It's amazingly easy to have your work environment spiral completely out of control as a med student. I mean that in the worst way possible. That, "I dread going to work every day, every one is out to get me (or, as we love to say in the medical world, "everyone is malignant", which means everyone has the potential to metastasize to other organs in your body. Because that's what malignant means. It doesn't really apply to human beings. It's a stupid analogy, but makes us sound smart. What was I talking about? I was in the middle of some quotations, so I'll just end them now and see how we do.)"
Medicine is unbelievably hierarchical (I spelled that write the first try, eat that Mrs. Farmer!), extremely territorial, and mind-blowingly adversarial. It is a place like no fucking other. So take all of the normal problems with coworkers, bosses, work assignments, and deadlines, then throw an awkwardly useless human into the mix, that has to get certain things accomplished, while unquesioningly slowing the whole system down, and you can see why problems start. Problems with residents. Problems with other med students. Problems with attendings. Problems with nurses. Problems with inanimate, but decidedly territorial objects. The list goes on.
One awkward misunderstanding and you have just tapped into a world of hurt. You won't say anything because you are being evaluated, and getting into it with a nurse who works there every single day with the doctors evaluating you; someone who has worked there since before you even came up with the idea for your shitty, overindulgent college personal statement, is a bad, bad, bad idea. So you won't say a thing. Or you will and dig yourself a further hole.
I have seen this. I have seen people have to essentially get entire chunks of their evaluations thrown out, and have to be moved to a different work site because of problems with staff. The only reason these students even get that kind of resolution is because it's 2010 and in the last few years it occurred to med school administrations that it isn't ok to abuse the shit out of medical students. Medical students who happen to be adults. Responsible, voting, recycling adults.