OBJECTIVE: We sought to better define surgical etiquette and elucidate operating room (OR) personnel expectations of medical students to determine areas for medical education improvement. DESIGN: A questionnaire probing medical student performance regarding elements of OR etiquette was developed. Questions were designed to obtain structured feedback through Likert scales and open-ended responses. Descriptive 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 respondents 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 students are not appropriately prepared with basic surgical skills prior to entering the OR. Two-thirds of respondents 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 awareness, 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 educational interventions to optimize the OR as a learning environment.