinic, ER, hospital, etc wants to see a guy with messed up hair, bad breath, no shave, and a brownish yellow wrinkled white coat telling them "hi, I'll be taking care of you today." Even as a student, and especially as a reaident, you're a reflection and representation of your hospital's pod surg department, so you have to remember that. Every program has that one student who always looked like he had slept in his car or that one who could make people drop dead with her breath on morning rounds. Don't be those people
Generally, you want to be mature in most clinical situations, but have some personality at the same time and be yourself - don't supress it (or you risk ending up "fitting in" and matching where you truly do not gel with the residents/attendings and may be miserable for 3yrs). As PADPM said, you don't want to change your personality, so just treat it like you would any serious job.
If you rotate high level programs, you have to realize how much the attendings and residents know. You will generally learn by watching a lot, listening much more than talking, and eagerly helping out when asked (offer to help where appropriate... casting, bandaging, post op notes, etc). Stand in the room and listen to attendings talk to clinic pts, grab a front seat at rad rounds, offer to tag along with the intern as they go to see an ER consult, etc... be interested (or at least fake it). DO NOT "disappear" or zone out... yeah, we've all been students and gottn bored sometimes, but don't disapear to the library while the director is in clinic, pass on surgery cases since you will be 3rd assist, walk around sending text messages instead of paying attention during hospital rounds, etc.
Ask questions where appropriate, but don't ask stuff you can easily look up yourself and never come anywhere near "pimping" up the chain by asking residents/attendings questions in front of patients or their senior clinicians. I'm not saying you should be "seen and not heard," but you have to pick your spots. During times that need focus (difficult ER consult, pre-op H&P when the patient is stressed, putting in the fixation in the OR, etc), you have to realize that you are welcome to observe and learn but the attending/resident needs to focus on the task at hand. The best time to ask questions about patients or surgeries you've seen is usually when you have a 1-on-1 situation with the residents outside of direct patient care.
As a student, you (should) read a lot and are eager to apply what you read, but just tread a bit carefully. Every program/attending has their own procedure/treatment/etc preferences (which they naturally think is the best way to do things), and they really do not care what you read about or how program X that you visited last month does it. Most of all, I'd strongly avoid talking to patients about any surgery, major treatment decision, etc. They are not your patients, you aren't the attending, and you aren't the residents who work with the attending every day for months and years. You're a rotator doing s short stint at the hospital, and you definitely don't want to contradict something the attending or residents will tell the patient later, so
"that's a good question, but let's ask Dr. X" is your best answer for most patients - esp regarding any question pertaining to surgery/treatments. It sounds like you are meant to be nothing but a wallflower, but
you will have your times to show what you know (rad rounds, pimping in OR or on rounds, etc). Directors, chief residents, etc can quickly acertain which students are high quality. If you're smart, they have seen your paper application. If your paper app is avg, then show up early, offer to help frequently, and show you're a very hard worker. Either way, less is more in many situations. Again, your time will come. Basically, it's better to have them wonder why you don't talk than wonder why you do.
...The over-the-top student sucking up, asking questions you know the answer to in order to (attempt to) show off or impress the attending, subtle self promotion, etc is pretty transparent...
-"Is that intra-articular calc fracture going to need surgery? A plate reduction maybe?" (no ___, Sherlock!)
-"Graftjacket is acellular human cadaver tissue, isn't it?" (a good student reads, but doesn't have to blatently show off that he reads)
-"Would the other surgical options be a cheilectomy or implant if you didn't want to fuse this joint?" (thanks, Mr. 4th year student, for stating to residents and attendings what every 3rd year student should know)
...That type of rhetorical question stuff gets old very fast, and while I often give them the benefit of the doubt by assuming they don't know it's annoying, I sometimes do give the students a blank look of disgust or flat out tell them "quit asking questions you know the answer to"... or I just follow up with a very hard question to humble them a bit.
One of my favorite attendings who I met on my first clerkship greeted me with a roll of the eyes and "I think that's pretty obvious" after I had asked "is that purulence tracking up the extensor tendon sheath" at an inpatient's bedside. When students do that stuff (and again, I learned the hard way for a bit), it's fairly easy to see they are trying to showboat. It's basically like the d-bags who do charity work or donations but then brag about it; there's no need, and it will make you look very stuck up and insincere in the long run. There's nothing wrong with being a bit of a gunner (showing up early, offering to stay late, being polite, bringing snacks for the clinic one day if you appreciate the teaching you're getting on the rotation, etc). That is part of the game, but you are light years better also just staying fairly quiet, being confident in your abilities and comfortable waiting for your appropriate windows to show your solid smarts, demonstrating strong interest in the patients/cases, and displaying basic good work ethic. Don't worry about the students who are counting on their "charm" and rhetorical/canned "questions" to get them a good match... most residency directors, key attendings, and even residents have seen that act a couple times before
