OBJECTIVE: We sought to better define surgical eti-quette and elucidate operating room (OR) personnel expectations of medical students to determine areas for medical education improvement. DESIGN: A questionnaire probing medical student perfor-mance regarding elements of OR etiquette was developed. Questions were designed to obtain structured feedback through Likert scales and open-ended responses. Descrip-tive and thematic analysis was conducted on Likert scale and free-text responses, respectively. SETTING: Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ. Tertiary academic center.PARTICIPANTS: A questionnaire was distributed to nurses, surgical and anesthesia faculty and residents. The survey was distributed via email amongst various hospitals, predominantly our home institution.RESULTS: We received 126 complete responses. About half of respondents (46.3%) self-identified as female. Most respondents were part of the surgical team (74.7%), with most (57.8%) from attending physicians. A majority of respondents agreed that medical students responded well to feedback. Roughly half of respond-ents agreed that medical students understand their role, maintain sterility, and assist in delivery of effective patient care. More than half of respondents did not believe that medical students understand traffic patterns. The majority of respondents indicated that medical stu-dents are not appropriately prepared with basic surgical skills prior to entering the OR. Two-thirds of respond-ents did not feel that medical students contribute towards maintaining safety in the OR. We identified 4 themes from free text responses: students should assume an active role in the OR, utilize situational aware-ness, understand sterility and OR workflow, and have knowledge of basic operative technique and anatomy. CONCLUSIONS: Medical students are not meeting OR personnel expectations and may benefit from early edu-cational interventions to optimize the OR as a learning environment. ( J Surg Ed 81:70-75. (c) 2023 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)